Nursing Interventions

[ABRN2012]

This has probably been asked a million times before but do you have standard nursing interventions you do for students with say a headache (not a migraine), stomachache, ect. I check temp, ask when and how long its been hurting, pain scale, where the pain is, access for appendicitis signs if stomach ache, offer rest, or head down on desk, water, snack, soft peppermint. I cant give OTC meds but of course the teachers think I can cure things. But then they say I give peppermints and ice packs for everything and I do for a lot but just wondering if yall do other things I might could try. I dont have to notify parents and most of the time I dont unless they come back again. Just looking for more ideas. The help is greatly appreciated!

[River Song, RN]

Stomach ache before 11 a.m. -I always ask about breakfast. Take temp offer bathroom, have them drink a glass of water then back to class.

Stomach ache after lunch- inquire on what they ate for lunch after which they generally receive a lesson on how what they ate isn't nutritious as answers are usually something like chips, ice cream and chocolate milk. Take temp then bathroom, water and return to class. Edited to add: I don't keep mints or snacks so with the before lunch stomach aches, generally give them a pep talk of "I know it might be tough but I bet you can make it to lunch, you're such a trooper!" For the after lunch ones, it's generally a "wow there's only 2 hours left in the day! I bet you can make it!"

Headaches- ask for description of where it is, then assess for eating that day, drinking water and if they have been wearing their glasses (I get TONS of afternoon headaches and kids who don't wear their glasses). If they are smiling, chatty and clearly not really hurting- they get water a 5 minute dose of therapeutic boredom in a chair and back to class. If they actually seem to be hurting, then water and 15 minutes lie down. If still hurting after 15 minutes, I might call to see if a parent can bring in something OTC (I don't keep meds) - a lot of that depends on if they are a known frequent flyer. I rarely see unilateral headaches that could be migraines in my population (PK-5) and am more likely to allow longer rest and contact a family member to see if meds can be brought in.

The symptoms that I can't prove or disprove are the hardest so I just try to be consistent with how I approach it. Headaches and stomach aches are for sure the easiest way to skip out of class and kids learn that quickly.

[ruby_jane, BSN, RN]

I love all these answers!

Don't have much to add, but if the student is in frequently I usually chat with the teacher about behavioral expectations. As in: No medication in clinic, I called parent, they can't/won't bring anything, rest and ice pack is what I can do, and sometimes we go to work not feeling our best but we do it anyway.

Consistency is important. I also have a list of parents who want me to call every.darn.time their kid is in the clinic. So I do.

Actually...that worked in my favor this year. Turns out the kid who came in three times a week for headache medication actually had a concussion and nobody put the pieces together until mom and I had a good phone convo.