Term
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Definition
| A specialized practice of professional nursing focusing on improving students’ health and safety to improve their achievement and success. |
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Term
| Who sets the standards for school nurses? |
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Definition
| The scope and standards of professional School Nursing Practice from the American Nurses Association (2005) defines the practice of school health. |
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Term
| What are important healthy people 2020 goals for school nurses? |
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Definition
increase the proportion of school that provide school health education to prevent health problems in….
Increase the proportion of schools that promote personal health and wellness….
Increase the proportion of schools that have a full-time RN to student ratio of at least 1:750 |
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Term
| What are the skills needed of the school nurse? |
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Definition
Health assessment
Health promotion
Health education
Child health advocacy |
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Term
| What are the common health issues that school nurses see? |
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Definition
Pediculosis
Cystic Fibrosis
GERD
Celiac Disease
Muscular Dystrophy
Scoliosis
Diabetes Type I |
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Term
| What is Pediculosis captious? |
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Definition
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Term
| What is Pediculosis pubis? |
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Definition
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Term
| What is sarcoptes scabieie? |
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Definition
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Term
| Who is infected with parasites mostly? |
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Definition
| ANY child can come in contact with parasites. No economic status is less susceptible. |
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Term
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Definition
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Term
| How is pediculosis transmitted? |
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Definition
| direct contact with hair of infested people; incubation period from nit to nymph= 6-10 days. 2-3 weeks later = Adults |
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Term
| What are the clinical manifestations of pediculosis? |
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Definition
| pruritus, can see adults and nits |
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Term
| How is pediculosis treated? |
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Definition
| washing hair with pediculicide and removal of nits. |
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Term
| What is lice is still present after 24 hours after wash? |
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Definition
| If lice still evident in 24 hours, the product was not used correctly or was not effective. |
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Term
| What are the control measures for lice? |
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Definition
| examine close contacts and bedmates- treat prophylactically if necessary. Wash linins in hot water. Sealing non-washables in a plastic bag for 10 days |
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Term
| How are scabies transmitted? |
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Definition
| prolonged close personal contact |
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Term
| What is the incubation period of scabies? |
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Definition
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Term
| What are the clinical manifestations of scabies? |
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Definition
| intense pruritus with excoriations. |
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Term
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Definition
| : a scabicide should be applied to the entire body and left on for 8-14 hours. |
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Term
| When should itching associated with scabies stop? |
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Definition
| Itching may not subside of several weeks even after successful treatment. |
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Term
| What are the contact precautions for scabies? |
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Definition
| prophylactic for close contacts. Bedding washed n HOT water. Vacuum and clean the room used by the person. |
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Term
| What is the pathophysiology of cystic fibrosis? |
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Definition
Epithelial cells fail to transport CHLORIDE. So water transport abnormalities occur.
Results: thick tenacious secretions by sweat glands, GI tract, pancreas, respiratory tract, and other exocrine tissues. |
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Term
| Why do children with cystic fibrosis taste salty? |
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Definition
| The sweat glands produce a larger amount of CHLORIDE which leads to a salty taste to the skin. |
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Term
| What does the buildup of mucus cause in C.F.? |
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Definition
obstruction of respiratory small airways (bronchioles) pancreas, bile ducts, intestinal glands.
Secondary infections |
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Term
| How is the pancreas affected in C.F.? |
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Definition
| Pancreatic enzymes are decreased and malabsorption occurs. Inability to absorb fats and proteins. |
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Term
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Definition
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Term
| What are the treatment goals of CF? |
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Definition
Decreasing respiratory complications
Maximizing lung function
Preventing infection
Facilitating growth |
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Term
| What are the goal of people who live to be 30-40 w/ CF? |
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Definition
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Term
| How are respiratory complications decreased in CF? |
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Definition
Chest physiotherapy with postural drainage 3-4 times daily.
Recombinant human Dnase (Pulmozyme)- to loosen secretions |
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Term
| How is infection prevented in cystic fibrosis? |
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Definition
| Aerosolized antibiotics are often prescribed |
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Term
| How is growth facilitated in CF? |
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Definition
Pancreatic enzymes
Supplemental fat soluble vitamins
Increased calorie high protein diets |
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Term
| What is important health history to note in CF? |
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Definition
Salty taste to skin
Newborn- meconium ileus
Abdominal pain or difficulty passing stool
Bulky greasy stools
Poor weight gain or growth
Chronic cough and respiratory infections. |
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Term
| What are the diagnostic tests for CF? |
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Definition
Sweat chloride test
60 mEq/L is diagnostic
Pulse oximetry
Chest radiograph
Pulmonary function tests |
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Term
| What is the pathophysiology of GERD? |
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Definition
| back flow of gastric or duodenal contents into the esophagus |
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Term
| What are the clinical manifestations of GERD? |
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Definition
Pyrosis-burning in the esophagus
Dyspepsia- indigestion
Regurgitation
Dysphagia |
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Term
| What is the diagnostic testing for GERD? |
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Definition
Endoscopy
24 hr pH monitoring (longer the pH is below 4 the more dangerous |
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Term
| What is the 1st priority in GERD management? |
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Definition
| Situations causing esophageal sphincter pressure (teach patient to avoid!) |
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Term
| What foods should be avoided in GERD? |
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Definition
| High fat diet, Caffeine, tobacco, beer, milk, peppermint or spearmint |
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Term
| What is the 2nd priority in GERD management? |
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Definition
| proton pump inhibitors and prokinetic agents like to increase gastric |
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Term
| What is the 3rd priority in GERD management? |
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Definition
| Nissen fundoplication - surgery |
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Term
| What is celiac's disease? |
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Definition
| Immunologic disorder- gluten (found in grains) causes damage to the small intestine. The villa are damaged and do not absorb nutrients |
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Term
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Definition
| eliminate gluten from the diet. |
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Term
| What foods contain gluten? |
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Definition
Wheat products; rye barley oats oat bran graham, etc.
Creamed or breaded vegetables
Canned baked beans
French fries
Malted milk or yogurt
Meats prepared with wheat
Commercial prepared: dressings, soups, condiments, sauces, licorice |
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Term
| What health history is pertinent to celiac's? |
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Definition
| Diarrhea, steatorrhea, constipation, failure to thrive or weight loss, abdominal distention or bloating, anemia, nutritional deficiency. |
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Term
| What labs are used to diagnose celiac's? |
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Definition
Serum antibody screening
Intestinal biopsy
Genetic testing |
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Term
| What nursing management is involved with celiac's |
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Definition
| Teaching them the diet and ensuring they'll stick to it |
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Term
| What is muscular dystrophy? |
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Definition
Inherited condition where muscles progressively weaken
Usually skeletal muscles are affected |
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Term
| what is the most common type of muscular dystrophy? |
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Definition
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Term
| What is the pathophysiology of Duchenne (Du-shin)? |
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Definition
X-linked recessive – mainly boys are affected
Absence of dystrophine ( a protein that is critical for maintenance of muscle cells.)
Weakness progressed over time. |
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Term
| How does muscular dystrophy first manifest itself in school children? |
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Definition
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Term
| How does muscular dystrophy manifest in 7-12 y.o? |
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Definition
| loose ability to ambulate |
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Term
| What happens in teens w/ muscular dystrophy? |
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Definition
| activity requires use of assistance or support. |
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Term
| Is there a cure for muscular dystrophy? |
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Definition
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Term
| What medications are used to treat muscular dystrophy? |
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Definition
Corticosteroids help slow progression of the disease
Calcium supplements to prevent osteoporosis
Antidepressants |
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Term
| What are the complications of muscular dystrophy? |
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Definition
Contractures-
Surgical tendon release
ROM exercises
Pulmonary, urinary, or systemic infections
Aspiration pneumonia as oropharyngeal muscles are affected |
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Term
| What health history is important to muscular dystrophy? |
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Definition
Ability to walk
Functional status
s/s depression |
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Term
| What physical exam findings are important for muscular dystrophy? |
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Definition
| Gowers sign- inability to rise from the floor in standard fashion p. 1609 Ricci |
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Term
| What labs and diagnostic tests are used to diagnose muscular dystrophy? |
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Definition
Serum creatine kinase levels are elevated due to muscle wasting
Muscle biopsy
DNA testing for the gene |
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Term
| What is the nursing management of muscular dystrophy? |
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Definition
Promote mobility
Maintain cardiopulmonary function
Maximize Quality of Life
Work with child to continue with exercise along with periods of rest. |
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Term
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Definition
S curve to the spinal column (lateral curvature)
Can be idiopathic, neuromuscular, or congenital |
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Term
| What is the pathophysiology of scoliosis? |
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Definition
The vertebrae rotate to the convex side of the curve
Shape of the thoracic cage changes
Respiratory and cardiovascular compromise |
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Term
| What is the management of scoliosis? |
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Definition
Decreasing the progression of the curve and the impact on pulmonary and cardiac function
Bracing
Surgical correction for curves >45 degrees
Spinal fusion
Rod placement |
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Term
| What nursing assessment information is important to scoliosis? |
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Definition
Physical exam
Scoliosis screening |
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Term
| What is the nursing management involved with scoliosis? |
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Definition
Encourage brace compliance
P. 1657 Ricci
23 hours per day
Rubbing of skin by brace
Promote positive self image
Provide pre-operative and postoperative care. |
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Term
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Definition
| Caused by a deficiency of insulin secretion due to pancreatic B-cell damage |
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Term
| What is the pathophys of diabetes type 1? |
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Definition
An autoimmune disorder
As the susceptible person is exposed to factors such a viruses, chemicals, or toxins the immune system begins to damage and destroy Beta cells of the pancreas and then inadequate insulin results. |
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Term
| What is the pathway of diabetes 1? |
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Definition
| Deficiency of insulin -> inability of cells to uptake glucose -> glucose increases in the blood -> inability to use as energy -> kidney's try to lower glucose by glucosuria/polyuria -> proteins and fats are broken down for energy which makes ketonurea and acidosis |
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Term
| What is diabetic ketoacidosis? |
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Definition
| fat catabolism resulting in anorexia, nausea and vomiting, stupor altered LOC, Kussmaul respirations, fruity or acetone breath odor. |
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Term
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Definition
| emergency- can occur during times of stress: illness, infection, surgery |
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Term
| What does prolonged high glucose levels lead to? |
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Definition
Damaged blood vessels and nerves
Failure to grow
Delayed sexual maturation
Poor wound healing
Infections
Retinopathy
Neuropathy |
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Term
| What are the infantile developmental issues r/t diabetes? |
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Definition
Parents/Caregivers
Can’t express symptoms
Crying
Hypoglycemia due to strange feeding hours/inconsistency
Brain development stunted |
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Term
| What are the toddler developmental issues r/t diabetes? |
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Definition
Parents/Caregivers become overprotected
Can express symptoms through temper tantrums |
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Term
| What are the preschoolers developmental issues r/t diabetes? |
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Definition
Notice different w/in friends
Hypo/hyperglycemia brain development
Lack skills to perform care
Hypoglycemia through varied intake and nutrition
Simple explanations |
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Term
| What are the school-age children developmental issues r/t diabetes? |
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Definition
Have developed psychomotor skills to test own sugar and such
Family still involved |
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Term
| What are the adolescent developmental issues r/t diabetes? |
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Definition
Independence
Can lead to non adherence
Conflict w/ self management and image
Have skills to perform test and such
Make bad decisions about diet
Balance between parents and kids for management
Assess for s/s of depression, eating disorders, etc.
Blood sugar goes up when sexual maturation occurs
GH active, acts as anti-insulin agent |
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Term
| What are the goals of therapeutic management of diabetes? |
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Definition
Promoting optimal serum (glycemic control):
glucose levels
near normal hemoglobin A1C (hemoglobin that glucose binds to)
Prevention of complications
Promoting self adjustment
Insulin replacement therapy
Pre pubertal growth spurt- the dose is increased
Illness or stress- the dose is increased
Diet and Exercise
Management of complications |
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Term
| How do sulfonylureas (Glucotrol and Diabeta) work? |
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Definition
| stimulate insulin secretion by increasing the response of Beta cells to glucose |
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Term
| How do meglitidines (prandin) work? |
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Definition
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Term
| How do nateglinide (starlix) work? |
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Definition
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Term
| How does biguanides (METFORMIN) work? |
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Definition
| reduces glucose production from the liver |
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Term
| What health history is important for diabetes patients? |
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Definition
Problems in school related to mental or behavioral changes due to hyper or hypoglycemia
Polydipsia – excessive thirst
Polyuria – excessive urine
Blurred vision, headaches or bedwetting
Poor growth |
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Term
| What labs and diagnostics are important for diabetes? |
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Definition
Hemoglobin A1C for diagnosis- criteria for DM greater than 6.5%
Fasting plasma glucose and 2 hour post-prandial glucose for diagnosis criteria for DM- fasting > 126, random glucose>200, or a 2 hour pp>200 |
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Term
| What is important to teach with regulating glucose control with insulin? |
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Definition
Teach proper Sub Q injection techniques and rotation of sites
Teach insulin pump |
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Term
| What do you do for severe hypoglycemia? |
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Definition
| administer glucagon or Dextrose (50%) IV if needed |
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Term
| What do you do for moderate hypoglycemia? |
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Definition
| glucose paste or tablets or offer orange juice and follow with complex carbs like peanut butter and crackers |
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Term
| What do you need to educate the family on with diabetes? |
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Definition
| Diet, insulin, medications, meal preparation |
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Term
| What are the challenges of having a children with a chronic illness? |
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Definition
Children do not understand long term consequences of the serious chronic illness
Children do not want to be different than their peers
Income- it is expensive
Lack of role modeling by parents
Stress on family from the 24/7 diagnosis and monitoring |
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