I AM A TEACHER

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I AM A TEACHER

• Cathy Harris, RN, BSN
• Region 18 ESC
• 567-3279, caharris_at_esc18.net

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Career as a Teacher

• Career
• If you care, it shows.

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ACTIVE LISTENING DOES NOT

• Make judgments while speaker is speaking
• Mentally rehearse what the listener is going to
  say next
• Do a distracting activity while listening
• Interrupt before speaker is through, or complete
  speakers sentences
• Assume that the listener already knows what the
  speaker is going to say
• Prematurely give advice or solutions

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AN ACTIVE LISTENER

• Stops talking
• Listening for feelings and perception, as well as
  facts
• Makes eye contact, if culturally acceptable
• Paraphrases back to the speaker what the listener
  heard, for clarification, not necessarily to
  agree
• Ask questions for clarification, not to establish
  facts or make a point or embarrass the speaker
• Controls anger and aims for understanding

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Students that do not have a chronic or emergent
conditions, can be treated under the following
guidelines

• Chapped lips Cover with thin layer of Vaseline,
  if available
• Minor abrasions (scrapes) Wash with soap and
  water, apply Band-Aid on clean, dry wound
• Mosquito/insect bites, presenting with mild,
  localized itching Apply towel, moistened with
  cool water
• First indications of not feeling well Put head
  on desk, go to bathroom, get drink, see if lunch
  helps
• Contact lenses Student should provide own
  solution for cleaning lenses.
• Itchy eyes wash face/eyes with cool water
• Pierced ears, showing no signs of infection
  Clean with cool water

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Student should stay in class when

• Healing abrasion (scab) is itchy or sore, but
  intact.
• Soreness from old injury, no apparent redness or
  swelling
• (ice will not help more than 24 hours after
  injury)
• Student frequently asked to leave class and
  rarely has to go home due to illness.
• Student frequently asks to go to clinic at the
  same time, each day.
• Student has loose tooth, not due to injury.

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Valid Reasons For Sending a Student to the
clinic

• Vomiting (not just spitting up phlegm)
• Bleeding
• Animal bite
• Not feeling well persists beyond 45-60 minutes
  OR is extremely sudden and severe
• Obviously ill in appearance or behavior, compared
  to other days
• Symptoms of infection in any area redness, heat,
  pain, swelling, pus
• Earache (never put cotton, tissue or anything IN
  the ear)
• Undiagnosed rash

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Additional Reasons to Send to clinic

• Exhibits problems related to chronic illness
  (asthma, diabetes, migraines, allergic reactions)
  accompany student, if indicated
• Sore throat
• Injury to head, eyes, face, ears
• Bone/joint injury student should not bear
  weight, bend or move extremity until assessed
• Signs of allergic reaction hives, itching,
  swelling of mouth/lips, hoarseness, abdominal
  pain, nausea, vomiting, dizziness or wheezing
• Suspected head lice
• Nosebleed student should pinch own nose closed,
  breathe through mouth, be accompanied to clinic
• Splinters the site will be cleaned and covered,
  if it is embedded

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Reasons to call nurse to site

• Loss of consciousness
• Seizure
• Serious falls or accidents that involve head,
  neck, spinal or upper leg injury DO NOT MOVE
  STUDENT
• Signs of severe hypoglycemia

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Assess the Situation

• As a school employee you are dedicated to
  children and your first instinct might be to
  assist an injured child right away. It is
  important for you to take a moment to collect
  yourself so you can safely approach the
  situation.

• Be calm and reassure the victim.
• Assess the severity of the injury.
• Avoid exposing yourself to blood or other body
  fluids without precautions.

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Administer First Aid

• For minor cuts and scrapes, encourage the victim
  to self-administer first aid.
• For more serious injuries, put on a pair of
  gloves before you administer first aid.
• If you are accidentally exposed to blood or
  another fluid in the course of administering
  first aid, wash the exposed area with
  anti-bacterial soap and water.
• If your eyes, nose, or mouth have been exposed,
  flush them with running water.

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Use Gloves

• Always wear gloves when you anticipate touching
  blood, bodily fluids, or contaminated surfaces.

• Use single-use, disposable gloves when
  administering first aid.
• Cover any cuts with bandages before putting on
  gloves.
• Make sure gloves fit snugly, not loosely.
• Check for rips or tears.
• When removing gloves be sure that your bare skin
  does not come into contact with the exterior of
  the glove.
• Dispose of gloves in hazardous waste container.

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Potential Risk of Exposure

• Infected blood or other body fluid that
  contacts your mouth, eyes, or nose
• Infected blood or other body fluid that contacts
  broken areas of skin, even tiny breaks you cant
  see
• Accidental injury with a sharp object like a
  needle, broken glass, or something that can
  pierce your skin

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Universal Precautions

• Universal precautions are measures taken to
  prevent the transmission of BBPs and other
  disease conditions.
• They are standard precautions that should be used
  in every workplace because
• You cannot necessarily tell if someone has a BBP.
  Many people carry a virus for years without
  visible symptoms.
• Because you never know who might be carrying a
  BBP, you should treat any exposure to blood or
  other bodily fluids as a serious matter.
• You should also be aware that you might be a
  carrier of a BBP without your knowing it.
  Prevention measures also protect your students
  from exposure.

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The 5 Universal Precautions
1. Wash hands and work surfaces frequently.
2. Avoid contact with sharp objects.
3. Use gloves and other personal protective
equipment when you anticipate exposure to blood
or other bodily fluids.
4. Wash your hands immediately following exposure.
5. Dispose of hazardous material safely using
engineering controls like a sharps box for needle
disposal.
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Bloodborne Pathogens (BBPs)

• Bloodborne pathogens (BBPs) are disease-causing
  microorganisms carried by human blood and other
  body fluids.
• The three most common BBPs are
• ? Hepatitis B virus (HBV)
• ? Hepatitis C virus (HCV)
• ? Human immunodeficiency virus (HIV)

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Indirect Transmission

• Hepatitis B virus (HBV) can be transmitted
  indirectly if you touch a contaminated surface
  and then touch your nose, mouth, eyes, or broken
  skin.
• HBV can survive dried and at room temperature on
  surfaces for up to a week.

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HIV is a fragile virus.

• It cannot live for very long outside the body.
• is not transmitted through day-to-day activities
  such as shaking hands, hugging, or a casual kiss
• You cannot become infected from a toilet seat,
  drinking fountain, doorknob, dishes, drinking
  glasses, food, or pets.
• You also cannot get HIV from mosquitoes.

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HIV TRANSMISSION THROUGH BODY FLUIDS

• HIV can be found in the blood, semen, or vaginal
  fluid of an infected person
• sexual contact (anal, vaginal, or oral) with
  someone infected with HIV
• sharing intravenous needles, syringes, and needle
  sharing equipment
• can be passed to a baby during pregnancy or
  delivery.
• since 1985, all donated blood in the U. S. is
  tested for HIV. The risk for HIV infection
  through the transfusion of blood or blood
  products is extremely low.

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Dispose of Hazardous Material Safely

• Used needles should be immediately placed in a
  sharps container

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HOW DO I KNOW IF I HAVE BEEN EXPOSED

• The time from infection to the development of
  detectable HIV antibodies is generally 1-3
  months.

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HIV TESTS

• most HIV tests look for the HIV antibodies rather
  than looking for HIV itself
• EIA (enzyme immunoassay) blood, saliva or urine
• Rapid screening test
• Home Testing Kits
• RNA Tests

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HIV TO AIDS

• The time from HIV infection to the development of
  symptoms and later diagnosis of AIDS ranges from
  several months to ten years or longer.

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Symptoms when immune system weakens in
HIV/AIDS

• extreme weakness or fatigue
• rapid weight loss
• frequent fevers that last for several weeks with
  no explanation
• heavy sweating at night
• swollen lymph glands
• skin rashes and mouth, genital, and anal sores
• white spots in the mouth or throat
• chronic diarrhea
• a cough that won't go away
• trouble remembering things
• Girls may also experience severe vaginal yeast
  infections
• as well as pelvic inflammatory disease (PID)

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Causes of Allergic Reactions

• Insects
• Foods
• Plants
• Medications
• Miscellaneous

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Insects

• Most common reactions come from stings from bees,
  wasps, yellow jackets and hornets.
• Reaction can be rapid and severe, due to the
  sting being quickly absorbed into the bloodstream.

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Food

• Most common allergies include nuts, eggs, milk
  and shellfish. Peanut allergies are commonly more
  rapid and severe than other food allergies. Usual
  food allergic reactions are slower onset than
  insect stings.

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Plants

• Contact with the poison plants (ivy, oak,
  sumac), will cause allergic reactions,
  characterized by rashes. Plant pollen is also a
  cause of allergies in many people.
• Plant allergic reactions are rarely severe enough
  to be characterized as anaphylaxis.

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Medications

• Common allergies are to antibiotics, such as
  penicillin or aspirin related products. People
  with penicillin allergies are usually allergic to
  related antibiotics as well.

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Miscellaneous

• Latex allergy can include exposure to gloves,
  balloons and injections.

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Physical Findings

• Itchy and/or watery eyes, headache, runny nose.
• Skin Swelling of face, lips, tongue, neck, or
  hands. Also itching, red, raised skin (hives), or
  cool, clammy skin and delayed capillary refill
• Breathing Coughing, rapid breathing, noisy
  breathing, change in voice, loss of voice,
  wheezing. Breathing changes are sure signs of
  anaphylaxis.

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Physical Findings Cont.

• Heart Tachycardia, hypotension,
• Mentation Altered Status, partial or full loss
  of consciousness.

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The Epinephrine Auto-Injector

• Definition Liquid Medication administered by an
  automatically injectable needle and syringe
  system.
• Medication Name
• Generic Epinephrine
• Trade Adrenalin
• EpiPen or EpiPen Jr.
• Twinject

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The Epinephrine Auto-Injector

• Indications
• Signs and symptoms of severe allergic reaction.
• Epinephrine Auto-Injector is prescribed to
  patient by a doctor.
• Medical Direction has been notified if the
  patient does not have a prescription for an auto
  injector.
• Contraindications
• None in a life threatening scenario.

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The Epinephrine Auto-Injector

• Action
• Bronchodilation Dilation of airways.
• Vasoconstriction constriction of blood vessels.

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Epinephrine Auto-InjectorSide Effects

• Increase in heart rate
• Dizziness
• Headache
• Vomiting

• Pallor
• Chest Pain
• Nausea
• Anxiety, Excitement

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When to use the Epi-Pen

• for a patient with a history of severe allergic
  reactions that comes in contact with substances
  that cause an allergic reaction.
• for a patient in severe respiratory distress, and
  has a prescribed auto-injector.

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Students with Diabetes Implications for Educators

• Students with hyperglycemia or hypoglycemia may
  not concentrate well.
• During academic testing
• Check blood glucose before and during testing,
  per educational plan.
• Access to food/drink and restroom.
• If a serious high or low blood glucose episode
  occurs, students should be excused with an
  opportunity for retake.
• Students should have adequate time for taking
  medication, checking blood glucose, and eating.

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HYPOglycemia LOW sugar

• Onset
• sudden,
• may progress to unconsciousness if not treated
• can result in brain damage or death
• The DMMP should specify signs and action steps
  each level of severity
• mild
• moderate
• severe

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Hypoglycemia Possible Causes

• Too much insulin
• Too little food or delayed meal or snack
• Extra physical activity
• Illness
• Medications

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Mild Hypoglycemia What to do

• Intervene promptly.
• Verify with blood glucose test when available.
• When in doubt, always treat. If no meter is
  available, treat immediately, on-site.
• If untreated may progress to more serious events.
• Initial treatment Have student eat or drink fast
  acting carbs (15g)
• Test blood glucose 10-15 minutes after treatment
• Repeat treatment if blood glucose level remains
  low or if symptoms persist
• Duration of symptoms depends on how low the blood
  glucose was and for how long
• After 10 -15 minutes, if symptoms continue, call
  parents

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Severe Hypoglycemia Symptoms

• Convulsions (seizures)
• Loss of consciousness
• Inability to swallow

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Hypoglycemia Prevention

• Keep a quick-acting sugar source with the
  student. ALWAYS.
• Treat at onset of symptoms
• Eat, Insulin, Test, Exercise ON TIME.
• Ensure reliable insulin dosing, per DMMP.
• Ensure insulin dosing matches food eaten.
• Watch picky eaters
• Provide nutritional information to families
• May give insulin after eating if intake uncertain

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HYPERglycemia HIGH Sugar

• Too much sugar in the blood, but cells are
  starving
• Onset
• Severe hyperglycemia is usually slow to develop
• Can be rapid with pumps
• Hyperglycemia due to insufficient insulin may
  lead to diabetic ketoacidosis (DKA) if not
  treated (mainly in type 1)

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Hyperglycemia Possible Signs Symptoms
Severe Symptoms Severe Symptoms
Labored breathing Confused Very weak Unconscious Labored breathing Confused Very weak Unconscious

Moderate Symptoms Moderate Symptoms











Dry mouth Vomiting
Stomach cramps Nausea
Mild Symptoms
Lack of concentration Thirst
Frequent urination Blurred vision
Flushing of skin Increased hunger
Sweet, fruity breath Weight loss
Fatigue/sleepiness Stomach pains
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Hyperglycemia Risks Complications

• Hyperglycemia due to inadequate insulin can lead
  to DKA and/or coma or death (mainly in type 1).
• Interferes with a students ability to learn and
  participate.
• Serious complications develop when glucose levels
  remain above target range over time or are
  recurring.

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Hyperglycemia Prevention

• Eat, insulin, check BG, exercise ON TIME.
• Reliable and accurate insulin dosing, per DMMP.
  
• Ensure that food eaten matches insulin dosing
• Monitor food intake per DMMP
• Report binge eating
• Teachers consult parent/guardian prior to extra
  snacks.
• Consult with parent/guardian when snack, meal, or
  exercise times must be changed.

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MEDICATIONS

• The school district, its board of trustees, and
  its employees are immune from civil liability
  from damages or injuries resulting from the
  administration of medication to a student ifthe
  school district has received a written request to
  administer the medication from the parent, legal
  guardian, or other person having legal control of
  the student when administering prescription
  medication, the medication is administered
  either (A) from a container that appears to be
  the original container and properly labeled or
  
  (B) from a properly labeled unit dosage
  container
• TEC 38.015 Self-Administration of Prescription
  Asthma or Anaphylaxis Medicine by Students

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• Attractiveness is based on a positive, caring
  attitude and has nothing to do with face-lifts
  or nose jobs.

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SERVING SIZES, THEN AND NOWThe Land of Plenty?
1950 2003
French Fries 2.4 oz 7.1 oz
Soda 7oz 12 - 64 0z
Hamburger patty 1.6 oz 4.4 12.6 oz
Muffin 3 oz 6.5 oz
Pasta 1.5 cups 3 cups
Candy bar 1 oz 2.6 8 oz
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What Are We Eating?

• Standard
• American
• Diet

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PIMA INDIANS

• American Pima Indians live in Arizona for
  centuries
• Until the 1950s, they had been thin, fit and
  healthy
• Pima Indians in Mexico still live the lifestyle
  of the ancestors and are still healthy
• The Arizona Pima Indians 80 are diabetic, life
  expectancy 46 years
• -Ultrametabolism Mark Hyman, MD Mark
  Liponis MD

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Students intake of soda

• More sodas not only lead to obesity, but also
  bone fractures and more cavities. Even diet soda
  harms teeth!
• Teenage boys 2.2 sodas/day 800 cans/year
• Teenage girls 1.7 sodas/day
• Soda provides no VITAMINS, no CALCIUM, no
  PROTEIN, no FIBER.

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HOW MUCH WATER DO YOU NEED?

• 8 10 glasses of water daily,
• in addition to other liquids
• Not enough water intake can cause
• fluid retention
• constipation
• unexplained weight gain
• loss of the natural thirst mechanism

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FUNctional Foods

• Almonds lowers LDL and total cholesteral
• Avocado reduces risk of CVD
• Beans reduces risk of CVD and diabetes
• Blueberries Reduces risk of cancer
• Broccoli lowers LDL, reduces risk of cancer,
  maintains healthy immune system
• Cheese decreases risk of certain cancers

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FUNctional Foods

• Garlic reduces risk of cancer lowers
  cholesterol, BP
• Hot cocoa reduces risk of CVD, cancer
• Milk reduces risk of osteoporosis, BP, colon CA
• Oatmeal reduces total cholesterol/LDL
• Olive oil improves cholesterol levels

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• Tea, black/green - reduce risk of stomach,
  esophageal and skin CA, CVD
• Tomatoes reduce risk of prostate CA/heart
  attack
• Tuna Reduce CVD
• Tree nuts enhance mental functioning, lowers
  total cholesterol and LDL

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FUNctional Foods

• Whole Grains reduce risk of certain CA and CVD
• Red wine, grapes, grape juice reduce risk of
  some CA and CVD
• Yogurt (live culture) improves intestinal
  health, reduce risk of CA, lowers cholesterol

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Tarahumara Indians

• Their only transportation between villages is
  running on foot
• Known to run 50 60 miles for hunting, carrying
  messages
• Harvard Univ studied aerobic capacity, fitness
  and lung capacity. 60 year olds were in better
  shape than the 40 year olds, who, in turn, were
  more fit that the 20 year olds.
• - Ultrametabolism Mark Hyman, MD Mark
  Liponis MD

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10,000 Steps a Day

• Journal of American Medical Association studies
  show that this type of daily walking, as
  lifestyle approach, can be effective
• 10,000 steps a day will burn between 2000 -3500
  extra calories per week
• Putting on a pedometer can track daily activity,
  every step counts. It is recommended that at
  least 30 minutes be fast enough to break a sweat
• Start slow and work your way up to 12,000 to
  15,000 steps a day for successful weight loss

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A Daily Moving Experience

• Physical activity can help physically and
  emotionally
• Releases endorphins, which give a sense of
  well-being
• Increases blood circulation through the body,
  including the brain, assists with problem-solving
  ability
• Uses up excess adrenalin and cortisol

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Wash Hands Frequently

• The simplest precaution against the spread of
  bloodborne pathogens and other germs is
• Hand-washing.

• Wash your hands with non-abrasive soap and
  running water for at least 15 seconds.
• Dry your hands and throw away the towel.
• Use a clean towel to turn off the faucet.
• If hand-washing facilities are not available, use
  anti-bacterial hand cleanser as a temporary
  measure until you get to a sink.

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• There is no exercise
• better for the heart
• than reaching down
• and
• lifting someone else up.

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RESPONSE-ABILITY

• It is PROACTIVE instead of REACTIVE
• Looks to the future instead of dwelling on the
  past
• Asks What can we do from here? or Whats the
  solution? instead of Who did it?
• Whatever you dwell upon grows
• 100 of your response to any situation is under
  your control

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A careless word can kindle strife. A cruel word
may wreck a life. A timely word may level
stress. A loving word may heal and bless.
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Anything said by a Prestigious Person is taken
as a true representation of reality, especially
a child. It by passes the conscious mind and
goes straight to the subconscious and is stored
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The happiest people dont necessarily have the
best of everything, they just make the most of
everything that comes their way.
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Love begins with a smile, grows with a kiss and
ends with a tear. When you were born, you were
crying and everyone around you was smiling. Live
your life so that when you die, youre the one
smiling and everyone around you is crying
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You Make a Difference

• Do more than exist LIVE
• Do more than hear LISTEN
• Do more than touch FEEL
• Do more than talk SAY SOMETHING

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I AM A TEACHER

• I Integrity
• A Active Listener
• M Memory Makers
• A Attitude
• T Time Together
• E Eat Fruit/Veggies
• A Active
• C Cough Etiquette
• H Handwashing
• E - Empathetic
• R Role Model

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It is the little thoughtful things you do for
people that they will remember.