Pediatric Voiding Dysfunction, Essay Example

Introduction

An examination of evidence-based practice solutions for patients requires an understanding of the concepts that are associated with a specific problem and the potential solutions that exist. This strategy is instrumental in supporting the expansion of knowledge in order to demonstrate the impact of evidence-based solutions on improving quality of care for many patients. This process is an important step towards the discovery of new techniques and strategies that are likely to have a significant impact on patients when they are taken seriously and support effective patient outcomes. It is expected that evidence-based practice will continue to shape healthcare and nursing practice for the foreseeable future. In examining the context of the case study, it is important to address the clinical aspects of pediatric voiding dysfunction to determine the possible outcomes that the patient might experience under this scenario.

Analysis

The 14 year-old male patient in question has recently experienced frequent urination in conjunction with difficulty in voiding, accompanied by a lack of emptying completely and nocturia (Ellsworth & Caldamone, 2008). The patient had a right nephrectomy at six months of age for a multicystic and dysplastic kidney, but has presented with a normal urine culture and urinalysis (Ellsworth & Caldamone, 2008). Based upon the presentation and the factors that were determined to be important to the case, the patient was prescribed a high fiber diet and timed bowel movements, along with oxybutynin XL 5 mg to address his symptoms (Ellsworth & Caldamone, 2008). Since the symptoms continued, the patient was required to undergo a urodynamics study, and this demonstrated detrusor activity, thereby requiring an increased dosage of medication (Ellsworth & Caldamone, 2008). In addition, the patient was given an MRI to examine if there were any complications associated with the change in bowel movements, and the test indicated that a tethered cord was not evident; therefore, the patient was given anticholinergic therapy for a period of time and then it was discontinued (Ellsworth & Caldamone, 2008).

The patient in question experienced a bout of overactive bladder, which is a common occurrence in many children that is attributed to a variety of issues and should be diagnosed through physical examination and other testing as necessary (Ellsworth & Caldamone, 2008). A young patient with overactive bladder also requires an examination of bowel habits and any constipation that is reported in order to develop an appropriate treatment plan, along with a urinalysis and other tests as necessary to rule out specific conditions that may cause similar symptoms (Ellsworth & Caldamone, 2008). From a clinical perspective, the use of anticholinergic therapies should be closely monitored in order to address any possible side effects and level of tolerability for patients (Ellsworth & Caldamone, 2008). For nurses working with young patients with overactive bladder, it is necessary to consider activities to routinely monitor patients that involve voiding and bowel movements in a timely manner, pelvic floor exercises to increase muscle strength, proper fluid intake, and general education regarding the condition that will be useful in alleviating some of the symptoms that persist (Ellsworth & Caldamone, 2008). Furthermore, an overactive bladder may contribute to negative concerns regarding quality of life and the development of new perspectives to ensure that patients improve their quality of life through the activities and behaviors in which they participate (Ellsworth & Caldamone, 2008).

Prior research regarding the pathophysiology of overactive bladder also demonstrates that patients experience symptoms that are difficult to understand and to accept as part of the daily routine (Franco, 2007). It is necessary to evaluate the conditions under which patients might respond effectively to treatments based on prior evidence that support the ability to alleviate symptoms and to be effective in addressing some of the behavioral concerns that accompany this condition (Franco, 2007). The potential risks associated with this condition and its impact on multiple organs and systems should also be explored as a means of examining new perspectives to ensure that patient outcomes are effective and appropriate to meet the needs of this population and their quality of life (Franco, 2007). Treatment methods for overactive bladder must be comprehensive in nature and consider a wide variety of conditions that are likely to be effective in supporting patient care quality and the outcomes that are necessary to support patients who require treatment for this condition (Franco, 2007).

For a young patient with overactive bladder, it is important to identify the key factors in managing the condition effectively to prevent long-term complications and other concerns through a detailed evaluation and focus on proper diagnosis and treatment (Santos et.al, 2014). From this perspective, it is likely that patients who receive the appropriate evaluation and subsequent treatment will improve their prognosis over the long term and also improve their behavior and understanding of the condition (Santos et.al, 2014). The use of specialists to diagnose the condition is often favorable because specialists are experts in the diagnosis of disorders related to bladder and bowel dysfunction that impact quality of life (Santos et.al, 2014). It is important to identify the tools and resources that are required to ensure that patient outcomes are effective and appropriate in meeting the needs of patients and in expanding knowledge that is based upon prior evidence (Santos et.al, 2014). This process is instrumental in enabling patients to receive high quality care and the required treatment without delays in order to alleviate symptoms and improve long-term outcomes (Santos et.al, 2014). Patient care quality is essential to the discovery of new strategies that are grounded in prior evidence and the adoption of nursing principles that will have a positive impact on patients who experience overactive bladder and related symptoms (Santos et.al, 2014). Understanding the nature of the disease and its prognosis will also provide greater insight regarding the needs of patients and the development of new factors that will impact patient care quality and the effectiveness of treatments with minimal complications (Santos et.al, 2014). By educating patients and their parents regarding the nature of overactive bladder and the complications that may arise, it is possible to develop greater insight regarding the needs of this patient population and the evidence that is available for evaluation (Santos et.al, 20140.

Conclusion

For young patients with overactive bladder as shown in the case study, it is important to identify the tools and resources that are required to ensure that patient care outcomes and quality of life are optimized and improved through proper diagnosis, effective treatment, and evidence-based solutions. Furthermore, nurses must be effective communicators in supporting this patient population and in adopting the most feasible techniques and treatment strategies to support this patient population and meet their needs effectively. Patients who have overactive bladder and receive successful treatment will not only experience fewer symptoms, but they are likely to adapt behaviorally to their condition. Therefore, continuous and focused nursing care is required in order to ensure that the desired patient outcomes are achieved for this patient population. This method is appropriate in determining the extent of nursing care that is required and the level of evidence that exists in order to improve outcomes for these patients, using expert nursing-based care as a guide in adapting evidence-based principles to improve quality of care and expand treatment alternatives for patients with this condition.

References

Ellsworth, P., & Caldamone, A. (2008). Pediatric voiding dysfunction: a case study. Urologic Nursing, 28(4), 259-261.

Franco, I. (2007). Overactive bladder in children. Part 1: Pathophysiology. The Journal of urology, 178(3), 761-768.

Santos, J., Varghese, A., Williams, K., & Koyle, M. A. (2014). Recommendations for the Management of Bladder Bowel Dysfunction in Children. Pediat Therapeut, 4(191), 2161-0665.