Throat exams

kidzcare · Feb 9, 2015

"Joey says he has a sore throat, but I have no idea what his throat looks like because I can't get a good look because he won't move his GIANT TONGUE out of the way."

Hahahahahahaha! I would love to chart this.

"Visualization of throat not possible r/t Tungus Giaganticus" :)

I don't have any tricks. I run into the same problem and I do sometimes use tongue depressors but like you said, they fight it and I'm not going risk a broken piece of tongue depressor cutting a kids mouth or getting puked on.

As long as there are no other objective findings, I let them head back to class.

SnowyJ, RN · Feb 9, 2015

Some kids just won't open or stick their tongue out far enough. Then of course they gag like crazy if you try to use the tongue depressor. I always wonder just how anyone ever gets a strep culture with those kids!

I do the same thing if it's a big fuss to be able to see. I usually have them do a warm salt water gargle, then let the parent know.

JenTheSchoolRN, BSN, RN · Feb 9, 2015

Hahahahahahaha! I would love to chart this.
"Visualization of throat not possible r/t Tungus Giaganticus" :)
I don't have any tricks. I run into the same problem and I do sometimes use tongue depressors but like you said, they fight it and I'm not going risk a broken piece of tongue depressor cutting a kids mouth or getting puked on.
As long as there are no other objective findings, I let them head back to class.

Lol, me too! I have some kids with pretty strong gag reflexes and giant tongues - so sometimes I do document that throat was difficult to visualize and the other findings.

Wave Watcher · Feb 9, 2015

My problem is I have kids that come into my clinic saying their mom/dad wanted them to come see me so I can find out if they have strep. I don't even look at their throat. I send a note back home saying that they need to be assessed by a physician and a possible quick strep test if needed. That is the ONLY way we know if anyone has strep. Tired of it.

GmaPearl BSN RN · Feb 10, 2015

The aaah sound tends to drop the tongue a bit farther down than the ah sound. And I do not use gag sticks except to apply soda paste to insect bites/stings.

Saw a throat today that was a glowing burgundy! Poor kid was in some pain. Warm saline gargle in the health room and advised mom to check in with their Doc.

kidzcare · Feb 10, 2015

My problem is I have kids that come into my clinic saying their mom/dad wanted them to come see me so I can find out if they have strep.

This drives me bonkers! Kids come in straight from the bus "My mom told me to come see you so you can check my (temperature) (wrist that I hurt over the weekend) (throat) (ears)"

AdobeRN · Feb 10, 2015

I don't have any tricks either.....I don't use tongue depressors - I just have the kid open mouth and I use my pen light to assess then I just let the parents know - yes throat is red, I really cant see anything because of the tongue or even sometimes I just come out and say I really can't tell - if you are concerned/your child continues to complain - please see your physician.

Drives me crazy when I get the request by parents "can you check to see if my child has strep"...ugh.

OldDude · Feb 10, 2015

I will occasionally look at throats but generally I don't. It really doesn't matter what I think; only what the doctor thinks. I've been burned too many times over the years in having an opinion... only for a parent to take the time out of their day to tell me the doctor said I was wrong. There's no telling what the parent told the doctor I said and I can't control that so I eliminate that scenario. School nurses get enough "pot shots" anyway and this is such a small town I don't need to provide the ammunition!!

allnurses Guide · Feb 10, 2015

I agree with OldDude. :up:

NanaPoo · Feb 10, 2015

I think I'm learning this the hard way, OldDude.

Thanks for helping us learn through your experience. I'm putting down my little flashlight and stepping away now.