Case # 1

Client has experienced enuresis at night for the past 2 weeks and frequently requests to use the bathroom while at school. The client was previously toilet-trained with no nighttime bed-wetting for 6 months; client recently relocated to a new home and school where the client lives with parents.

The parent reports that the client has recently demonstrated fatigue, irritability, and multiple behavioral outbursts that resemble past tantrums. The client frequently reports feeling thirsty. No dysuria or urinary hesitancy.

The previous visit a year ago showed weight and height at the 40th percentiles. Growth charts today show the client’s weight at the 20th percentile and height at the 40th percentile.

The client appears tired and irritable. Dry mucous membranes. No increased work of breathing.  Lungs clear to auscultation bilaterally. No cardiac murmur.