Question

Using the pathophysiology text. Complete the questions below, providing references to the location of the answers. Jessica Peyton, age 4 years, began wetting her bed again after being dry at night for the past 3 months. She cried when she urinated and was crabby and lethargic. Jessica's mother had seen these signs before and recognized them as manifestations of yet another urinary tract infection (UTI). She took Jessica to a pediatric nurse practitioner who had just opened an office nearby. After taking a thorough health history, the nurse practitioner obtained a urine sample, diagnosed cystitis, and prescribed an antibiotic. She also referred Jessica to a urologist, who discovered that Jessica has vesicoureteral reflux (VUR). instructions: Answer the questions about Jessica in the case example activity below. 1. What findings in the urine sample would be characteristic of cystitis? 2. Why would a UTI cause Jessica to develop nocturnal enuresis? 3. Why did the nurse practitioner suspect that Jessica had VUR? 4. Explain what VUR is. 5. Why does VUR predispose to UTI?

Answer 1

1.The following findings in urine would he characteristics of cystitis

• Presence of bacteria
• Presence of pus
• Presence of nitrate or leukcoesterace or WBC or leukocytes

2.The child who is 4 years will have bladder control but not complete control .They achieve this by age 5 to 6 years.More over a UTI can irritate the bladder function altering it expand causing nocturnal enuresis in the child .Here as the child is having cystitis there over action or over contraction of the derisory muscle in the bladder causing frequent urination all time and if it is for a child in night time can lead to night time enuresis

3.The main reason for suspecting is the child has already had a UTI and this is the consecutive time or for the second time .Usually it can happen before diagnosing for UTI.The child showed symptoms of second infection, bed wetting ,irritable,cried while urinating .

4.VUR (Vesicoureteral reflex) in simple refers to the backflow of the urine (from bladder to ureter and then to kidney)