Assessing Medical Complaints of Children

From the Sprague School Nurse, Sharon Kahn RN

             Sometimes parents apologize to me when I notify them that their child is ill and requires dismissal, I feel there’s no need to apologize, since we aren’t able to predict that our children may become sick.  When your child has a good night’s sleep, eats breakfast and tolerates it well, and doesn’t have a fever or other objective signs of illness, then the child should attend school. Some mornings he or she may complain of nonspecific discomfort, but we all know these complaints usually resolve as the child participates in the daily routine. On the other hand, if your child was clearly ill the previous day or evening, required fever-reducing medicine in the preceding 24 hours, had interrupted sleep, vomiting or diarrhea, or is unable to eat breakfast, it is advisable to keep him/ her home from school.

            At school when a child comes to the nurse I make an assessment according to the specific complaint - for example, if a student complains of a sore throat I visualize the throat using a flashlight and palpate for enlarged tender neck glands. I listen to the quality of the voice, ask if he or she ate breakfast (or snack), and check for a fever. I provide a drink of water and watch for signs of pain with swallowing. Often I am told if family members are home sick with a similar complaint.

            If the child does not have a fever or any objective signs of illness, I recommend a return to class. I suggest comfort measures, such as increasing fluids, telling the student, “Keep your throat wet today - be sure to drink lots of water.” I ask what his/her after school plans are and if the child says he feels fine to go to soccer practice, I send him back to class, since he clearly is okay. Please be mindful that if I do make a call to you, your child has already been through this evaluation process.

            This is where I can use your help. If your child has a complaint in the morning before school, it is useful for me to know. I appreciate a heads-up call with a message saying your child complained of a stomachache or headache (or whatever) in the morning, but seemed fine to come to school. Then I know to call you if your child comes to see me complaining of not feeling well at school. Otherwise, I would likely send your child back to class.

            Sometimes a child is not feeling well but doesn’t have a fever or other easily measurable sign of illness. Obviously if I see a child four times in a morning or if the student is clearly unfit for the classroom, I will call a parent or designated caretaker.  As a parent myself, I know I would want to be informed if my child was having such a bad day.

            This is another way you can help. It is essential that we have the correct phone numbers to reach a parent or designated caretaker. If you change your work, cell, or home number, or have a new babysitter, please be sure to let us know here at Sprague so we can keep your information current and reach you or your designee quickly.

            Please call me if you have any questions.  

 

          Sharon Kahn RN

          Sprague School Nurse

          sharon_kahn@wellesley.k12.ma.us

          781-263-1965