A parent expresses concern about their child's frequent episodes of enuresis.The nurse should first assess for:

Choice A rationaleUrinary tract infections can cause bladder irritation and dysfunction, leading to symptoms such as frequency, urgency, and nocturia, which can manifest as enuresis, especially secondary enuresis (bedwetting that starts after a period of dryness). Therefore, assessing for a UTI is a crucial first step to rule out a treatable medical cause. Normal urine specific gravity ranges from 1.005 to 1.030, and a urinalysis can detect the presence of bacteria, white blood cells, or nitrites indicative of infection.Choice B rationalePsychological stressors can contribute to enuresis, particularly secondary enuresis. Anxiety, family changes, or school-related stress can manifest physically. While important to explore, medical causes like UTIs should be ruled out first.Choice C rationaleSleep patterns are relevant in the context of enuresis, as bedwetting occurs during sleep. However, assessing for a medical cause like a UTI should precede a detailed evaluation of sleep habits.Choice D rationaleA family history of enuresis can suggest a genetic predisposition. However, the immediate nursing priority is to assess for and rule out treatable underlying medical conditions, such as a urinary tract infection.