A school-age patient presents to the office with caregiver concerns about daytime incontinence. The caregiver denies any episodes of incontinence overnight. How should the NP best document this finding in the patient's physical examination record?

Enuresis refers to involuntary urination in a child old enough to be expected to have bladder control, generally age five and older. The term is further classified by the time of day the episodes occur. Diurnal enuresis specifically refers to daytime urinary incontinence while the child is awake, which is exactly what this caregiver is describing — wetting episodes that occur during the day with no nighttime episodes. This distinction is clinically important because diurnal enuresis often has a different underlying etiology than nocturnal enuresis, with daytime wetting more often associated with overactive bladder, dysfunctional voiding, urinary tract infections, or behavioral factors. Nocturnal enuresis, by contrast, refers exclusively to bed-wetting during sleep and is the most common form in school-age children. Primary enuresis describes a situation in which a child has never achieved consistent dryness, while secondary enuresis indicates the return of wetting after at least six months of being dry. The case does not provide information about prior continence history, so classifying it as primary or secondary would require additional history. The most accurate documentation that captures the daytime-only nature of the incontinence described by the caregiver is diurnal enuresis, making that the correct answer.