The parent of a 5-year-old child tells the primary care pediatric nurse practitioner that the child has been using the toilet to urinate for since age 3 but continues to defecate in "pull-ups." The nurse practitioner learns that the child has predictable bowel movements and a physical examination is normal. What will the nurse practitioner recommend?

Question

Quizplus · Accepted Answer

The nurse practitioner should recommend putting the child on the toilet for 5 to 10 minutes at the usual time of defecation. This will help the child associate the feeling of needing to defecate with using the toilet rather than relying on pull-ups. The reward system may be helpful for encouraging the child to use the toilet but does not address the issue of defecating in pull-ups. Putting the child back in diapers is a step backward in toilet training and will not encourage the child to use the toilet. The use of polyethylene glycol is not necessary if the child has predictable bowel movements and a normal physical examination.

The Parent of a 5-Year-Old Child Tells the Primary Care