W13_06 common issues in the older child Flashcards
define primary enuresis
never been dry since birth for more than 6 months in a row
define secondary enuresis
has been dry at some point for more than 6 months in a row
define diurnal enuresis
wetting themselves when they’re awake
define nocturnal enuresis
wetting themselves when asleep
when to worry about enuresis?
diurnal enuresis in school agers;
secondary enuresis
note: diurnal enuresis is almost never a result of a severe disease when it’s in isolation
it’s usually other things, like constipation or other more motivating things like playing games
note that it’s more difficult to wake up those with nocturnal diuresis
ok
what’s the workup for primary nocturnal enuresis?
do nothing. Watchful waiting
should you give imipramine to bedwetting children?
not recommended unless exceptional;
can cause torsades de pointes
should you give desmopressin (DDAVP) to bedwetting children?
decent efficacy;
take an hour before bed and don’t drink water
should you give sleep-alarms to bedwetting children?
no mostly - don’t give them the wrong message. Convince it’s not a problem.
In older, more motivated kids, can use these
which gender is more affected by ADHD?
boys
which ages are more affected by ADHD
under 12 years
what are factors associated with ADHD?
single parent fam;
low parent education;
low family income;
low birth weight;
developmental problems
what are factors identified in infancy that can predict ADHD?
prenatal smoking;
maternal depression;
poor parenting practices;
living in a disadvantaged neighborhood
