RCE Nurse Knows

2009 in the RCE clinic

2009-01-26T09:57:00.000-08:00

Allergies and sinus drainage seem to be causing many problems for us in Houston. Thanks to cold fronts,which have brought mountain cedar pollen with them, we have been experiencing high tree pollen counts. I've also noticed trees in bloom already in my neighborhood, so keep an eye on the pollen counts as we head into our traditional allergy season. And remember, that allergy symptoms can include stomach upset (from sinus drainage) and a light-headed, dizziness. Houston is prime for allergies due to our long growing season. We have great weather in the Spring that welcomes us outdoors. Just remember that pollen may be in the air and covering us as we enjoy the great outdoors. Such things as showering and changing clothing after being outside can cut down on continued exposure to pollen. So be sure to have your baseball players shower after practice...for more reasons than just this!
Parents have reported to me that we have had a few cases of the Flu, diagnosed by doctors. These children have not had the high temps that normally go along with the flu. Please let me know if your child is diagnosed with the Flu, or any other contagious illness.

2008-04-23T06:15:00.000-07:00

RCE Clinic update, week of April 21st:
We are still seeing many kiddos with strep throat. Some have fevers, some do not. Sore throat and stomach ache/ nausea are common signs.
We also have lice (yikes!) sightings every week. So, please, check your children weekly. Most cases can be traced back to sleepovers. If your child plays baseball/ softball, be sure they use their own helmet, rather than sharing all that may come with the team helmets.
Please remember that I need a doctor’s note authorizing me to give your child prescription medicine at school. This is in addition to the pharmacy label that is on the medicine. This has been the SBISD policy for a very long time. It is based on the law in the State of Texas. A link to the official form is on our school website. In a pinch, if you do not have the form with you, have the doctor write and sign an authorization and bring that to me. Doctors usually know what to write!
Please keep your child at home for a full 24 hours, fever-free, after they have a fever. Body temperatures fluctuate during the day. Your child’s temp may be normal first thing in the morning, and then be in the fever range as the day goes on. We have seen fever viruses that tend to act this way.
The weather has become warmer and our students are very active at school and on the playground most school days. Here are a few reminders:
- The shoes your child wears to school need to be durable, and also cover and protect their feet. I have seen foot injuries that would not have occurred if the child had worn more protective shoes. Sandals, flip flops, and the like do not give much protection to busy children’s feet. They are very cute, but not the best choice for our very active environment. Your child will be safest while running and climbing, wearing their good old athletic shoes every day.
- Houston weather may become very hot during the next few weeks. Encourage your child to stay hydrated at school by sending them with their own water bottle every day.
-Watch itchy mosquito bites on your child’s body for signs of infection. We have had several children at RCE become very ill from infected bites…and it happens FAST!

2008-04-23T06:12:00.000-07:00

We are seeing many students with strep throats these days. Below is the letter I sent to all Kindergarten parents this week to alert them to watch for this in their children.

April 21, 2008

Dear Parents of Kindergarten Students:

STREP THROAT seems to be making the rounds of your child’s grade level right now. Quite often these days, strep throat does not look like strep throat of the past. We are seeing children without fever, and sometimes without even a sore throat, who test positive for strep. Sometimes a stomach ache is the only symptom. Because it “doesn’t look like strep” many doctors will not do a strep test unless the parent requests it. So, if your child just seems to not feel quite right, and you take them to the doctor in the near future, it’s probably a good idea to have them checked for strep.

Other hints:
-Keep your child at home for a full 24 hours after they have begun antibiotics…longer if your doctor recommends it or if your child is not feeling well.
- Remember to finish ALL of the prescribed antibiotic. Do not stop it after your child is feeling better, and hold on to the extras for the next time!...a sure way to increase antibiotic resistance….not good!
-Change your child’s toothbrush after they have been diagnosed with strep and have taken at least 24 hours of antibiotic. Keeping the same old toothbrush will re-infect your child UNLESS you run it through a complete dishwasher cycle. In fact, cleaning your child’s toothbrush in the dishwasher is a good thing to do on a regular basis!
-Remind your child to wash their hands frequently, and to cover their mouth with their arm, rather than their hand, when coughing and sneezing. These practices help to prevent the transmission of germs.
Hope this helps!
Karen

Lice Alert

2007-12-04T08:44:00.000-08:00

Parents,
Please be aware that we have lice in several grades right now. Please check your child's hair AT LEAST every week. If you have never dealt with lice, and do not know what to look for, please go to www.headlice.org . This is a great website, all scientifically-based research, and pictures of what to look for. Lice outbreaks at this time of the year are very common, with cold weather, lots of extra clothing, and folks "huddling together" to stay warm. Please watch carefully and let me know if you see anything. Remember that no commercial lice product is 100% effective. You must be vigilant about removing eggs to prevent a re-infestation. Remind your children that they may not share any hair-related items. Students with long hair are safest with their hair pulled back close to their head, either ponytail or braids. Send them to school that way EVERY day! You do NOT want to have to deal with this problem if you can avoid it!

SBISD Medication Policies

2007-11-14T06:48:00.000-08:00

SBISD has very specific policies regarding medication use at school. There is a link to the required forms on the RCE campus home page. I also have the forms in the school clinic.
ANY PRESCRIPTION MEDICATION must have a form signed by both the doctor and the parent...NO EXCEPTIONS, and they MUST be in the pharmacy container! NON-PRESCRIPTION MEDS may be signed for by the parent, and must be given according to the label on the package (age /weight). All medications must be in the original container. Children are not permitted to transport medication to school. All of these policies are for your child's protection.
Here are a few tips to make this easier for you:
1. If the pediatrician prescribes med for your child and you do not have the SBISD form, ask them to write a note to the school on an "official" pad, with your child's name, the name of and schedule for medication(times of day and for how many days), and then their signature. We can attach that to the SBISD form which the parent signs.
2. When you have the prescription filled, ask the pharmacist for duplicate containers. Measure medication for school and bring only that container to school. Prescription meds must have the pharmacy label.
3. Liquids that need refrigeration (many antibiotics) lose potency when they are not kept cold. DO NOT have your child carry these medications back and forth every day....it is not good for the medication and so not good for your child.
4. Do not wrap Tylenol or Motrin in a bag or foil and put it in your child's lunch box, just in case they need it later in the day! Teachers are always on the lookout for contraband! and they will send your child to me with the medication. We cannot give them any medication that is not provided according to SBISD policies. It is not safe for your child to carry medication. Have you seen our lost and found pile???...things get lost at school! We want to protect ALL of our children from contact with unknown substances at school.

2007-11-14T06:47:00.000-08:00

11/14/07
STREP THROAT seems to be on the rise at RCE. Several parents have told me in the past few days that their child was diagnosed with it.
Symptoms to watch for include: sore throat, sometimes accompanied by stomach ache, and fairly high fever, occasionally vomiting. Sometimes children have NONE of these!
Strep throat is diagnosed by strep tests, one rapid and one that takes longer. The rapid strep test can give false negative readings, so many doctors will do both if they suspect strep but get a positive result from the rapid test.
Strep throat needs to be treated by a full course of antibiotics. That means USE ALL OF THE MEDICINE!!! NO EXCEPTIONS!!! It might help to ask the doctor to prescribe medication that needs to be given 2 or 3 times per day rather than 4 times per day…it’s just easier to remember to give all of the doses that way. Leave reminders around the house where you will see it. Stopping the antibiotic early, “because they feel better” can help the bacteria get stronger and mutate, requiring even stronger antibiotics. DON’T DO IT! Remember that untreated strep throats can progress to Scarlet Fever and eventually Rheumatic fever, which is rare but can effect your child’s heart. So take notice!

Pre- K and Kindergarten ailments

2007-11-12T06:56:00.000-08:00

We have seen several ilnesses recently in Pre-K and Kindergarten that parents need to know about. The stomach virus that has been making the rounds is sometimes accompanied by high fever (may get to 103 or 104 before Tylenol/ Motrin) for a day or two, and stomach upset/ diarrhea that lasts for several days. Children seem to begin to feel better, but diarrhea persists for several days. Remember to gradually re-introduce solid food. Begin with clear fluids, such as water, ginger ale, clear soups, while they are having severe diarrhea. Ask your pediatrician about using pedialite during this time, helpful in preventing dehydration. There is new thought about what foods to use with children who are just getting over severe diarrhea, but who still have episodes of it, especially after they eat. Ask your doctor about the BRAT diet. Some pediatricians favor it, others do not. And, please keep your child at home while your child has diarrhea. Place extra clothing in your child's backpack when they are ready to return to school, just in case.
The other thing to watch for is persistent coughing (lasting for several days), with later fever development. If the fever (over 103) is untouched by medication (Tylenol, Motrin) and other interventions (lukewarm bathing), call your pediatrician. With 2 of our kiddos, chest films (xray) revealed pneumonia, even after the doctor heard nothing when listening to each child's chest. Hearing nothing may be a sign that part of their lung is blocked by the pneumonia. Both doctors remarked at the difficulty of diagnosis, because it didn't sound like typical pneumonia sounds.

Flu Shots

2007-11-01T07:21:00.000-07:00

11/1/07
I was a little bit concerned when I realized that we gave only 30 FLU SHOTS at RCE this year. In past years we have given between 80-100. I am hoping that our reduced numbers are due more to the easy availability this year (you can get it at most pharmacies in local supermarkets right now) rather than apathy about the approaching flu season. If you have not yet received your flu shot or provided this for your children, now is the time to do this. We can’t predict how severe this year’s flu season will be. So, get ready for it now!
From the Centers for Disease Control: This year, Tuesday November 27, 2007, is set aside as Children’s Flu Vaccination Day, with a focus on vaccinating high-risk children. Each year, over 20,000 children are hospitalized as a result of influenza. This day will help raise awareness about the value of vaccinating children—especially high-risk children—and their close contacts.
We do have a number of children at RCE who are considered “high risk”. If your child is one of them (and children with a history of asthma are considered high risk for flu) hopefully you have already taken care of this. Even if your child is super-healthy, remember that they come in contact with other family members, teachers and students, who may either transmit the flu to them, or become very ill if they contract the flu. Do your part now to protect your family and community.

Welcome to the Nurse's Blog

2007-10-31T08:09:00.000-07:00

October 31, 2007 We are beginning to see cases of lice in a few students. The ones I have seen are in grades 1, 2 and 3. This is a good time for a few reminders about lice…according to an article in yesterday’s Houston Chronicle, we are getting into the time of the year with cooler weather when we tend to huddle together more and wear, and perhaps share, more clothing, both of which provide more opportunities to share critters. So, take the time to be proactive with your children. Check their hair weekly under a bright light or outside in the sun for anything that should not be there. Check more frequently if they are itchy or if you hear of a case among their friends or classmates. Look from different angles, a section of hair at a time. If you do not know what to look for, go to www.headlice.org for pictures of both lice and their eggs. You may not see lice, as they are fast moving bugs. You may instead see eggs attached to your child’s hair. Something has put them there, so eggs are a sign of lice infestation. I caution you not to overlook the signs. The longer you take to deal with this, the bigger the job you will have.
Treating a lice infestation takes time and patience. Call me if you feel like crying...it can be overwhelming. There are many products on the market…read product literature carefully, consider the chemicals in each product. Commercial products contain pesticides…that’s what kills the bugs. Do not OVEREXPOSE your child to pesticides. Know that there are some “natural” products and methods available. Also know that no product is 100% effective…there is NO magic bullet no matter how much you pay for a product. This is a time-consuming, labor-intensive process, so take a deep breath, and maybe get some good videos for your child to watch as you go through their hair. Remember, that the key to getting rids of lice is to keep the hair clear of eggs. Then, after treating your child, you must clean your home, clothing, bed linens and towels, furniture, carpets, and car…anywhere lice may hide. Try to involve your entire family in this process…it’s too much for you to do alone.
Again I urge you to take a look at www.headlice.org This is a very informative website, backed by research, aware of health concerns caused by some treatments, and with many good suggestions and alternatives.

Please remember that your child did not invite the little critters to take up residence in their hair, but your child can take some responsibility to protect themselves from future contact. So, help them learn how to protect themselves from lice.
Girls with longer hair are safest when their hair is worn close to their heads, which means: ponytails, braids, pig tails, etc. EVERYDAY!
NO SHARING anything that has contact with hair: hats, scarves, head-bands, combs, brushes, hairclips, hooded jackets, helmets (batting, football, bicycle), etc.
Sleepovers: have your child bring their own pillows and blankets.
Check family members weekly.
Let the school nurse know if your child has lice. This helps me find contacts who may be in school. I’m a good secret keeper and will not tell others.