The Role of the School Nurse Case Study

Which criteria led the nurse to suspect the child needed to be evaluated for ADHD? (Select all that apply.)

- A decline in or poor academic skills. - Hyperactivity inappropriateness for the age of the child. - Inattention and difficulty with concentration. - Labile mood and temper outbursts.

Which are characteristics of "female athlete triad?" (Select all that apply.)

- Premature osteoporosis. - Amenorrhea. - Pressure to obtain a particular weight for a sport.

The school nurse then assesses the 5-year-old with the complaint of a stomachache. Which assessment questions would be appropriate to ask the 5-year-old?

- When was the last time he had a bowel movement? - Where does it hurt? - When and what did he last eat?

Sarah spends the first portion of her morning conducting an inservice for some of the teachers on early recognition of communicable diseases. When she arrives at her office, there are four children waiting to be seen. In what order should the nurse assess these children?

1. 10-year-old boy who thinks he has a fever 2. 6-year-old girl complaining of a headache 3. 5-year-old boy reporting a stomachache 4. 9-year-old girl with an abrasion to the knee

Place Erickson's Developmental Stages in the correct order. (Place from he youngest age to the oldest age.)

1. Trust vs. Mistrust 2. Independence vs. Shame and Doubt 3. Initiative vs. Guilt 4. Industry vs. Inferiority 5. Identity vs. Role Confusion

Methylphenidate (Ritalin) is recommended 0.3 to 2 mg/kg/day. What is the maximum recommended dose per day in mg for a child who weighs 66 pounds? (Enter numeric value only. If rounding is required, round to the whole number).

60 mg

When auditing a student record, which finding requires intervention by the nurse?

A 9-year-old boy who had one dose of the measles, mumps, rubella vaccine (MMR).

Sarah prepares to administer medications using the five rights of medication administration. Which child's medication should Sarah administer first?

A child returning from physical education class who is requesting a prn dose of albuterol inhaler.

Sarah takes the child's temperature, which is 101.2. She then completes a brief head-to-toe assessment. Which assessment finding if of most concern to the nurse?

A red rash on the cheek and trunk.

Sarah is called to the playground to assess a 7-year-old boy who fell from the jungle gym. The child is crying and clutching his right arm. The forearm is edematous and the child states that he cannot more his wrist. The arm appears to have a closed fracture. Which action should the nurse take first?

Check for the presence of a radial pulse.

Which of the following is an indicator that Danny is meeting the following Nursing Outcomes Classification (NOC): Impulse self control and self restraint of compulsive or impulsive behaviors?

Displays calm demeanor without supervision.

The RN further assess for characteristics of the "female athlete triad." Which finding by the nurse is of most concern?

Electrolyte imbalance.

She attaches the mouthpiece to the spacer, shakes the MDI for 3 seconds and places the mouthpiece correctly in her mouth. Which action should the nurse tell Sarah to take next?

Exhale steadily and completely through the nose.

A teacher's aide sees Katie approaching the nurse's office and asks Sarah why Katie visits her office each day. How should the nurse respond to the aide?

Explain that this is confidential student information.

Sarah cares for several children with multiple healthcare need in the public school system. Which act enhances the ability of children previously served in acute and long-term care to have access to public education?

Individuals with Disabilities Education Act (IDEA).

According to Erickson, when children are highly imaginative, they are accomplishing which psychosocial developmental stage?

Initiative

The RN prepares to give scheduled prescription medications to 20 different students. Which method for medication administration by the nurse is safest?

Keep each student's medication in the original bottle until the student arrives, then verify the five rights prior to administration.

When Sarah assists Katie with the intermittent catheterization, she is startled to find Katie's vagina is red and badly torn. The RN gently asks Katie if anyone has been inappropriately touching her genitals. Katie tears up and nods her head yes but refuses to talk further about the situation. Which action should the nurse take first?

Notify child protective services (CPS).

Which intervention should the nurse implement for a child taking methylphenidate (Ritalin)?

Periodically assess height and weight.

The next morning, Katie's step-father shows up at the school He is agitated, and demands to know Katie's whereabouts. Sarah happens to be in the administrative office when he arrives. Which action should the RN and the office personnel take?

Place an emergency call to the police department from another room.

When using an automated external defibrillator (AED), which action should be taken first?

Remove clothing to expose the chest.

Sarah then evaluates the little girl who has a complaint of a headache. She takes her temperature tympanically and it is 97.8 F. Sarah determines through her assessment and questioning, that the little girl was up late last night and did not get enough sleep. Which is appropriate action for the school nurse to take?

Send the child back to class with a note allowing her to rest her head on the desk.

Sarah assists Sarah, a child with newly diagnosed asthma, with the use of her albuterol metered-dose inhaler (MDI) using a spacer. The RN notices the child has audible wheezes prior to the MDI use. Which instruction should the nurse provide Sarah?

Shake the aerosol MDI three to four times prior to administration.

When assessing the 10-year-old student, which action should the RN take first?

Take the child's temperature.

Which other individuals are most at risk for contracting fifth disease?

The children who were the child during the 2 weeks before the symptoms appeared.

Which resource provides the best information to the school health nurse on recommended childhood immunization schedules?

The website for the Centers for Disease Control (CDC).