COPING WITH ILLNESS

Lesia Oesterreich, M.S.
Family Life Extension Specialist
Human Development and Family Studies
Iowa State University

Copyright/Access Information


Health care issues for children vary greatly from those of adults. Several aspects of health care in children require planning and decision-making on your part. Others require appropriate information and access to information for handling of emergencies.

ILLNESSES - HOW TO RESPOND

Illnesses are common in young children. You should be aware of the different signs of illnesses and be able to decide if it is mild, severe, or life-threatening in order to provide timely care and comfort.

LIFE-THREATENING SIGNS

In the case of the following life-threatening signs, call for emergency assistance and for parents.

• severe coughing, high pitched whistling sound, redness or blueness in face, difficulty breathing
• vomiting with other signs such as headache or fever
• fever more than 101 degrees Fahrenheit, extreme tiredness, difficulty in waking up
• sore throat, difficulty breathing and swallowing

PROBABLE SIGNS OF COMMUNICABLE ILLNESS

In the case of the following probable signs of communicable illness, call parents, ask them to take the child to the doctor, and isolate the child until she is treated.

• redness, swelling of eye, and drainage in eye
• unusual spots or rashes with fever or itching
• sore throat
• crusty, bright yellow, gummy skin sores
• diarrhea (more than 2 loose stools a day)
• vomiting (more than 2 times a day)
• yellow coloring of skin and whites of eyes
• clay colored stools or tea colored urine.

POSSIBLE COMMUNICABLE ILLNESS

In case of signs of possible communicable illness, watch child closely, and discuss signs with parents.

• earache (check for fever or discharge)
• headache
• itching of scalp; check for nits and if present, isolate until treated
• fever less than 101 degrees Fahrenheit
• unusual behavior
• runny nose (check color and smell; check temperature if discharge is yellow with odor)

(Adapted from "Stop Disease in Your Family Day Care," Ohio Department of Health, Ohio Department of Human Services, Health and Safety in Family Day Care, December 1991.)
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ILLNESS POLICY

A written illness policy communicates to parents what your procedures and policies will be if their child should become ill. This policy should take into consideration:

• whether the illness is contagious
• whether the child is running a high fever or vomiting
• whether you have an arrangement that allows you to keep a sick child isolated
• whether you would be able to take the child to the doctor or hospital if the child got worse and the parent was unavailable
• whether you could give proper care to the sick child and still care for the others

HOW TO TAKE A CHILD'S TEMPERATURE

Oral temperatures should not be taken on children younger than 4 years (or younger than 3 years if a digital thermometer is used). Use underarm method for infant, toddlers, and those children not in good control. Rectal temperatures should be taken only by persons with specific health training.

Do the following before you take the child's temperature:

• Rinse thermometer, especially if it has been stored in a chemical solution.
• Inspect the thermometer for any sharp or broken edges.
• Shake the thermometer until the mercury or alcohol is at its lowest level.

HOW TO TAKE ORAL TEMPERATURE

• Make sure the child doesn't drink hot or cold liquids for several minutes before taking the temperature.
• Place the long silver or red tip (bulb) of the thermometer under the child's tongue.
• Have the child close lips gently, taking care not to bite the thermometer.
• Keep the thermometer under the child's tongue for 3 minutes. Continue to hold onto the thermometer. Do not leave the child alone.
• Wipe the thermometer with a clean tissue and rotate to read the mercury or alcohol level. (Normal oral temperature is about 98 degrees Fahrenheit to 99.4 degrees Fahrenheit.)

HOW TO TAKE A CHILD'S UNDERARM TEMPERATURE (AXILLARY)

• Place the thermometer under the armpit. Bring the child's arm in gently and press the bulb (silver or red tip) against the child's body.
• Hold the thermometer in place for 3 to 4 minutes.
• Remove and read it by rotating. (Normal armpit temperature is 97.6 degrees Fahrenheit to 98.6 degrees Fahrenheit.) A high fever is 101 degrees Fahrenheit.

CLEAN THE THERMOMETER AFTER EACH USE

• Wash with cold water and soap.
• Rinse under cool, running water. Hot water may break it.
• Dry thoroughly with a clean cloth.
• Soak it in isopropyl (rubbing) alcohol for at least 15-20 minutes. Change alcohol solution weekly.
• Rinse again, dry, and store in a clean container or in alcohol.

WHEN TO EXCLUDE CHILDREN FROM YOUR CARE

Most health professionals recommend that children with the following illnesses or symptoms be excluded from child care.

Aseptic Meningitis	Impetigo	Ringworm
Bacterial Meningitis	Measles	Rubella
Chicken pox	Mouth sores with drooling	Scabies
Uncontrolled diarrhea	Mumps	Shigella
Head lice	Pertussis (Whooping Cough)	Shingles
Haemophilus influenzae Type B	Pinworm	Strep throat
Hepatitis A	Purulent conjunctivitis (pink eye)	Tuberculosis
Herpetic gingivostomatis	Rash with fever or behavior change	Vomiting

Frequently children can return to child care after treatment has been initiated. Check with your health care professional to verify when it is safe to return.

IMMUNIZATIONS

Make sure that children are up to date on all immunizations and physical checkups. This will help prevent serious diseases such as diphtheria, tetanus, whooping cough (DPT), measles, mumps, rubella (MMR), polio (OPV), Haemophillus influenzae meningitis (HiB, and hepatitus B (HBV). Ask parents to supply you with a current immunization record.

MEDICATIONS

Note the following procedures in storing and administering medicines for children.

• Have the parent or legal guardian make out and sign a Medication Release Form for each medication.
  
• Give only medicine (prescription or over the counter) that is in the original container. It should be labeled with the child's name, correct dosage, and the name of the pharmacy that supplied the
  medicine. If you have any questions, contact the child's medical professional or pharmacist.
  
• You need parental permission to give the following medications; medical permission is NOT required:
  • Antihistamines
  • Nonaspirin pain relievers and fever reducers
  • Cough medicine
  • Decongestants
  • Anti-itching creams
  • Diaper ointments and powders
  • Sunscreen
    
• Use an accurate medicine dropper or measuring spoon. Regular silverware spoons are NOT acceptable for measuring medicine.
  
• Stop giving medication if you observe side effects. Inform parents and/or medical professional.
  
• Keep a small notebook and record of each dosage of medicine that you give any child. Note child's name, medication, dose, date, and time of day.

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