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  1. nicole.schoolRN

    Diabetic question!

    Done. Now what? Wait? Keep reporting it?
  2. nicole.schoolRN

    Diabetic question!

    Hi everyone! You all helped me so much with my last question, now I have a fun new scenario! I have a diabetic student that was diagnosed back in June 2018. He is 10. He was last seen at the endocrinologist August 2018. His BG is all over the place but usually 300-400. Ketones usually negative but sometimes trace amounts. The DMMP that I have on file (FROM AUGUST) only allows me to give him insulin during lunchtime. I have contacted the diabetic educator and MD multiple times for further instruction but because he hasn't been seen in such a long time they are unable to give me further instruction or orders. Yes, I have reported this (the Dr. office did too!) His family will not take him to the doctor, nor will they give me any information why. I have offered to help in any way possible (car ride, insurance reasons, costs, etc.) but they wont accept help. The last time he has a high BG (427) I sent him home and he didn't come back to school for TWO WEEKS!! Family said he is home until they are able to "regulate" his sugar. So now I fear sending him home.... My question is... What is your school policy on high BG levels? Do you send home at a certain point? 911? I don't know what else I can do! **Help new school nurse and I don't have much information in my files about what to do in this scenario**
  3. nicole.schoolRN

    Asthmatic emergency

    I have a student that has severe asthma. When she has an attack, I immediately give her a nebulizer treatment which is the only medication that I have in my clinic. Let me tell you, her attacks are scary! She wheezes, has contractions and my pulse ox reader normally registers her O2 at 94-95%! After treatment, contractions and wheezes are gone but her O2 usually doesn't get much higher than 97%. Last week, she came in for a treatment in the early morning but returned an hour later, having another attack. Mom was working as a sub so I immediately paged her. After an assessment I offered to call 911 but mom was hesitant. Mom did give her an inhaler, and it helped a little bit. I called her pediatrician because I knew she needed help but I didn't want to overstep mom and call 911 without her permission. I'm a new school nurse and still get anxious about those kind of things... Long story short, Mom took her to the pediatrician after the student calmed down a big and she was admitted to the hospital for a couple of days. Mom stopped by the clinic this morning with an update and informed me that the next time this happens, I need to call 911 immediately, not her but 911. I was taken back seeing how I suggested that last week and she said no. Anyways, I'm curious when would you call 911 for an asthmatic patient? I don't want to be put in that situation again. Now thinking about it, I feel like I should call 911 on her initial attacks because they are so bad! Help..new school nurse and I'm second guessing everything!