Leslie Currin, R'N'

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Leslie Currin, R.N.

• School Health Services Specialist

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4 Disease Entities

• Attention Deficit Disorder
• Epilepsy
• Diabetes
• Asthma

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Attention Deficit Disorder

• 6 to 8 student population (estimate)
• Medical Treatment
• - Behavioral
• - Medication

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• Affect on students school performance
• Inattention, hyperactivity, impulsivity
• - difficulty with focus
• - difficulty with follow through
• - may include oppositional behavior

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• Incidences in Oregon schools
• How many in this room have had interaction with a
  student with this diagnosis?

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MEDICATION
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• Medications History
• 3 times daily, necessitating one dose during
  school hours.
• Medications currently
• 1 time daily, usually not given at school.

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Causes

• Unknown, but may include
• - brain injury
• - genetics
• - environmental agents
• - etc.

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School Nurse

• Frequent interactions
• Injury
• Medications (through adulthood)
• Behavior plan interface

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Epilepsy

• 300,000 diagnosed cases in children under 18
• Frequently undetected
• Males more likely
• Onset before 18 in 50

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Causes

• Unknown in 70 of cases
• When known
• Head injury
• Brain tumor / stroke
• Infection
• Other

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Types

• Grand Mal
• Petit Mal or Absence
• Other

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Treatment

• Goal full or partial control (achieved in 85 of
  cases)
• Medications
• Surgery
• Diet

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School Nurse Role

• Emergency Care Plan
• Safety during seizure
• Interface with parent and MD
• Participate in IEP plan / 504 plan process
• Medication management
• Many medications
• Frequent changes in dosage and medications due to
  childrens growth and metabolic changes

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School Nurse Role cont.

• Education for school staff
• Nature of the disorder
• What to expect from seizure
• Influence of medications on learning abilities
• Interface with parents
• Medication interactions and changes
• Frequency of seizure

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DIABETES
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Types

• One insulin dependent
• Two non-insulin dependent

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Affect on Attendance and Performance

• Good control of blood sugar best attendance and
  best academic performance

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Who Gets It?

• In Oregon (and nationally), an upsurge in children

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Causes

• Unknown
• Autoimmune disorder
• Some set of environment and genetics sets off the
  autoimmune disfunction

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Treatment during school day

• For Type I
• Insulin (/frequent injections/insulin pumps)
• Frequent checks of blood sugar
• Diet Monitoring

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Children

• Frequent changes
• Growth
• Metabolic maturation
• Activity levels
• Dietary changes

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Affect of poor control

• Lost school days
• Hospitalizations
• Impaired mental functioning leading to decreased
  academic performance

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Emergency events

• Low and high blood sugars can lead to coma and
  death
• Rapid onset (low)

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Treatment in School

• Insulin
• Diet
• Blood sugar checks during the school day

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School Nurse Role

• Emergency care plan
• Participate in 504 plan process
• Instruction of designating school staff in
  special tasks (blood sugar monitoring, dietary,
  etc.)
• Staff instruction
• Interface with parent and doctor re., changes
  to care plan

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ASTHMA
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Leading cause of school absence

• In Oregon, 6 diagnosed with asthma
• 2-3 students per each class of 30 students

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What is it?

• Chronic
• Affects air passages in lungs
• Causes varied

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Symptoms

• Cough
• Wheezing (whistling sound)
• Chest tightness
• Short of breath

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Treatment

• Medications
• Stay away from triggers
• EMS for airway obstruction

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School Nurse Role

• Emergency Plan
• Asthma treatment plan
• Teach specific tasks to involved staff
• General staff education on the disease
• Interface with parents / doctors
• Work with affected student on his/her ability to
  recognize early signs, and treat early in the
  episode
• Participate in 504 plan generation