Because of county need, a school nurse was transferred from a new suburban school to a large inner-city school in an older low-income neighborhood. Which of the following changes in role should be anticipated by the nurse? (Select all that apply.)
a. An increased absentee rate because of infectious diseases
b. Cooperating with the school meal program to be sure fruits and vegetables and other healthy choices are included
c. Regularly checking each child for visible signs of child abuse
d. Emphasizing to parents that their child cannot attend school until immunizations are done
e. Need for lead poisoning screening and education
f.
Screening for head lice several times a year
ANS: B, E
Because cheap food is often high in portion size and sugar and fat, school may be the only place where children have the opportunity to eat fruits, vegetables, and protein choices. Thus, it will be important to make sure these choices are included in the school lunch program. Because old neighborhoods often have lead pipes and old lead paint, lead screening is crucial in older neighborhoods, particularly low-income neighborhoods where parents have fewer resources and are often in aged housing. Stereotypes such as "only poor people get head lice" abound. Head lice do not respect socioeconomic class, so such screening might be done in any school. Similarly, child abuse occurs among families of all social economic classes. Free immunizations are available, so this is probably not as big a problem as stereotypes about the poor might suggest. Indeed it is usually in wealthier neighborhoods that parents are concerned about mercury poisoning and try to avoid having their children immunized. There is unlikely an increased absentee rate because of infectious disease, as these are not seen at an increased incidence in suburban versus urban neighborhoods.
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