S & L Chapter 31: The Nurse in the Schools

Community Outreach

a role of a nurse whogivescare outside one defined setting

Case Manager

a school nurse who performs a number of general activities concerning health problems of the children

School Nurses give care to children as?

direct caregivers, educators, counselors , consultants, and case managers.

In regards to lice and nits what are teh school nurses responsibilities?

- Teach children, parents, and teachers how to prevent lice and treat cases of infestations - Teach parent how to completely treat the child with the anti-lice medications - Teach parents to remove all nits from the head with fine toothed comb - Teach parents to wash all bed linens and clothing

A school nurses primary prevention efforts do what?

- Access children and families to determine their level of knowledge about health issues - Find out whether children are at risk for preventable problems - Analyze the assessment findings - Make plans to develop teachingoplans or health promotion activities - Implement the health promotion activities - Evaluate and revise health promotion plans

What responibities dose the school nurse have when dealing with homebound children?

- Being the liaison between the child's teacher, physician, school administrators, and parents regarding the child's needs - Helping individuals make up the child's IEP in a way that dosn't remove necessary learning form the plan - Allowing the child to go to school when possible Coordinating the child's health care needs and classes

When dealing with IEPs the nurses responsibilities include?

- Havinginformation about the child's medications to be given during school hours - Knowing if the child needs any therapy during the school day,, such as physical or occupational therapy - Knowing if the child has hearing or vision problem - asking the teacher to seat the child in best place in the classroom so the child can better see or hear the teacher

Children seek out a school nurse for what different needs?

- Headaches - Stomaches - Diarrhea - Anxiety over being separated from the parents - cuts, bruises, or other injuries

The immunization/vaccination records of all children in a school, that are kept by the school nurse, must have what in them?

- Name of Student - Date of birth - Address - Telephone number - Parent'/guardians' names - Contact infrmation - Primary health care providers name, telephone number and address - All the vaccinations with teh dates the child received booster shots

The school nurse focuses on what areas of promary prevention?

- Preventing childhood injuries - Preventing substance abuse behaviors - Reducing the risk of teh development of chronic diseases - Monitoring the immunization status of children

The AAP stated that school nurses should ensure:

- That children get the health care they need, including emergency care in the school - That the nurse keeps track of the state-required vaccinations that children have received - That the nurse carries out the required screening of the children based on state law - that children wit health problems are able to learn in teh classroom

What is the best action for a school nurse to do if a adolescent in school threatens to commit suicide?

- remove the student from the school situation immediately - notify the parents while assessing the students risk - refer the child or teenager to crisis intervention or mental health services

Nurses should do what to aid in Suicide Prevention efforts in adolescents:

. Lead educational programs within the schools to emphazise coping strategies and stress management techniques for children and adolescents who have problems and to teah about the risks - Teach faculty members to look for the risk factors - Help organize a peer assistance program tohelp teenagers cope with school stresses

What six characteristics may point out a student who may be thinking of comminting an act of violence agnist their school?

1. venting: having mood swings 2. Vocalizing: threatening others 3. Vandalizing: damaging property 4. Victimizing: seeign himself or herself as a victim 5. Vying: belonging to gangs 6. Viewing: witnessing the abuse of others

At least how many different staff memebers must be identified as responsible for determining if emergency care is needed?

2

1. A unique characteristic of the standards of practice for school nurses is which of the following? Alignment with the American Academy of Pediatrics (AAP) guidelines for providing health care to students Requirement of bachelor's degrees in nursing and special certification in school nursing Restriction on delegation of care to other school personnel Use of research findings in the practice of school nursing

A In general, the National Association of School Nurses (NASN) standards align with those developed by the American Academy of Pediatrics (AAP) regarding giving health care to students in the schools. The AAP developed its own ideas about how nurses function in schools based on its assessment of school children's health needs. These guidelines are very similar to those written by the NASN. Additionally, the AAP recommends that the nurse be the head of a health care team that includes a physician (preferably a pediatrician), school counselors, the school psychologist, and members of the school staff including the administrators and teachers. DIF: Cognitive Level: Comprehension REF: Page 569

7. A school district in the Midwest has included health education, physical education, health services, nutrition services, and counseling, psychological, and social services as components of the student health services. Additionally, the district has integrated family/community involvement, staff health promotion, and a commitment to a healthy school environment in its program design. This school district has adopted the school health service program scope of which of the following? CDC's Federal School Health Program Healthy Schools, Healthy Communities program Healthy People 2020 School-linked program

A The federal government, through the coordination of the CDC, has developed the Federal School Health Program. The plan includes eight parts: health education; physical education; health services; nutrition services; counseling, psychological, and social services; healthy school environment; health promotion for staff; and family/community involvement. DIF: Cognitive Level: Application REF: Pages 570-571

2. A second-grade child with cerebral palsy receives services from a physical therapist and occupational therapist during the child's academic day. The school nurse sets up the schedule to ensure that the therapists' visits do not unnecessarily affect the child's academic day negatively. This role of the school nurse is best described as which of the following? Case manager Counselor Consultant Direct caregiver

A The school nurse is expected to function as a case manager, helping to coordinate the health care for children with complex health problems. This may include the child who is disabled or chronically ill, who may be seen by a physical therapist, an occupational therapist, a speech therapist, or another health care provider during the school day. The nurse sets up the schedule for the child's visits so that those appointments do not unnecessarily have a negative effect on the child's academic day. Direct caregiver is the traditional role of the school nurse where immediate nursing care is provided. As a consultant, the school nurse can provide professional information about proposed changes in the school environment and their effect on the health of the children. The school nurse as counselor occurs when children go to the nurse to share important health information. DIF: Cognitive Level: Application REF: Page 570

9. The school nurse at the intermediate level arranges for a presentation by the trauma educator at the local regional medical center. Bicycle and helmet safety will be the primary topic at the school's open house. This is an example of which of the following school nurse roles? Community outreach Counselor Consultant Case manager

A When participating in community outreach, nurses can be involved in community health fairs, reaching others about influenza immunization programs, promoting health education fairs, and coordinating with local charities to provide education to the schools. As a consultant, the school nurse can provide professional information about proposed changes in the school environment and their effect on the health of the children. The school nurse is expected to function as a case manager, helping to coordinate the health care for children with complex health problems. The school nurse as counselor is available to students who need to discuss confidential health matters. DIF: Cognitive Level: Application REF: Page 570

10. Secondary prevention activities are the largest responsibility of the school nurse and may include which of the following? (Select all that apply.) Establishing an emergency plan when a child or staff member needs immediate care Giving medications to children during the school day Participating in developing an individual education plan (IEP) for students with long-term health needs Screening for vision, hearing, height and weight, oral health, TB, and scoliosis Teaching standard precautions to all staff

A, B, D, E Secondary prevention involves caring for children when they need care and is the largest responsibility of the school nurse. It may include such activities as caring for ill or injured children or staff (including the development of an emergency plan and appropriate training of staff in standard precautions, first aid, and relevant emergency procedures); screening and assessing children; making appropriate referrals; giving medications; identifying abuse and neglect; communicating with health care providers; preventing suicide and violence; and responding to disasters. DIF: Cognitive Level: Application REF: Pages 574-575

What two things should be kept by the school nurse or other school offical that is responsible for ensuring emergency care is provided for a sick or injured child?

An injury or illness log and Procedures on notifying parents about the emergency that include what was done for the child, where the child is, and what is required

The crisis plan should include what?

An administrative policy made either for entire school district or for individual schools in the district. The names of persons on the crisis team\ The superintendent of the school district The school nurse the guidance counselor the school psychologist or social worker police or school security clery from community Parents

4. At the end of each school term, the school nurse schedules an equipment safety assessment of each school playground in the district. The school nurse uses the guidelines of the U.S. Consumer Protection Safety Commission and prepares a report of the findings for the school board for planning purposes. This intervention by the school nurse is an example of which of the following? Community outreach Primary prevention Secondary prevention Tertiary prevention

B Injuries are the leading cause of death in children and teenagers. The school nurse educates children, teachers, and parents about preventing injuries. School nurses also provide information on how to prevent playground injuries. They assess school playgrounds for equipment safety on the basis of the U.S. Consumer Product Safety Commission guidelines. DIF: Cognitive Level: Application REF: Page 573

8. An urban school-based clinic is located in a school district where many of the children lack health insurance. The school nurse continues to provide screening, assessment, first aid, and record keeping but can refer students who require additional services to the nurse practitioners that staff the school-based health center (SBHC) on the school grounds. The SBHC is federally funded under which of the following? CDC's Federal School Health Program The Affordable Care Act Healthy People 2010 School-linked program

B School-based health centers are family-centered, community-based clinics run within schools under a federally funded program. These clinics give expanded health services, including mental health and dental care, in addition to the more traditional health care services. The Affordable Care Act of 2010 appropriated $200 million to improve and expand services at SBHC. They can vary in size, hours, and days of operation, or administrative model (i.e., school clinic, health center, school-linked program). They are successful because they focus on bringing health care services to children in a community school location and are coordinated with the school health program. DIF: Cognitive Level: Knowledge REF: Page 571

3. A middle school student approaches the school nurse and asks, "Can I speak with you about something important?" The school nurse responds affirmatively but should also state which of the following? "Anything you tell me will be kept private and confidential." "If anything you tell me indicates that someone is in danger, the parents and school officials must be told." "It may be best for me to set up an appointment with the school counselor." "You can always speak to me if you are in trouble or when you need someone to talk to."

B The school nurse may be the person whom children trust to tell important secrets about their health. The school nurse has a reputation as being a trustworthy person to whom the children can go if they are in trouble or when they need to talk to someone. Nurses in this situation should tell the children that if anything they reveal points out that someone is in danger, the parents and school officials must be told. DIF: Cognitive Level: Application REF: Page 570

The 2 staff members who are identified as responsible to determine if emergency care is needed should be educated by whom in what?

By teh School Nurse in first aid techniques

After World War II, as the number of chldren with communicable diseases decreased due to immunizations and antibiotic use, the School Nurses turned their attention to screening children for what?

Common Health problems, vision and hearing,

6. The future of school nursing is very strong and will be further enhanced by the future trend in which of the following? Development of an HIV/AIDS health curriculum Enhanced use of picture boards Improving the air quality of school buildings Telehealth and telecounseling

D The amount of health care being given in the schools is increasing. In the future, school nursing will use telehealth and telecounseling to teach health education. School nurses will use the Internet to work with children and parents. The school nurse is responsible for keeping up with the latest changes in health care and health practice so that the health of children in the schools can be enhanced by new trends in health care. DIF: Cognitive Level: Knowledge REF: Page 581

5. A child with severe macular degeneration and some hearing loss will be attending the third grade in a local school. A tertiary prevention intervention the school nurse should perform would be which of the following? Assess the child's language skills, motor abilities, and social abilities. Ensure that a telephone is available for calling emergency personnel or parents. Lead educational programs to address coping strategies and stress management techniques. Meet with the assigned teachers to discuss classroom seating to enhance the child's learning experience.

D The school nurse gives nursing care related to tertiary prevention when working with children who have long-term or chronic illnesses or with special needs. This may include participation in the development of an individual education plan (IEP); identification of medication, therapy needs, and/or physical, auditory, or visual limitations; and interventions to ensure the appropriate placement of the child in the classroom environment or physical accommodations required, which enhances the child's learning experience. DIF: Cognitive Level: Application REF: Page 578

It is the job of the school nurse to teach teenagers about the dangers of all?

Drugs

American Academy of Pediatrics (AAP)

a professional organization for pediatricians that sets policy statements for child health

The school nurse should have what necessary equipment?

Full oxygen tanks w/oxygen masks of different kinds, and splints Cervical spine collars in different sizes sterile dressings

direct caregiver

a role of a nurse giving health care to the ill or injured

health educator

a role of a nurse in providing instruction on heealth topics

The eight parts of the CDC school health program are:

Health Education Physical Education Health services Nutrition services Counseling and psychological and social services Healthy school environment Health promotion for staff Family and community involvement

What level of prevention is the school nurses largest responsibility?

Secondary Prevention

researcher

a role of a nurse to investigate phenomena related to health

A school nurses required level of education depends on what?

State laws

The AAP recommends that the nurse be what member of the health team that includes a physician, school counselor, school psychologist, members of the school staff including the administrator, and teachers?

The head of the health team

counsler

a role of a nurse when mental health support is provided

If a child is in a wheelchair or uses crutches, then the school building itself needs to be alteed toallow the chid access and use of the schoo facilities, who is responsible for tellig the school administrators about these special needs if changes need to be made?

The school nurse

Centers for Disease Control and Prevention (CDC)

a branch of the U.S. public health service whose primary responsibility is to propose, coordinate and evaluate changes in the surveillance of disease in the U.S.

full-service school-based health centers (FSSBHCs)

a federal program providing comprehensive health care at a site within a school to all including social services, day care, and job training may provide social services, day care, job training, educational counseling, medical and nursing care, mental health counseling and dental care

School based health centers (SBHCs)

a federal program providing health care, dental care and mental health care to children and families in schools

Safe Kids Campaign

a federal program to provide education to children about safety

School Health Policies and Programs Study 2000 (SHPPS 2000)

a federal study of CDC-funded school health program run by community health agency

Americans with Disabilities Act (ADA)

an act passed in 1990 that mandated that individuals with mental and physical disabilities be brought into the mainstream of American Life

How can the school nurse help prevent violent actions by children/students?

by teaching teachers and students the six characteristics that point out a student who is at risk to commit drastic violent acts and by providing follow up on children/students who need help.

In the school setting school nurses must carry out what skills often?

catheterizations, suctioning, gastrostomy feedings, and other skills in schools

tertiary prevention

continued long-term health care

Since 2002 school nurses have been directly responsible for what nursing care?

direct care health education counseling case management community outreach

PL 105-17 Individuals With Disabilities Education Act (IDEA)

educational services that must be provided for disabled children from birth through age 22

How often should a crisis plan be updated?

every year

PL 93-112 Section 504 of the Rehabilitation Act of 1973

federal law requiring services for persons with handicaps

The goal of the AAP standards/recommendations for school nurses is?

for children to obtain complete health care in the schools

Getting what information to the parents of the children is often a challenge for teh school nurse?

health promotion

Primary prevention in School Nursing

health promotion and education; provides health promotion and education to prevent childhood injuries and substance abuse

In the early 1900's school nurses did screenings for what in school children?

infectious diseases

do-not-resuscitate (DNR) orders

physcians orders to not medically intervene when deathis about to occur

individualized education plans (IEPs)

plans to decide educational accommodations for disabled children

emergency plan

procedures to effectively give care in a crisis situation

Standard Precations

procedures to prevent exposure to blood-borne diseases

National Association of School Nurses (NASN)

professional organization for school nurses that sets standards and guidelines for them

crisis teams

school staff designated to deal with crises at school

Secondary prevention in School Nursing

screening and providing health care that involves screening children for illnesses and providing direct nursing care

consultant

someone who provides professional advice, services, or infromation

School Nurses assess school playgrounds for equipment safety on what basis?

the U.S. consumer Product Safety Commission guidelines

When dose a school nurse give tertiary prevention care?

when working with children/students who have long-term or chronic illnesses or when working with children with special needs

Ethical dilemmas in schools are related to?

women's health care and religious beliefs of the students or nurses