Bellyache

[iRNman]

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.

[ruby_jane, BSN, RN]

49 minutes ago, BunnyBunnyBSNRN 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.

Jumping up and down on toes was an ER doc's tip to me for ruling out appendicitis, and I use it to this day. However, if there's impacted poop up in there, the kid will also complain of pain so it's not the best differential dx... Of course, if it's gas....the jumping may mobilize that as well.

[BunnyBunnyBSNRN, ASN, BSN]

Just now, ruby_jane said:

Jumping up and down on toes was an ER doc's tip to me for ruling out appendicitis, and I use it to this day. However, if there's impacted poop up in there, the kid will also complain of pain so it's not the best differential dx... Of course, if it's gas....the jumping may mobilize that as well.

I'm pretty positive I learned the "jump up and down" assessment tool from here....maybe even from you??? ?

this is why I love this board - support, tips and tricks, and people that find the same things funny as I do. ❤️❤️

[SaltineQueen]

8 minutes ago, ruby_jane said:

Jumping up and down on toes was an ER doc's tip to me for ruling out appendicitis, and I use it to this day. However, if there's impacted poop up in there, the kid will also complain of pain so it's not the best differential dx... Of course, if it's gas....the jumping may mobilize that as well.

When we thought my son might have appendicitis the doc had him do this and also lay on his back and try to sit up without pushing with his arms...just engaging his core. They shouldn't be able to do that if it's a hot appendix.

[SchoolNurse91, BSN, RN]

I check temp, ask when they last ate/pooped. I have them go to the bathroom and then lay down for 10 minutes. They're usually so bored by 3-5 minutes that they ask to go back to class

20 hours ago, BeckyESRN said:

apparently, he was caught stealing from a teacher's desk first thing this morning and his tummy ache was guilt induced.

I had this happen last year- a third grade girl came in crying and clutching her stomach. Actually made me nervous. Was complaining of pain with palpation, etc. Really really dramatic. I went over to the front desk to tell them I was calling mom for pick up and to be on the lookout and the principal happened to be there. When she heard who was in my office she says "Oh she was just in my office and is in major trouble. She got caught writing the F word in sharpie in the stair well and mom is already on the way" ? Would have been really nice if someone had given me a heads up. Teacher knew and sent her down to me when she complained of a stomach ache. Needless to say the kid was 100% A-OK!