Case Two:

While conducting a sports physical for camp on a 9 year old boy, you discover he wets the bed at least 3 times a week.

1-What information will you need to determine the cause of his enuresis and what is the best treatment for this child?
2-You conclude that he has an organic cause for his enuresis.What might be an appropriate treatment for UTI?
3-What other organic problems can cause enuresis?
4-What treatments might be available for these other causes?
5-If you conclude that he does NOT have an organic disease causing his enuresis what treatment POC will you develop with the child and family to help him?

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Case Three:

You are seeing a 15 year old adolescent that is trying out for the varsity football team at his school. His dad played football in high school and this boy is very excited about the possibility of getting on the team.

1-What information do you need to know about this boy?
2-His family?
3-What physical assessment techniques should be done during a sports physical to screen for hypertrophic cardiomyopathy?
4-What about other heart conditions that may be present but not exhibited in his daily life up to this point?
Burns, C. E., Dunn, A. M., Brady, M. A., Blosser, C. G., Starr, N. B., & Garzon, D. L. (2017). Pediatric Primary Care (6th ed.). Philadelphia, PA: Saunders.


Health Case Studies

Case Two

            The information required to determine the cause of enuresis would require clinical test as well as observation of child’s wetting behaviors. Therefore, a physical examination would be conducted to assess the health of the child, especially on the spine, anal and genital areas (Von Gontard & Kuwertz-Bröking, 2019). Also, the ultrasound would be applied to check on the urinary tract, kidney, rectal diameter and the thickening of wall bladder. Also, information on urine status would be collected using a dip-stick.

UTI should be treated by the use of antibiotics and drinking a lot of water to flush the bacteria from the body (Burns et al. 2017). Also, if a child shows signs of organic problems, should be treated using pharmacotherapy with desmopressin. The child takes an antidiuretic hormone in the form of tablets for four weeks (Burns et al. 2017).

Other organic causes of enuresis include maturation of normal bladder functions and the possibility of comorbidities (Von Gontard & Kuwertz-Bröking, 2019). At this instance, alarm therapy should be added to desmopressin. In most cases, alarm therapy shows better results.     However, if there is an absence of organic causes and intensive counseling and on the urination and drinking habits of the child (Burns et al. 2017). At clinical point care, I would advise the parents to encourage the child to increase the voiding frequency and recording the frequency of urination (Von Gontard & Kuwertz-Bröking, 2019). This plan implies that the child has to go to the bathroom for specific times a day without stress. If the child shows defiant disorder, behavioral therapy should be integrated.

Case Three                 In this case, joining the varsity football team demands healthy individuals who can endure high energy demands by the body and functional body organs. Hypertrophic cardiomyopathy is a critical heart condition that results in instant death during competitive sports. Therefore, it would be essential to collect information related to family genetic makeup, secondary Dilated Cardiomyopathy, structural heart disease

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