ReQLI: Emergency and Disaster Preparedness and Response for Schools

Group C: Adair Shannon & Guilday (2019). Ch. 20 Emergency & Disaster Preparedness and Response for Schools (from the Selekman et al. (2019) text)
Student Name NURS 614 Module VI ReQLI
Reference
Wyckoff, L. (2019). Students with diabetes. In J. Selekman, R. Adair Shannon, & C. F. Yonkaitis (Eds.), School nursing: A comprehensive text (3rd ed., pp. 575-602). F. A. Davis.
Questions
 Does acanthosis nigricans (AN) that occurs in type 2 occur in other types of diabetes?
 What is the AN screening tool (p. 579)?
 Why shouldn’t you exercise if ketones are present (p. 584)? What are the consequences if you do?
 Should the school nurse test for ketones prior to a diabetic student participating in gym?
 What is meant by “stacking” insulin (p. 586)?
 What does the nurse do if a pump becomes dislodged while at school (p. 589)?
Learned
 Nurses use the DMMP to develop IHPs and EAPs (p. 575). The IHP for a student with infusion pump should include the model and manufacturer’s help number, plan for carbohydrate counting, glucose and ketone monitoring, dislodged tubing, pump malfunction, location of supplies, pump storage, and target blood glucose level; the EAP should include care during hypo- /hyperglycemia episodes, symptoms experienced and treatment, location of glucagon (pp. 589- 590, 592, 593).
 Complications can begin after puberty or 5 years after diagnosis of type 1 diabetes (p. 580).
 Consider type, student's age, developmental level, socioeconomic conditions, resources, peer pressure and support from the family/provider when managing diabetes (pp. 580-581).
 The blood glucose and A1C goals for children with type 1 and type 2 diabetes are different (p. 581).
 Carbohydrate restriction is not recommended in children and adolescents (p. 582).
 Some important meal planning principles and physical activity considerations (pp. 582-584).
 If hypoglycemia is suspected, blood glucose should be checked by a finger stick, and the student should always be escorted to the health office; examples of 15 g of carbohydrates (pp. 590, 593).
 If glucagon is administered, the child should be side-lying because vomiting is common (p. 593).
 Examples of accommodations that may be necessary for a student with diabetes (pp. 596-597).
Issues
 The DCCT found that complications from diabetes decreased by 76% with rigorous treatment and blood glucose control (p. 575). Early control in children is beneficial in having lasting effects on reducing complications (p. 580). However, data showed that many children are above the A1C goal with some levels for teens being at 9.2% (p. 581). These statistics are concerning and should be included in the education that school nurses provide to the student and family to emphasize the importance of adhering to the DMMP.
 Diabetes is difficult to manage, and many things need to be considered during a student’s care, especially when correcting episodes of hyperglycemia. A student’s status and the correction dose needs to be approved by the school nurse (p. 586). This information can be used to stress the importance of the school nurse and what they do.
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