Diabetic student having surgery

Specialties School

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Specializes in Cardiology, School Nursing, General.

Student is not here today and mom called telling me that yesterday, after he went home for severe stomach pains (We thought it was Diabetic issue), is having surgery for his appendix. I didn't think it would be that since usually when he has these stomach pains it's his glucose and ketones issue.

Mom said she will let us know how it goes, but I'm worried it might be my fault, or I didn't take care of him well enough.

What were his signs and symptoms?

Appendicitis can come on very quickly.

Specializes in School Nursing.

What else could you have done? You called a parent and sent him home. If he worsened at home (vomiting and even worse pain) then his parents took him in and now he'll get his appendix taken care of. You didn't do anything wrong.

Specializes in Cardiology, School Nursing, General.
What were his signs and symptoms?

Appendicitis can come on very quickly.

Sweating, stomach pains, nausea. But he has these when he has large Ketones, so I didn't think twice. I checked his BG twice before him going home, and they were 155 and 170.

Specializes in Cardiology, School Nursing, General.
What else could you have done? You called a parent and sent him home. If he worsened at home (vomiting and even worse pain) then his parents took him in and now he'll get his appendix taken care of. You didn't do anything wrong.

That's good to hear, I just don't know what else I could of done.

Specializes in ICU/community health/school nursing.
That's good to hear, I just don't know what else I could of done.

Nothing else. You're not mom.

Specializes in Cardiology, School Nursing, General.
Nothing else. You're not mom.

Thank you. I'm trying to not feel at fault. I just hope he comes out alright and doesn't have stomach issues anymore.

Can his high glucose be also attribute to have appendicitis?

Specializes in School Nurse, past Med Surge.

You did not cause his appendix to become inflamed. You do not have a CT scan in your office. You got him home, which was a sound decision. Not your fault, nothing you could have done.

Just FYI: RLQ rebound tenderness is the classic sign for appendicitis. Are you trained to know this as an MA (no offense)? When we had my son in the ER for what we thought was appendicitis, the doc had him do these two things: sit up from a supine position without using his hands/arms...so just engaging his core muscles, and hop on his right foot. He could do both of those things so doc said it was not his appendix.

Specializes in School Nurse, past Med Surge.
That's good to hear, I just don't know what else I could of done.

Short of taking out his appendix, nothing. You're good.

Specializes in Cardiology, School Nursing, General.
You did not cause his appendix to become inflamed. You do not have a CT scan in your office. You got him home, which was a sound decision. Not your fault, nothing you could have done.

Just FYI: RLQ rebound tenderness is the classic sign for appendicitis. Are you trained to know this as an MA (no offense)? When we had my son in the ER for what we thought was appendicitis, the doc had him do these two things: sit up from a supine position without using his hands/arms...so just engaging his core muscles, and hop on his right foot. He could do both of those things so doc said it was not his appendix.

No, we aren't trained in that aspect. I do the symptoms and such of appendicitis but as I said, we thought it was diabetes related since he has had these symptoms in the past and it was his Ketones usually. But I was reading up on it and him having issues peeing into the ketone testing strip should of been a red flag for me, but I didn't know.

Specializes in ICU/community health/school nursing.
You did not cause his appendix to become inflamed. You do not have a CT scan in your office. You got him home, which was a sound decision. Not your fault, nothing you could have done.

Just FYI: RLQ rebound tenderness is the classic sign for appendicitis. Are you trained to know this as an MA (no offense)? When we had my son in the ER for what we thought was appendicitis, the doc had him do these two things: sit up from a supine position without using his hands/arms...so just engaging his core muscles, and hop on his right foot. He could do both of those things so doc said it was not his appendix.

High glucose could possibly have contributed to inflammation but in no way "caused" the appendicitis. And Saltine Queen is right...AND the kid still could have passed all those hospital tests AND had appendicitis. My kid had no RLQ tenderness, no rebound tenderness, could hop on one foot AND still had an emergency appendectomy.

You're way over your pay grade here - assess, call parent, done.

Specializes in School Nurse, past Med Surge.
High glucose could possibly have contributed to inflammation but in no way "caused" the appendicitis. And Saltine Queen is right...AND the kid still could have passed all those hospital tests AND had appendicitis. My kid had no RLQ tenderness, no rebound tenderness, could hop on one foot AND still had an emergency appendectomy.

You're way over your pay grade here - assess, call parent, done.

Yeah...appendicitis is tricky. No one really knows what that little thing is for or why it gets angry & wants to come out. Like NOW!! It's a fickle little (useless) thing.

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