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School health programs provide valuable services for students and
may also serve the school’s community. School-age children and
adolescents with health problems are at major risk for underachieving
or failing in school. The leading health problems of
elementary-school children are injuries, infections (including influenza
and pneumonia), malnutrition, dental disease, and cancer.
The leading problems for high-school students are alcohol
and drug abuse, injuries, homicide, pregnancy, sexually transmitted
disease, sports injuries, dental disease, and mental and
emotional problems. Ideally, school health programs have an
interdisciplinary health team consisting of physicians, nurses,
dentists, social workers, counselors, school administrators, parents,
and students. The school may serve as the site for a family
health clinic that offers primary health and mental health services
to children and adolescents as well as to all family members in the
community. Many school nurses have baccalaureate degrees, and
advanced practice nurses are ideally suited to provide the primary
care in these settings. Some school nurse programs provide community
care. Physical examinations are performed by advanced
practice nurses who then diagnose and treat students and families
for acute and chronic illnesses. These clinics are cost-effective
and are especially beneficial for students from low-income families
who lack access to traditional health care or have no health
insurance. (continue reading…)

The use of complementary and alternative health has been steadily increasing in the United States (Eisenberg, Ettner, Appel, Wilkey, Van Rompay, & Keesler, 1998). For many clients with chronic conditions, mainstream medical care offers few options. Long-term treatments with medications often produce their own iatrogenic (treatment-caused) health problems, some of which are as troubling to the individual as the original disease process. A common response to these problems has been to add more medications and more treatments, each with its own potential adverse effects. Mainstream health care providers often give little attention to the problems of daily living that are of greatest concern to the individual. Stress and anxiety also add to the burden of these clients. For clients with acute health conditions, certain treatments or medications may produce unpleasant or harmful side effects. Clients often are looking for alternative treatment methods that do not appear to have the same potential for harm. Some alternative therapies have been available for many years, and there are people who believe that they have been significantly helped by these approaches. Unfortunately, traditional health care providers often have dismissed these therapies without investigating them thoroughly. On the other hand, few alternative therapies have been formally researched, and proponents often rely on undocumented reports of effectiveness.
Research into alternative therapies now is supported by the federal government but only in a small way compared to other research. The federal government has an Office of Alternative Health Care and a Web page of references, the National Center for Complementary and Alternative Medicine. (See list of Web sites.) More attention is being paid to the responses of individuals. Concern about the role of stress in illness has prompted an increased openness to nonmedical methods of managing stress. The possibility of alternative care practices working in a complementary fashion with traditional medical care is gaining wider acceptance. Often these complementary therapies are used to address the whole person and not simply the disease. (continue reading…)

While conducting an assessment of the patient’s situation, the
nurse evaluates the need for future visits and the frequency with
which those visits may need to be made. To make these judgments,
the nurse may find it helpful to consider the following
factors:
• Current health status: How well is the patient progressing?
How serious are the present signs and symptoms? Has the
patient shown signs of progressing as expected, or does it
seem that recovery will be delayed?
• Home environment: Are worrisome safety factors apparent?
Are family or friends available to provide care, or is the patient
alone?
• Level of self-care abilities: Is the patient capable of self-care?
What is the patient’s level of independence? Is the patient
ambulatory or bedridden? Does the patient have sufficient
energy or is he or she frail and easily fatigued?
• Level of nursing care needed: What level of nursing care does
the patient require? Does the care require basic skills or
more complex interventions?
• Prognosis: What is the expectation for recovery in this particular
instance? What are the chances that complications
may develop if nursing care is not provided?
• Patient education needs: How well has the patient or family
grasped the teaching points made? Is there a need for further
follow-up and retraining? What level of proficiency
does the patient or family show in carrying out the necessary
care? (continue reading…)