Bellyache

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Specializes in School Nurse.

My most dreaded office visit. How do you deal with them?

I always start with a temp check, listen for bowel sounds, palpate, then ask about most recent meal, gas, n/v and feel like I'm just pacifying more than anything - but what I really want to do is just send them home hah.

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I do all the above, ask them if they want to use the bathroom. If they straight up refuse bathroom, and VSS and assessment normal, I send them back to class. I have 600+ kids at my school, but I usually know which ones really have an issue and which other wants just want to see if I will send them home.

Also, a lot of kids at my school have not eaten and so are hungry....easy fix!

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Specializes in School nursing.
On 1/31/2020 at 8:24 PM, Skigirl978 said:

I do all the above, ask them if they want to use the bathroom. If they straight up refuse bathroom, and VSS and assessment normal, I send them back to class. I have 600+ kids at my school, but I usually know which ones really have an issue and which other wants just want to see if I will send them home.

Also, a lot of kids at my school have not eaten and so are hungry....easy fix!

All this.

As Scrubs said "It all comes down to poo" and so often they are right! Constipation is huge in kids - especially the MS/HS population I see. Also, they don't eat. Or what they do eat is sugar, sugar, and more sugar. And the sugar breakdown in digestion can cause a major stomachache.

What age are you working with? Because of the age I work with, I will also any of my students with a uterus "regular stomach or girl stomachache?" to determine if matter is cramp related - especially if my office is busy with mixed gender company ;).

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Specializes in School Nurse, past Med Surge.

I rarely listen & palpate. My building is K-3. I check temp, ask about what/when they last ate, ask if they're pooping OK, then let them rest for 10-15. If they're still complaining I'll have them point to where it hurts, sometimes I give them a Tums. 95% of the time it's just an "I miss mom" or "I want to get out of class for a little bit" stomachache and they bounce out of here just fine.

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38 minutes ago, SaltineQueen said:

I rarely listen & palpate. My building is K-3. I check temp, ask about what/when they last ate, ask if they're pooping OK, then let them rest for 10-15. If they're still complaining I'll have them point to where it hurts, sometimes I give them a Tums. 95% of the time it's just an "I miss mom" or "I want to get out of class for a little bit" stomachache and they bounce out of here just fine.

Same here - I only do an extensive assessment if they seem to be in alot of pain, crying, doubled over etc.

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I usually do temp, figure out if it's nausea or pain, last bowel movement, did you eat breakfast/snack/lunch, offer them 5 minutes in my quiet bathroom, sometimes lay on their belly in the office for a few minutes (gets the gas out) if I don't think they're faking it. Usually it's "see if you can make it to (next "event" of the day) and if it doesn't get better come see me again."

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Specializes in kids.

HS nurse here, so I always ask about LMP, unprotected sexual activity in order to assess for pregnancy or STI in addition to all the others noted above.

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Specializes in ICU/community health/school nursing.
15 minutes ago, BiscuitRN said:

sometimes lay on their belly in the office for a few minutes (gets the gas out) if I don't think they're faking it.

This is GENIUS!!!

11 minutes ago, NutmeggeRN said:

HS nurse here, so I always ask about LMP, unprotected sexual activity in order to assess for pregnancy or STI in addition to all the others noted above.

Sad reality but excellent history taking skills!

Unless there's a chandelier sign (you palpate the abdomen and the kid screams and climbs the wall to hang on the invisible chandelier) there's really not much we can do until emesis happens.

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Specializes in IMC, school nursing.

We do a 12 ounce water challenge, if they are going to puke, that will induce it. Otherwise back to class. My wife had 2 members of the same family with stomach complaints, father is a staff member here and mom was home from a long business trip. Yup, they wanted to see mom. If you send every child home, you are not necessary, a secretary can do that. That is what my school did before we were here.

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Specializes in School nursing.
38 minutes ago, NutmeggeRN said:

HS nurse here, so I always ask about LMP, unprotected sexual activity in order to assess for pregnancy or STI in addition to all the others noted above.

True story. LMP is a must for me for any student with a uterus. Than sexual history.

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I've seen one for a tummy ache 3 times today. Between visits 2 and 3, I asked the teachers how he was doing: apparently, he was caught stealing from a teacher's desk first thing this morning and his tummy ache was guilt induced.

I second all of the above advice and add "check in with a the teacher" if it becomes an issue.

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Specializes in School Nursing, Ambulatory Care, etc..

Same as everybody else has said.

When I worked elementary school, I would ask them to jump up and down - a kid who can't or won't d/t pain or nausea deserves more assessment and (most likely) a call home for pick up.

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