NCSN cheat sheet

For children and adolescents aged 2-19 years, BMI percentile is classified as underweight below the 5th, healthy weight 5th to below 85th, overweight 85th to below 95th, and obesity at or above the 95th.

A temperature of 38.0 degrees Celsius (100.4 degrees Fahrenheit) or higher is generally considered fever; measurement route and device can affect the reading.

A common pure-tone hearing screening protocol tests 1000, 2000, and 4000 Hz at 20 dB; no response at any frequency in either ear is a screening failure requiring rescreening.

Common vision screening referral thresholds are 20/40 or worse in either eye for preschool-age children and 20/30 or worse for school-age children, but state or district protocols govern.

Scoliosis screening commonly uses the Adams forward bend test; an angle of trunk rotation of 7 degrees or more on a scoliometer is a common referral threshold.

Head lice diagnosis requires a live louse or a nit within 1/4 inch of the scalp; no-nit policies are not recommended by major health organizations.

Suspected concussion requires removal from play the same day and a gradual, stepwise return to learning and activity after symptom resolution.

Growth is assessed by plotting height, weight, and BMI for age and sex on CDC growth charts; a change in growth trajectory can prompt referral.

Soap-and-water handwashing should last at least 20 seconds; alcohol-based hand sanitizer should contain at least 60% alcohol.

Children and adolescents aged 6-17 years need at least 60 minutes of moderate-to-vigorous physical activity daily.

Routine Tdap booster is recommended at 11-12 years; meningococcal conjugate vaccine is recommended at 11-12 years with a booster at 16 years.

HPV vaccination can start at age 9 and is routinely recommended at 11-12 years; catch-up vaccination is recommended through age 26.

Annual influenza vaccination is recommended for everyone aged 6 months and older, including school-age children.

Sunscreen with broad-spectrum SPF 30 or higher reduces ultraviolet radiation exposure during outdoor school activities.

Dental sealants on permanent molars reduce caries risk; school-based sealant programs target high-risk children.

School immunization requirements and exemption processes are set by state law, not by a single national standard.

An asthma action plan uses green, yellow, and red zones to guide daily control, early worsening, and emergency response.

For a conscious student with blood glucose below 70 mg/dL, give 15 grams of fast-acting carbohydrate, recheck in 15 minutes, and repeat until glucose is above 70.

A seizure lasting longer than 5 minutes, or repeated seizures without recovery, is status epilepticus and requires emergency medical activation.

Intramuscular epinephrine is first-line treatment for anaphylaxis; antihistamines do not treat airway or circulatory compromise.

A student with sickle cell disease and temperature of 38.3 degrees Celsius (101 degrees Fahrenheit) or higher needs urgent medical evaluation because of sepsis risk.

Section 504 provides accommodations for a disability that substantially limits a major life activity; an IEP provides specialized instruction under IDEA.

Individualized health care plans translate prescriber orders and family goals into school-specific nursing actions and emergency protocols.

Diabetes care at school includes glucose monitoring, insulin or carbohydrate administration per orders, and recognition of hypoglycemia and hyperglycemia.

For adult CPR, use a 30:2 compression-to-ventilation ratio; for two-rescuer child and infant CPR by healthcare providers, use 15:2.

Chest compressions are delivered at 100-120 per minute; adult depth is at least 2 inches, child depth about 2 inches, and infant depth about 1.5 inches.

Severe extremity bleeding is controlled with firm direct pressure; a tourniquet is used for life-threatening bleeding when direct pressure fails.

A conscious choking child who cannot cough, speak, or breathe receives back blows and abdominal thrusts; an infant receives back slaps and chest thrusts.

Suspected poisoning warrants contacting poison control or emergency services; vomiting should not be induced unless specifically instructed.

Anaphylaxis is treated with intramuscular epinephrine promptly, followed by emergency medical services activation.

Head injury warning signs include loss of consciousness, repeated vomiting, worsening headache, confusion, seizure, or unequal pupils.

Standard precautions require gloves for contact with blood or body fluids and hand hygiene before and after glove use.

Asking directly about suicidal thoughts does not increase risk and is part of identifying students who need immediate safety planning and referral.

Calling or texting 988 connects individuals in the United States to the Suicide and Crisis Lifeline for crisis support.

School nurses are mandated reporters; suspected child abuse or neglect must be reported under state law and district policy.

De-escalation begins with reducing stimulation, maintaining safe distance, using calm brief statements, and avoiding arguing or crowding.

The PHQ-A is a commonly used adolescent depression screening tool; positive screens require follow-up assessment, not diagnosis by the screener alone.

Eating disorder warning signs include rapid weight loss, food restriction, purging, excessive exercise, and preoccupation with body shape or weight.

Confidentiality for mental health information is limited by safety concerns, mandated reporting duties, and legitimate educational need-to-know.

Behavioral crisis response should include a safe environment, supervision, notification of guardians as appropriate, and referral to emergency or crisis services when risk is imminent.

School health records are generally education records protected by FERPA; HIPAA generally does not govern school health records because of the education-record exclusion.

FERPA requires written parent consent for most disclosures of education records, with exceptions such as school officials with legitimate educational interests and health or safety emergencies.

Section 504 prohibits disability discrimination and requires accommodations; IDEA requires special education and related services for eligible students.

Medication administration generally requires a valid prescriber order, parent authorization, pharmacy-labeled container, and trained staff under state law and district policy.

An RN may delegate specific tasks to trained unlicensed personnel according to the state nurse practice act but cannot delegate nursing assessment or judgment.

Emergency care may proceed without prior consent when delay could endanger the student, following district policy and state law.

Documentation should be timely, objective, and complete, including assessment findings, interventions, notifications, and outcomes.

The ADA provides broad civil rights protections for individuals with disabilities in school and community settings.

A school health needs assessment uses student health data, screening results, surveys, attendance, and family input to identify priorities and gaps.

The PDSA cycle tests a small plan, carries it out, studies results, and acts on findings before broader implementation.

Emergency reunification planning defines controlled release locations, parent verification procedures, and communication methods after evacuation or crisis.

School health budgets align staffing, supplies, screening, and training with identified student needs and legal requirements.

Immunization compliance and screening completion rates are common program performance indicators.

A school health advisory council includes families, staff, and community partners who advise on health policy and coordinated school health.

Emergency drills and stock epinephrine or naloxone programs require written protocols, staff training, and documented maintenance.

Staff training in medication administration, confidentiality, and emergency response is a program management responsibility.

PICO stands for Population, Intervention, Comparison, and Outcome and structures a focused question for evidence searching.

Systematic reviews and randomized controlled trials generally rank higher than observational studies or expert opinion in evidence hierarchies.

Evidence must be appraised for validity, applicability to the school population, and feasibility before practice change.

Care coordination organizes communication and services among students, families, school staff, and health providers.

Cultural humility involves self-reflection, openness, and power-sharing rather than assuming knowledge about a student's culture.

Interprofessional collaboration requires clear role boundaries, shared goals, and closed-loop communication.

Quality improvement uses measurable aims, data collection, and repeated tests of change to improve school health processes.

Continuing competence includes staying current with school nursing standards, state law, and evidence-based guidelines.