School Nurse Blog - Archived Posts

Headfirst Lice Lesson

Dear Parent or Guardian:

As you may know, head lice cases have been on the rise nationally. An estimated 6 to 12 million infestations occur each year in the United States, most commonly among children ages 3 to 11.1 I am writing to you to help you learn how to identify lice and provide information on what you can do if lice hit your home.

What are head lice?

Head lice are tiny, wingless insects that live close to the human scalp. They feed on blood. The eggs, also called nits, are tiny, tear-drop shaped eggs that attach to the hair shaft. Nits often appear yellowish or white and can look like dandruff but cannot be removed or brushed off. The nymph, or baby louse, is smaller and grow to adult size in one to two weeks. The adult louse is the size of a sesame seed appears tan to grayish-white. An itchy and inflamed scalp is a common symptom of lice. Although not common, persistent scratching may lead to skin irritation and even infection.1

Who is affected by head lice?

Head lice are not related to cleanliness.2,3 In fact, head lice often infest people with good hygiene and grooming habits.3 Infestations can occur at home, school or in the community. Head lice are mostly spread by direct head-to-head contact—for example, during play at home or school, slumber parties, sports activities or camp. Less often, lice are spread via objects that have been in recent contact with a person with head lice, such as hats, scarves, hair ribbons, combs, brushes, stuffed animals or bedding.1,2

What to do if an infestation occurs?

If you think your child has head lice, it’s important to talk to a healthcare provider to discuss the best treatment approach for your family. Resistance to some over-the-counter head lice treatments has been reported, but the prevalence of resistance is not known.4,5 There are new prescription treatment options available that are safe.

As your school nurse, I want to provide you with the information you need to safeguard your children’s health and pave the way for a healthy school year. I hope you find this information useful.

Additionlly, I am including the link to the 2010 clinical report from the American Academy of Pediatrics which provides additional information and guidance for parents and for schools related to screenings and management of head lice:

Melissa Jeffries, RN

HCPS District Nurse



  1. Centers for Disease Control and Prevention (CDC). Parasites: Lice: Head Lice: Frequently Asked Questions. Accessed April 15, 2015.

  2. Centers for Disease Control and Prevention (CDC). Head lice: epidemiology and risk factors. Accessed April 15, 2015.

  3. Meinking T, Taplin D, Vicaria M. Infestations. In: Schachner LA, Hansen RC, eds. Pediatric Dermatology, 4th ed. Mosby Elsevier; 2011:1525-1583.

  4. Burkhart CG. Relationship of treatmentresistant head lice to the safety and ef?cacy of pediculicides.Mayo Clin Proc. 2004;79(5):661– 666.

  5. Meinking TL, Serrano L, Hard B, et al. Comparative in vitro pediculicidal ef?cacy of treatments in a resistant head lice population on the US. Arch Dermatol. 2002;138 (2):220–224.

When should you keep your child home from school?

In the midst of cold and flu season, it is sometimes hard to discern when to keep your child home from school.  This practical article by Dr. Claire McCarthy offers sound advice on this very issue.  Take the time to check out Dr. McCarthy's suggestions which include clear-cut guidelines and judgement calls:

Don't Get Sidelined By The Flu

originally posted on Tuesday, Dec 7th, 2010

With flu season upon us, it is important that we work together to keep our children healthy. Viruses spread easily among children in schools, and families with school-age children have more infections than others, with an average of one-third of these family members infected each year. By keeping our children flu-free, we benefit the community as a whole. You can help prevent the spread of flu or help your child get better if he/she does get sick by following a few simple steps:
  • If possible, you and your child should get a flu shot
  • Remind your child to cover his/her nose and mouth with a tissue when sneezing or coughing and dispose of the tissue immediately
  • Have your child wash his/her hands frequently with soap and warm water for at least 20 seconds
  • Disinfect frequently-touched surfaces and shared items at least once a day
  • Ensure that bathrooms are stocked with soap, hand towels and tissues
  • Teach your child not to touch his/her mouth, nose and eyes
  • If your child is sick and has a fever, keep him/her at home to prevent the spread of illness to others

If you are concerned about your child’s flu symptoms, call your doctor early. Call your doctor immediately if your child has a chronic disease. Common symptoms of flu include high fever, severe headache, muscle and body aches, exhaustion, and dry cough. Additionally, children often exhibit other flu symptoms that are rare in adults, such as nausea, vomiting and diarrhea. Some children might benefit from an antiviral medication, which can be prescribed by a physician and can help lessen duration of the virus and reduce the risk of complications, such as pneumonia. To be effective, antiviral medication should be taken within 12-48 hours after flu symptoms begin.

Additionally, as a preventive measure, antiviral medication may be administered to children under a doctor’s care to help them avoid catching the flu from others in some special situations. For example:
  • Children who have egg allergies and therefore cannot receive flu vaccine
  • Children who have been vaccinated, but are at such high risk for serious complications due to a chronic condition, that extra protection is warranted
  • Children who may not have received a vaccine but are exposed to flu

If you have any questions or would like additional information about preventing and treating the flu, please contact the school nurse, Melissa Jeffries, at Also, there are additional resources from the NASN attached for your information.

The Flu: A Guide for Parents
When Sickness Strikes: Know when to keep a child home from school


originally posted on Friday, Feb 5th, 2010

It's never too early to start planning for Middle School. As parents of a 5th grader, this is an exciting and sometimes anxious time for both parents and students!

Early planning and preparation can make this move much easier for your child and you. Part of that plan should include a trip to your child's pediatrician. Your child is required to have a 6th grade entry physical and an updated immunization certificate for 6th grade enrollment. In addition, if your child would like to play any school sponsored sports, they must also have a sports physical. This does NOT take the place of the 6th grade entry physical. The state requires a separate physical for 6th grade entry and sports participation and there are different forms for each type of physical. If your child will need both physicals, talk to your physician about the best way to handle this.

Your child will need three shots for 6th grade entry this year but please note that these vaccinations should be given only after your child has turned 11 years old. In addition to a Tetanus booster shot your child will also need a second chickenpox vaccination (Varicella) and a Meningitis vaccination (Meningococcal) so please talk to your health care provider about these newly required immunizations.

If your child will not be 11 years old upon 6th grade entry, you will still need to have their physical and an updated immunization certificate turned in for enrollment. Then, when your child turns 11, we will require an updated certificate with the additional 11 year old shots.

Health documentation can be turned into your child's school any time and should be flagged to the attention of the school nurse. If you have any questions about middle school requirements please give me a call. I have attached the two physical forms as well as a link to the CDC adolescent immunization center for your convenience.

6 - 12th Grade Physical Form
Sports Participation Physical Form
CDC recommendations for adolescent immunization

Dental Screening Requirement for all students, ages 5-6, entering Kindergarten 2010

originally posted on Wednesday, Jan 27th, 2010

Amendment changes to 704 KAR 4:020 School Health Services beginning with the 2010-2011 school year:

For the 2010-2011 school year and beyond, students age five (5) or six (6) who are enrolled in a Kentucky public school shall provide evidence of a dental screening or dental exam no later than January 1 of the first year of enrollment.

Attached is the state form required for this screening.

Please contact me if you have any questions about this screening.

Dental Screening Form

Parents Beware - Energy Drinks May Pose Health Risk

originally posted on Friday, Feb 20th, 2009

For many teens, Pepsi and Mountain Dew have been replaced by the newly popular “energy drinks”. Marketing for energy drinks is targeted at adolescents and teens despite the overwhelming data that show they may not be at all safe for this population.

What are energy drinks?
Energy drinks are beverages like Red Bull, Venom, Adrenaline Rush, 180, ISO Sprint, and Monster. These drinks contain large amounts of sugar, caffeine and other legal stimulants like ephedrine. Energy drinks may contain anywhere from 80—500 mg of caffeine. Compared to Pepsi or Coca Cola, which have 35 and 31mg of caffeine respectively, that’s a tremendous amount of caffeine per drink.

In addition most energy drinks contain herbal supplements such as guarana, yerba mate leaves, ginseng, gingko biloba, and milk thistle. Of concern is that the Food and Drug Administration does not control these additives and the potential for drug or nutrient interactions may be increased with the unique combinations of ingredients in these drinks.

Dangers associated with energy drinks:
  • Dehydration – Energy drinks may dehydrate your body if you drink them while exercising. The risk of dehydration is increased with the combination of fluid loss from sweating during exercise and caffeine intake.
  • Inability to Sleep – caffeine is a stimulant that interferes with sleep.
  • Emotional changes - irritability, emotional outbursts and being “charged or hyped up” are possible effects of energy drinks.
  • Physical reactions – jitteriness, nausea, and anxiety may all result from the consumption of energy drinks.
  • Abnormal heart rhythms - caffeine can cause an increase in heart rate and may trigger abnormal heart rhythms, which is especially dangerous if you have any type of heart disease.
  • Large amounts of sugar and caffeine can cause an unhealthy jolt-and-crash cycle. The caffeine comes from many sources, which makes it hard to tell how much caffeine is actually in the drinks.
  • Some energy drinks have B vitamins, which when taken in large doses can cause rapid heartbeat, and numbness and tingling in the hands and feet.
  • Although the various sugars used to sweeten energy drinks can briefly increase energy, consuming large amounts of sugar is likely to cause weight gain.
  • It is important to remember that herbal supplements often claim to provide health benefits but there is a lack of evidence to support this, furthermore, there is lack of evidence to even support their safety.
To further complicate matters, many manufacturers of energy drinks have added alcohol to their products and only minimally changed their product appearance. Even retailers may have problems identifying the energy drinks with alcohol. Attached is a power point to help you decipher which products may contain alcohol.

As parents we are often faced with challenges and barriers in keeping our children safe. As this new threat emerges, knowledge is the key to safety. Talk to your kids to see if they are using these products and discuss the possible health risks. Many teens do not realize the health risks associated with energy drinks and will be receptive to new information.

Alcoholic Energy Drinks Powerpoint Show

Top 5 cold and flu busters for your holiday season

originally post on Monday, Dec 15th, 2008

If you’ve stepped outside you’ve undoubtedly realized that winter is upon us. Just like winter brings snow and ice, it also brings colds and flu. During the holidays and winter season there are things that you can do to protect your families.

Following are the top five cold and flu busters for your holiday seasons:
#5 – Get plenty of rest: Holidays are busy and fun filled but can be exhausting. Lack of adequate sleep compromises your immune system and can increase your chances of becoming ill.
#4 – Eat balanced meals: It’s easy to skip regular meals and over indulge in not-so-good food choices. Try to include a variety of foods, including fruits and vegetables in your meals for a healthier holiday.
#3 – Keep hands away from your face: Hands spread germs that typically enter our bodies through our eyes, nose or mouth. Keeping hands and fingers away from our faces can significantly decrease the chance of illness.
#2 – Cover that cough: The new and improved elbow method stops the spread of germs that cause illness. Encourage your children and those around you to cover their cough and sneeze using the elbow method.
#1 – Wash those hands: Before meals, after using the restroom, after coughing or sneezing into your hands, when visibly dirty and as needed. This is the #1 way to prevent the spread of disease!!

Here’s hoping you and your family have a safe, happy, and healthy holiday season!

Pertussis / Whooping Cough

originally posted on Monday, Oct 27th, 2008

If you turn on your television you have undoubtedly heard information about the recent cases of pertussis. Pertussis, most commonly known as "whooping cough", is a highly contagious but vaccine preventable, disease that lasts for many weeks.

According to the CDC, in the United States there are 5,000 to 7,000 newly reported cases each year, and this number has continued to rise steadily since 1980. Most people are vaccinated against pertussis when they are infants, so you may be wondering why the increase in cases. First, because the initial symptoms of pertussis are so similar to other respiratory illnesses it may often be misdiagnosed, which leads to increased exposure and transmission. Also, as children get older the protection from their pertussis immunization begins to wear off and by the time they are reaching adolescence their immunity may be completely gone making them more vulnerable to catching pertussis.

Symptoms of pertussis may include all of the following: A slight fever, runny nose, a severe cough that may make breathing difficult and lasts for many weeks, choking spells and vomiting that occur as a result of the coughing.

Side effects of pertussis may be more than symptomatic and can include: pneumonia, broken ribs, low oxygen levels, malnutrition and hospitalization. While death can occur it is rare and is most common in high risk groups such as the very young and the elderly.

Pertussis is spread by direct contact with secretions of an infected person, such as the droplets from their cough or sneeze. The best protection is prevention. Adults and adolescents now have options related to pertussis immunization. Parents are encouraged to talk to their physicians about options for their children and themselves. Other precautions include using good hygiene such as covering your cough and hand washing. Above all, if you or your child experiences these symptoms, make an appointment to see your physician. Early detection and treatment of pertussis will help to minimize the spread and prevent complications.

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