• Important Health Issues at School


    Medication at School

    Each year, more students are attending schools with complex and chronic health conditions. According to the National Survey of Children with Special Healthcare Needs, 11.2 million children are at risk for chronic conditions that can affect their physical, emotional, and social well-being.

    Conditions such as asthma, diabetes, epilepsy, food allergies, obesity, and mental health issues can hinder academic achievement if not given proper attention. Schools can assist in managing these conditions by administering medications and treatments during the school day.

    Parent/guardian and prescriber authorization are needed to allow the administration of prescribed drugs at school. To assure safe delivery, all medications should be brought to the school in their original, properly pharmacy labeled container.  

    Over-the-counter (OTC) medications will only be administered at school when these OTC medications arrive at school in their original, properly labeled containers, accompanied by a signed parental request for administration and will be administered for two weeks only (A healthcare provider’s order is required if medication is to be administered beyond 2 weeks).

    To assure safe delivery, all medications should be brought to the school by the parent/guardian or a responsible adult, especially for elementary school students.

    Please contact your school nurse if you have any questions or concerns. Lancaster ISD medication forms are attached below.

    Health Problems at School


    Asthma is the most common chronic childhood disease.  Asthma is characterized by excessive sensitivity of the lungs to various stimuli.  With asthma, it is very hard to get air in and out of the lungs.  Changes in the airways block the flow of air, making it very hard to breathe.  Each child reacts differently to the various triggers that may cause asthma symptoms.  Asthma cannot be cured, but it can be prevented and controlled.

    Only in rare cases do children with asthma need emergency care.  However, even a mild asthma episode can be frightening.  

    Some symptoms of asthma are:

    §  Shortness of breath

    §  Wheezing

    §  Tightness and/or discomfort in the chest

    §  Coughing

    Some asthma triggers are:

    §  Upper respiratory infections (colds)

    §  Smoke from cigarettes, wood or burning materials

    §  Fumes from automobiles, cleaning products, or aerosol sprays

    §  Scents from cosmetics, lotions, or perfumes

    §  Odors from paints, glues or cooking

    §  Air pollution

    §  Pet dander, cockroaches, dust mites, molds and pollen

    §  Exercise

    §  Emotional stress

    §  Weather or temperature changes

    To control asthma episodes you must treat symptoms early, use medication regularly as prescribed, and know when medical help is needed.  Please contact your school nurse for more information.


    An allergic reaction occurs when the body detects the presence of a substance or food that it deems harmful. In an attempt to protect itself the body's immune system produces antibodies and releases chemicals, such as histamine, into the bloodstream.  The chemicals released cause many different reactions.  Each allergic reaction is unique.  An allergic reaction can be mild, severe or life-threatening, signs and symptoms can happen immediately or a few hours after a person has come in contact with an allergen. Please contact your school nurse for information and medical forms.

    Food Allergies

    A food allergy is an abnormal response to a food, triggered by the body’s immune system (NIAID, 2010). Symptoms of a food-induced allergic reaction may range from mild to severe and may become life-threatening. Reactions vary with each person and each exposure to a food allergen and the severity of an allergic reaction is not predictable.

    A food allergy is a potentially serious immune-mediated response that develops after ingesting or coming into contact with specific foods or food additives. A life-threatening allergic reaction to food usually takes place within a few minutes to several hours after exposure to the allergen. Eight foods account for over 90 percent of allergic reactions in affected individuals: milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat (Sampson, 2004 & Sicherer S., 2002). Although most allergic reactions are attributed to these eight foods, any food has the potential of causing a reaction. In addition, school settings may contain non-food items such as arts and crafts materials, that contain trace amounts of food allergens

    Insect Allergies

    The severity of an insect sting reaction varies from person to person. A normal reaction will result in pain, swelling, and redness confined to the sting site. You can disinfect the area (washing with soap and water will do) and apply ice to reduce the swelling.

    A large local reaction will result in swelling that extends beyond the sting site. For example, a sting on the forearm could result in the entire arm swelling. Although alarming in appearance, this condition is often treated the same as a normal reaction. An unusually painful or very large local reaction may need medical attention. Because this condition may persist for two to three days, antihistamines and corticosteroids are sometimes prescribed to lessen the discomfort.

    Fire ants, yellow jackets, hornets and wasps can sting repeatedly. Honeybees have barbed stingers that are left behind in their victim’s skin. These stingers are best removed by a scraping action, rather than a pulling motion, to avoid squeezing more venom into the skin.

    The most serious reaction to an insect sting is an allergic one. This condition requires immediate medical attention. Symptoms of an allergic reaction may include one or more of the following:

    • Hives, itching, and swelling in areas other than the sting site
    • Abdominal cramping, vomiting, intense nausea or diarrhea
    • Tightness in the chest and difficulty in breathing
    • Hoarse voice or swelling of the tongue or throat, or difficulty swallowing

    An even more severe allergic reaction or anaphylaxis can occur within minutes after the sting and may be life-threatening. A dose of epinephrine (adrenaline), typically administered in an auto-injector, and immediate medical attention is required. Symptoms may include:

    • Dizziness or a sharp drop in blood pressure
    • Loss of consciousness or cardiac arrest

    People who have experienced an allergic reaction to an insect sting have a 60% chance of a similar or worse reaction if stung again. 

    If you are concerned that your child may have an allergy to insect venom, please take your child to see their healthcare provider and provide the school with information and medication needed to take care of your child in the event they get stung while at school or a school-related event. Please note Emergency Medical Services (EMS 911) will be called for all allergic reactions assessed to be severe or possibly life-threatening.

    Diabetes House Bill 984

    Diabetes is the second most common chronic disease that impairs the body’s ability to use food for energy.  It is one of the most common chronic diseases in school-aged children, affecting 1 in every 400-500 children under 20 years of age.  In Texas, more than 1.3 million individuals have diagnosed diabetes, and an additional 343,000 Texans are estimated to have undiagnosed diabetes.

    Conservative estimates rank diabetes as the 6th leading cause of death in Texas with African Americans and Hispanics populations greatly impacted. Over seventeen million Americans have diabetes and over 200,000 individuals die each year of related complications.  Long-term complications include heart disease, stroke, blindness, kidney disease and amputations of limbs.  In the year 2002, the direct and indirect cost of diabetes reached $132 Billion in the United States, averaging $13,000 per each person with diabetes.

    Diabetes is a lifelong condition, requiring monitoring and judgment in all areas of an individual’s life, including exercise, nutrition, and illness.  Students with diabetes possess the unlimited potential for academic success along with their classmates, but also need the support of caring adults to guide them as they assume increasing responsibility and independence for their disease management to maintain wellness and prevent or delay complications.

    HB 984 requires a collaborative effort between the student, parent, physician, teacher and school nurse to develop a student’s Individual Health Plan, which includes the routine treatment and care that will be available for the student, and emergency interventions that will be provided to the student. Please contact your child’s school nurse for additional information.

    Special Needs / Specials procedures

    The school nurses for Lancaster ISD are committed to providing individualized, specialized care for students with special health needs including specialized nursing procedures such as glucose monitoring, insulin administration, tube feeding, catheterization, tracheostomy care, suctioning, and chest percussion therapy (CPT) with appropriate physician’s orders.  Please contact your child’s school nurse for additional information, to schedule a conference, and to get copies of the appropriate forms for your physician to sign.


    Vision and Hearing

    This screening is mandated by Texas law in grades Pre-K 4, Kindergarten, 01, 03, 05, 07, and all students in other grade levels who are new to Lancaster ISD.  Parents of students who fail two vision screenings will receive a referral letter from the school nurse recommending a more comprehensive exam by an eye doctor.  Parents of students who fail hearing screening will receive a letter from the school nurse recommending a more comprehensive exam by a hearing specialist.


    This screening is mandated by Texas law and is designed to detect abnormalities of the spine. This is done in a private environment by state-certified district school nurses.  Parents of students who have any positive findings will receive a letter from the school nurse with recommendations.

    In compliance with the Health and Safety Code, Chapter 37, all children undergo screening for abnormal spinal curvature in accordance with the following schedule:

    • Girls will be screened two times, once at age 10 and again at age 12.
    • Boys will be screened one time at age 13 or 14.


    Acanthosis Nigricans

    This screening is mandated by Texas law in grades 01, 03, 05, and 07 and is usually done at the same time as vision and hearing screening.  Acanthosis Nigricans (AN) is a skin discoloration that may indicate high levels of insulin in the blood which results from insulin resistance.  Insulin resistance can create a potential risk for the development of Type 2 Diabetes.  The skin on the nape of the neck will be visually examined.  If the AN marker is noted, then the student will have blood pressure, height, and weight measured individually and privately at a later date.  Parents will be notified of these specific findings.

    If you have any questions about any of these screenings or your child’s results, please contact the school nurse on your child’s campus.

     Healthy Practices

    The most important thing that you can do to keep from getting sick is to wash your hands with soap and water.

    Wash your hands before meals, after using the bathroom and when hands look and/or feel dirty. 

    Germs and viruses can enter the body through touching your mouth, nose, and eyes.  So avoid touching your face. 

    Germs that you have picked up from other people or from contaminated surfaces can be removed by frequently washing your hands with soap and water. 

    Help your children develop life-long healthy habits: cover your mouth when coughing or sneezing then wash your hands.

    Health Promotion and Education

    Age-appropriate health education classes are presented by school nurses during the school year.  Some of the topics are listed below.  If you have questions about any of these presentations, please contact the school nurse on your child’s campus.

    §  Growth & Development

    §  Dental health

    §  Disease prevention

    §  Hygiene

    §  Safety Awareness

    Bacterial Meningitis

    The following information on Bacterial Meningitis is for information only and does NOT indicate an outbreak in our area. The Texas Legislature recently passed SB 31, which requires that a school district provide information relating to bacterial meningitis to all students and their parents each school year.

    Meningitis is an inflammation of the covering of the brain and spinal cord. Viruses, parasites, fungi, and bacteria can cause meningitis. Someone with meningitis will become very ill. The illness may develop over one or two days, but it can also rapidly progress in a matter of hours. Not everyone with meningitis will have the same symptoms. Children (over 1-year-old) and adults with meningitis may have:

    §  Severe headache

    §  High temperature

    §  Vomiting

    §  Sensitivity to bright lights

    §  Neck stiffness, joint pains

    §  Drowsiness or confusion

    If diagnosed early and treated promptly, the majority of people make a complete recovery. In some cases, it can be fatal or a person may be left with a permanent disability, such as deafness, blindness, amputations or brain damage (resulting in mental retardation or paralysis) even with prompt treatment.

    Fortunately, none of the bacteria that cause meningitis are as contagious as such diseases as the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been. The germs live naturally in the back of our noses and throats, but they do not live for long outside the body. They are spread when people exchange saliva (such as by kissing; sharing drinking containers, utensils, or cigarettes). The germ does not cause meningitis in most people. Instead, most people become carriers of the germ for days, weeks or even months. Being a carrier helps to stimulate your body's natural defense system. The bacteria rarely overcomes the body's immune system to cause meningitis or another serious illness.

    Bacterial meningitis can be prevented by not sharing food, drinks, utensils, toothbrushes, or cigarettes. A vaccine is available that can prevent certain types of meningitis caused by meningococcal bacteria. This vaccine is recommended by some groups for college students, particularly freshmen living in dorms or residence halls. The vaccine is safe and effective (85%-90%). It can cause mild side effects, such as redness and pain at the injection site lasting up to two days. Immunity develops within 7 to 10 days after the vaccine is given and lasts for up to 5 years. For additional information, contact your school nurse, family doctor, or the staff at your local or regional health department.

    Health Information Links

    Heat-Related Illness

    Information on Heat-Related Illness

    Lice / Pediculosis

    Information on Lice (Pediculosis)

    Should I Keep My Child Home? 

    When to Keep Your Child Home

    Conjunctivitis / Pink Eye

    Information on Conjunctivitis

    Strep throat / Sore throat

    Information on Strep Throat

    Tuberculosis (TB)

    Tuberculosis Facts- Exposure to TB

    Staph / Methicillin-resistant Staphylococcus Aureus (MRSA)

    What You Need to Know About Staph/MRSA Skin Infections