- Cortisol-Dependent Conditions
- Cystic Fibrosis
- Alternate Feeding Methods
Northwest ISD schools are prepared to assist students with diabetes but we want parents to be part of the process. This means meeting with your school nurse, teachers and administrators to give them the information they need. We strive to help foster your student's independence while helping him or her manage diabetes while at school.
To help your campus nurse and your student, please ensure that you bring new orders from a diabetes specialist (endocrinologist) prior to the start of each new school year. Orders must address the following:
- Monitoring blood glucose by glucose meter or continuous glucose monitor
- Administration of insulin by pump (if applicable) or via syringe or pen
- Instructions for treating low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia)
- Administration of Glucagon (if applicable)
- Ketone monitoring
- Level of supervision required
We welcome parent input but please remember that all interventions must be supported by signed medical orders.
Please provide the following forms and supplies for your student with diabetes:
- A diabetes management plan from your doctor
- A signed CGM agreement (if your student has a CGM)
- Diabetes medicines including insulin and glucagon
- Testing supplies including a meter, strips, lancets, alcohol wipes and ketone test strips
Please contact your nurse as soon as possible to arrange a meeting and drop off paperwork and supplies.
A person with an allergy has an overactive immune system. When people have an allergy, their immune systems reacts to harmless things, such as grass pollen, pet fur or a specific food. This reaction can be mild or can be very dramatic, causing life-threatening symptoms. NISD staff are prepared to assist with allergic reactions, whether mild or very severe.
If your student has an allergy, it is best to let your campus nurse know. We can administer an antihistamine provided by you when it is accompanied by a signed medication form. If your student has a more severe allergy, one that might cause anaphylaxis, we can keep epinephrine or, if your student is capable, he or she can carry epinephrine to all school functions.
In addition to our preparation to treat known allergies, NISD staff are trained to use epinephrine for signs and symptoms of anaphylactic reaction in someone who does not have known or documented allergies.
As with many other medical conditions, NISD nurses and staff are prepared to respond to seizures among our students and staff. All employees receive a state mandated training called Seizure Training for School Personnel. In addition, when a student has a history of seizures, your campus nurse will coordinate with you and your son or daughter to develop an Individual Health Plan that specifically addresses his or her needs.
Sometimes, students have had an isolated seizure many years ago and no treatment is needed but knowing what that seizure looked like and what preceded the seizure may help staff recognize if it happens again.
Other times, seizures are recurring, and a student may require scheduled medication or emergency medication. We can administer medication at school. We also train staff to react during a seizure so that we can keep your student safe. Occasionally, students need Diazepam or Midazolam to stop a seizure. When either of these medications is given or if a seizure lasts more than five minutes, we are required to call 911 and the student's parent. The risk of status epilepticus and the possibility that oxygen might be needed are two reasons why we call EMT's to the campus. In most cases, the student can be released to a parent to rest at home for the remainder of the day.
If your student has had a seizure in the past, please coordinate with your nurse to develop an Individual Health Plan. This will help us to keep your student safe.
If your student has Attention Deficit Disorder or Attention Deficit Hyperactivity disorder, he or she may take medication to help focus. While we ask parents to give medications at home whenever possible, we can administer doses that are needed during the school day. To do so, we will need a signed Medication Administration Form. For this particular family of medicines, it is very important that the parent or guardian transports them to school, rather than the student.
As with other conditions, we welcome information that will help make the process easier. For instance, please let your nurse know if your student takes the medication before or after eating. Likewise, your nurse may call you if the student is frequently missing doses or if he or she refuses to take the medication. Some students do not like the idea of taking medication for ADD or ADHD just like some students who are nearsighted do not want to wear glasses. However, they often see the benefit if they can relate positive outcomes (such as improved grades or fewer disciplinary issues) to taking the medication. Nurses, counselors, parents and students sometimes need to meet to discuss these benefits.
In recent years, school nurses have seen an increase in the number of school-age students diagnosed with migraines. More frequently, we see treatment plans that include medication, rest, non-pharmacological interventions like biofeedback and other interventions.
If your student has been diagnosed with migraines, please communicate with your school nurse to develop an Individual Health Plan. Especially this year, because headaches are sometimes associated with COVID 19, it will be important for us to know what your student's migraine looks like and what treatments typically relieve the pain and other symptoms.
Many doctors recommend medication and a brief rest period. Sometimes, a second dose of medication is given at school. Due to the nature of our clinics, there may not be a way to turn off lights or ensure quiet. We can provide a place for your student to rest after taking medication that you provide. However, if interventions are not effective, we will call the parent or guardian. If a student misses school frequently due to headaches, it is best to consult your doctor. Falling behind in class may induce stress that actually leads to more headaches.
Please remember, school nurses cannot administer treatments such as essential oils that are not approved by the FDA.
Adrenal insufficiency is an endocrine disorder that occurs when the adrenal glands do not produce enough adrenaline in a crisis. This can be a life-threatening condition if not treated. While this is not common, we have several students with this condition throughout the district. Therefore, our nurses are prepared to care for your student with Adrenal Insufficiency.
To help your campus nurse develop an Individual Health Plan, please provide orders from your doctor that specify the following:
- MILD symptoms and the corresponding treatment such as oral hydrocortisone
- A clearly defined list of symptoms that would indicate the need for injectable medication (if applicable)
- Instructions for emergency care including transport to a preferred facility (if applicable) and treatments while en route to the facility
An RN or LVN will administer Solu-cortef if the medication is provided by the parent and if the RN or LVN is available on campus. An unlicensed NISD staff member may also be trained to administer Solu-cortef if the parent agrees. This would ensure that at least one other person on campus could administer the medication in the event the RN or LVN is not available to give it. If no RN, no LVN and no other trained staff member is available to give the medication, or if the doctor, the parent, the student and the campus nurse have previously approved, the student may prepare and inject the medication in an emergency. Any time a cortisol-dependent student has severe symptoms (defined by his or her doctor), 911 will be called regardless if there is someone on campus that can administer Solu-cortef.
We want to reassure you that we are prepared to take care of your student. Please coordinate with your campus nurse and administrators before school starts to make important decisions regarding his or her care.
Cystic Fibrosis impacts a student's everyday life and may influence his or her success at school. NISD Nurses are prepared to help students with Cystic Fibrosis by collaborating with the student, parents, medical professionals and school staff to develop a plan that includes medication administration, support of a student's nutritional needs and additional support when respiratory infections occur.
If your student has Cystic Fibrosis, please speak to your campus nurse to initiate this process.
Alternate Feeding Methods
When your student needs an alternate feeding method such as a tube feeding via a gastric button, your campus nurse will work with you and the academic team to help determine the best location and schedule for feeding at school. The Registered Nurse will coordinate training of staff members who can feed the student by a feeding pump, bag or syringe. An RN is available for questions and support when staff members administer feedings.
If your student requires feedings by an alternate method such as tube feeding, please contact your nurse to discuss the details. We will need the following items:
- A Medical Order for Specialized Healthcare signed by your student's doctor
- Tube feeding that is prescribed (including commercial feeding brands such as Pediasure or Nutren OR homemade feedings if approved by your doctor)
- Bags, tubing, extension sets, syringes and other supplies required to administer the feedings at school
Please make sure your doctor indicates details of the feeding process such as whether venting is indicated before the feeding, whether the student will need to be in a certain position either before, during or after the feeding, whether a residual measurement is required prior to feeding and any other instructions that will make feeding more comfortable for your student. Also, please note that nurses and staff are not allowed to put in replacement tubes or buttons in the school setting, even if your doctor has give you permission to replace buttons at home.