PARAEDUCATOR S ROLE HELPFUL RESOURCES SPECIAL HEALTH NEEDS CLASS

Transcription

1 PARAEDUCATOR SPECIAL HEALTH NEEDS CLASS Keystone Area Education Agency Elkader, Iowa Stephanie Wagner, RN PARAEDUCATOR S ROLE Why do we provide health care services for students? Because *20% of the US children are affected by chronic medical conditions. What you will learn today. Resources Delegation and Special Health Services Health conditions/topics and your responsibilities Hand washing/infection Control Allergies Seizures Nutrition/Feeding Disorders Orthopedic Conditions Asthma Diabetes HELPFUL RESOURCES School Nurse Special Health Care Needs Binder Reliable Internet Sites mayoclinic.com aap.org (American Academy of Pediatrics) idph.state.ia.us (Iowa Department of Public Health) 1

2 DELEGATION AND SPECIAL HEALTH SERVICES The registered school nurse in collaboration with the student s health care provider, the student s parents and the education team will determine what Special Health Services to be provided. The process is governed by laws such as Individuals with Disabilities Act (IDEA), Section 504 of Rehabilitation Action of 1973, and the Am. Disabilities Action (ADA) to ensure that children with special health care needs have the right to be educated with their peers in the least restrictive environment. DELEGATION AND SPECIAL HEALTH SERVICES CONT Prior to delegation, a student health assessment is required. Then the nurse can determine what training and supervision is required for safe delegation to occur for the student. The legal parameters for nursing delegation are defined by the State Nurse Practice Acts, State Board of Nursing Guidelines, and Nursing Administrative Rules/Regulations (NCSBN, 2005) In Iowa, only a registered school nurse or licensed healthcare provider can delegate health related tasks. The para educator has the right to refuse to perform special health services and intrusive non-emergency health services unless the provision of such services with in the description upon employment. DELEGATION AND SPECIAL HEALTH SERVICES CONT Key components of providing safe health care Communication among all members of the student s educational team Knowledge that providing health care is a requirement of many par educator's jobs. Training, ongoing supervision and training updates. 2

3 INFECTION CONTROL The basic principal of infection control is hygiene Includes hand washing, sanitizing and standard precautions INFECTION CONTROL CONT Hand washing is one of the single most important things we can do and IT DOESN T COST A THING!! How to Wash Your Hands Use soap and warm water SCRUB your hands for at least 20 seconds WASH between fingers, wrists, under fingernails, backs of hands RINSE well DRY your hands with paper towels TURN off water with paper towel When to wash?? After using restroom, after sneezing or coughing, before you eat INFECTION CONTROL CONT Sanitizing Reducing the number of germs to a level unlikely to cause disease 2 minutes of contact time with a bleach solution with sanitize most surfaces Recipe: Mix in Spray bottle 1 T. Bleach 1 Quart of Water Make fresh daily Remember-GLOVES (solution is hard on hands) Fun Fact-There are currently more than 8,000 registered disinfectant products for sale in Canada and the U.S. Important to look at what the product kills (MRSA, norvirus, etc.) 3

4 INFECTION CONTROL CONT Standard Precautions Guidelines issued to help prevent disease transmission Basic assumption that anyone may be infected Substances include blood, bodily fluids, secretions, excretions (except sweat), even if it is not visible GLOVES are the #1 barrier (Remember latex allergies) If gloves are not available-sandwich or trash bags Protect eyes from fluids-eye glasses, sunglasses Discard fluid containing material in secured trash bag Wash hands after removing gloves ALLERGIES Reactions can range from minor (itching) to severe (anaphylactic=breathing difficulties) Includes allergies to foods (peanuts, tree nuts, eggs, wheat fish, shellfish, milk, soy), insects, latex (gloves, crutch pads, tape, balloons, baby bottle nipples, diapers) What to look for Majority of time with start with c/o stomach ache Hives, itchy skin Short of breath, wheeze, cough Pale, faint, weak pulse, dizzy, confused Your responsibility-stay CALM! Check for IHP, follow instructions if applicable. May include EPI Pen. If not, call 911. What Happens during Anaphylaxis - YouTube SEIZURES Change in behavior caused by abnormal discharge of electrical activity in the gray area of the brain Types Generalized tonic-clonic (Grand Mal) Absence (Petite Mal) Partial (Simple or Complex) Atonic Myoclonic Infantile Recognition-See handout Epilepsy and Seizure Information for Schools - YouTube 4

5 SEIZURE CONT General First Aid Know the student s plan of care as outline on the Individualized Health Plan (IHP/IEP) Stay calm Moving objects that may be a hazard Loosen ties or shirt collar Protect their head from injury Turn on side to keep airway open, do NOT insert anything into mouth Reassure when consciousness returns Stay with the student until help arrives Report to parents, school nurse, teacher and parents SEIZURE CONT DOCUMENT Events that occurred before the injury Level of consciousness before, during and after the seizure activity Where the seizure occurred Skin color changes Incontinence Length of seizure and recovery time Specific activity (eyes rolled back, movement of bodily parts, blank stare) SEIZURE CONT Emergencies If the seizure is continuous for more than 5 minutes or if the IHP says so If the second convulsive seizure starts shortly after the first has ended If the student is injured, pregnant or diabetic If the seizure took place in water If it is the student s first documented seizure 5

6 SEIZURES CONT Medications Anticonvulsants Tegretol Klonopin Valporic Acid Dilantin Phenobarb Seizure control is achieved through regular, daily dosing. A missed dose greatly increases the likelihood of a seizure occurring. FEEDING/NUTRITION DISORDERS Check the IEP and IHP Students with special health care needs benefit greatly by being fed with peers Feeding Devices G- Tubes/Meds Special bowls, spoons, forks, cups Appropriate positioning is critical in feeding a student because it Increases interaction with classmates Increases respiratory function Increases a coordinated swallow Decreases fatigue FEEDING/NUTRITION DISORDERS CONT 6

7 ORTHOPEDIC CONDITIONS Check the IEP/IHP Orthopedic Conditions Muscular Dystrophy Ontogenesis Imperfecta Cerebral Palsy Spina Bifida Positioning is important: Decreases fatigue Increases physiological function Increases opportunities for interaction ORTHOPEDIC CONDITIONS ASTHMA Check IEP and IHP Asthma is believed to be the most common cause of school absenteeism due to chronic illness Asthma can NOT be cured, it can almost always be controlled 7

8 ASTHMA CONT What is asthma? An inflammatory condition (not an infection) of the bronchial airways Inflammation causes the normal function of the airways to become excessive and over-reactive. This causes increased mucus, mucosal swelling and muscle contraction Changes in mucosa produce smaller airway and possibly airway obstruction, chest tightness, coughing and wheezing ASTHMA CONT Triggers Allergens Pet dander Pollen Infection of the lungs and sinuses Cold or dry air Stress Exercise-80% of people with asthma Irritants in the environment (air that you breathe) Cigarette and other smoke Cleaning products Chemicals in spray Odors and gases ASTHMA CONT Signs of Asthma Episode Breathing Coughing Wheezing Breathing through the mouth Rapid breathing Having a hard time completing a sentence Verbal Complaints Tight Chest Can not catch breath I don t feel well 8

9 ASTHMA CONT Children First Aid: Asthma YouTube Your job Stay calm Check IHP Have child sit in comfortable position Reassure the child Call 911 if attack becomes severe or no medication available DIABETES Two Types of Diabetes Type 1-pancreas stops making the hormone insulin causing high levels of sugar in the blood The only treatment is to replace the missing insulin by injection or with a pump Type 2-body does not use insulin properly causing high levels of sugar in the blood Exercise and diet modification may help May need oral medications or insulin Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life Safe at School: Chapter 1 - Diabetes Basics - YouTube DIABETES CONT Hypoglycemia Abnormally low level of blood glucose (sugar) Signs and symptoms Confusion and/or abnormal behavior Visual disturbance (double or blurred vision) Seizures (uncommon) Loss of consciousness (uncommon) Heart palpations Shakiness Anxiety Sweating Hunger Tingling around the mouth 9

10 DIABETES CONT Treatment for hypoglycemia (low blood sugar) Immediate treatment Consume sugar-candy, fruit juice, glucose tablets IF SEVERE (UNCONSCIOUS) Glucose Injection Call 911 Check student s IHP or Emergency Action Plan for instructions for that specific child. DIABETES CONT Hyperglycemia High blood sugar Signs of Hyperglycemia Early Signs Frequent urination Increased thirst Blurred vision Fatigue Headache Late Signs Fruity smelling breath Nausea and vomiting Shortness of breath Dry mouth Weakness Confusion Coma DIABETES CONT Hyperglycemia (high blood sugar) treatment Check IHP or Emergency Action Plan Insulin injection may need to be given (maybe correction dose) 10

11 DIABETES CONT Complications of Hyperglycemia (high blood sugar) Diabetic Ketoacidosis Diabetic Coma Damage to nerves, eyes, heart, kidneys DIABETES CONT Living with diabetes Living with Diabetes: Molly - YouTube 11