ACANTHOSIS NIGRICANS- skin that is coarse, thickened and black or darkened; has a velvety texture and appears on the nape of the neck, knuckles, elbow, axillae, knees, abdomen, thighs and soles of the feet.

AMERICANS WITH DISABILITIES ACT (ADA)- Passed in 1990, guarantees equal access for persons with disabilities. Title III requires accessibility for people with disabilities in public accommodation (including day care); ADA, 42 U.S.C. Section 12111 (9) for definition of reasonable accommodation.

BLOOD BORNE PATHOGENS- disease causing germs that can be spread through contact with infected blood.

CAL OSHA- California Occupational Safety & Health Advisory; governmental authority of California that oversees health and safety issues in schools and workplaces.

CONTRACTS - used in conjunction with SPHCS or ISHP; used for special situations (e.g. student wants to independently perform SPHCS); helps delineate responsibilities and clarify what services are to be provided; sets up timelines for monitoring and evaluation of the situations.

DYSLIPIDEMIA- elevated blood fats (cholesterol, triglycerides)

HYPERTENSION- high blood pressure; usually occurs early adulthood

GLUCAGON- a hormone that stimulates the release of stored glucose from the liver.

HYPERGLYCEMIA- abnormally increased blood sugar resulting in dry, warm, flushed skin; increased thirst, urination and hunger; vision changes; and weight loss.

HYPOGLYCEMIA- an abnormally low blood sugar level manifested by sweating, pallor, numbness, hunger, trembling, headache, weakness, behavior changes, and/or seizure.

HYPOGLYCEMIC UNAWARENESS- a condition when the diabetic does not feel or exhibit signs or symptoms of hypoglycemia, resulting in extremely low blood sugars and potential seizures.

IDEA (Individuals with Disabilities Education Act)- Public Law 94-142 (guarantees a free appropriate public education for all handicapped children in the least restrictive environment possible) passed in 1975; renamed Individuals with Disabilities Education Act (IDEA) in 1990 and reauthorized in 1997. This federal legislation authorizes provision of healthcare services as related services or healthcare services under the category of Other Health Impaired.

IEP (Individualized Education Plan)- used in special education; SPHCS need to be listed on the service sheet of the IEP along with designated instruction and services (DIS); DIS shall be available when the instruction and services are necessary for the pupil to benefit educationally from his/her instructional program; the school nurse is part of DIS services; the school nurse is responsible for training staff on diabetes procedures (SPHCS); IEP can provide for a study period if needed, transportation assistance, individual academic assistance, and/or modified schedule (to assist with snack times, PE or lunchtime).

ISHP (Individualized School HealthCare Plan)- developed by the school nurse in collaboration with the parent and student (if appropriate). The plan assesses and identifies healthcare needs and accommodations necessary for a student to attend school. It includes parent consent and physician authorization for standard healthcare care procedures to be performed in school and identifies who will do what, when it is done, where and how it is to take place during school attendance and all school related activities.

POLYCYSTIC OVARY SYNDROME- amenorrhea, extreme facial hair, severe acne, enlarged ovaries, obesity and insulin resistance.

SECTION 504- of the Rehabilitation Act of l973 applies to persons with disabilities. Basically it is a civil rights act which protects the civil and constitutional rights of persons with disabilities. Section 504 prohibits organizations, which receive federal funds from discriminating against otherwise qualified individuals solely on the basis of handicap. The U.S. Department of Education, Office of Civil Rights (504) enforces section 504. Provides for reasonable accommodations (supervision or privacy for blood glucose testing and insulin injections, snack/meal time accommodation, flexible scheduling of physical education, etc.) that are necessary so that the student may benefit from the educational program (34 C.F.R. Part l04, Appendix A, p. 489 (l988)).

UNIVERSAL PRECAUTIONS- protective measures to prevent the spread of disease as regulated by CalOsha e.g.: hand washing, proper disposal of sharps, using gloves when handling potentially infectious substances or materials.