What would you have done?

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I had a 16 y/o girl present with pale skin, headache, nausea, dilated pupils, sitting b/p 104/70, pulse ox showed mildly tachy (104). Laid her down on the floor of an empty office (I don't have a health room or office.) put her feet up and started pushing fluids. It was right after lunch & she said she had eaten. She said this had happened twice before but that she'd never seen a doctor. I gave her some graham crackers to eat & started calling parents. I told dad I was very close to calling an ambulance.

She improved but would still get sick when sitting up. I told dad when he got there that I was concerned she would pass out if she had to stand or sit up & would feel better if we sent her by ambulance. Dad wasn't too concerned & said she might just be dehydrated. Her color somewhat improved & pupils. I took her out by wheelchair.

I spoke with mom about 4 hours later & she tells me her daughter has hypoglycemia--we have no record of this at school. Mom was just getting home & this young lady is still not feeling well & headache...

I am worried about her & thinking I made the wrong decision not to call an ambulance. Mom doesn't seem concerned but I was very close to calling....

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Seems fine. She is not altered, nor is she unstable. If parent requests for 911, then it is a different story. Focus on interventions to provide a safe school environment from this point forward.

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Specializes in Pediatrics Retired.

I can't think of anything you should have done differently or should not have done differently. You've beat yourself up enough already. Let it go, Nurse. You did a great job.

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Thanks Old Dude!! I am doing a good job of second guessing every decision I make & beating myself up. Hopefully, I can get better at letting go of it.

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Specializes in 12 years as a school nurse.

I might have asked about substances (drug exposure-dilated pupils), pregnancy possibility, or menstrual cycle with these symptoms. Otherwise you did what you could. I have several HS girls that get severe symptoms with their cycle (pale, dizzy, nausea, vomiting). Now knowing the bit about hypoglycemia I'd ask for a doctor's note concerning what to do at school if these symptoms happen again.

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Specializes in kids.

I agree with all of the above and also the date of her last period....

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