What’s the best beverage for my child during exercise?

Staying hydrated when exercising is very important for everyone. The amount of exercise and how much sweating goes on are the biggest things to think about when deciding what your child should drink and the amount of fluid he should have.

Exercise lasting less than an hour in a cool environment where there is little sweating calls for plain water. The longer your child exercises and the more he sweats, the greater the chance he will need a sports drink.

Be sure to check the label to see how much sugar (carbohydrates), caffeine, vitamins and electrolytes the beverage contains. Children do not need drinks with caffeine.

Nor does your child need vitamin water after exercising. All vitamins are best obtained from fruits and vegetables. Many vitamin waters are flavored with alternative sweeteners, and kids don’t need added sweeteners or alternative sweeteners in their drinks.

Water is the best fluid replacement in most instances for most children. If adding a flavor will help your child to drink water, then squeeze in the juice of a lemon, a lime or an orange (no seeds!), which will add flavor without adding calories or salt.

What is an ingrown toenail, and how can my child avoid getting one?

Ingrown toenails are very common and often occur on the big toe. They are caused by the sideways growth of the toenail, and the edge goes under the skin. This causes pressure and soreness on the side of the toe, and the toe often gets swollen and red. It may even get infected. Those most commonly affected by an ingrown toenail are athletes (such as pitchers) who are putting a lot of pressure on their toe when they push off for a sport, or growing children who might be wearing shoes that are too tight.

To prevent ingrown toenails, be sure you child is wearing shoes that are wide enough for her foot and don’t pinch her toes. Toenails should be trimmed in a straight line across the top; do not cut them in a curved pattern. Feet should be kept clean and dry. If there is an area of redness or pain on the side of the toe, the foot can soak in warm water two to three times a day to keep it clean, and you can apply an antibiotic ointment.

Don’t wait too long to get your health care provider to take a look if this doesn’t help and if the toe area is very painful, infected or getting worse. And don’t try to remove the nail at home.

What do I do for a bee sting?

Most people will get a local reaction to a bee sting — a reddened painful area of skin around the sting, which is normal. Swelling and itching may also occur. The pain usually disappears in a few hours. When the sting occurs, check to see if the stinger is still present (look for a small black dot at the sting site). You can scrape over the area with a credit card to remove the stinger. Apply ice or cold packs to help reduce swelling. Clean the area with soap and water, and you can use an anti-inflammatory cream like hydrocortisone or apply a paste of baking soda and water to reduce the reaction. Unseasoned meat tenderizer paste made with water also helps to break down the bee venom. You can also use an antihistamine such as diphenhydramine for itching, or a pain medicine like acetaminophen. Call your health care provider to make sure you have the correct dose.

A systemic allergic reaction is much more severe, and your child may develop hives, redness and swelling at sites other than where the sting occurred. She may also be nauseated, may vomit or may feel dizzy. If this type of reaction occurs, it might lead to difficulty breathing. You should go to a health care facility as soon as possible or get emergency help.

What are the safety rules when lightning strikes?

Lightning is a unique environmental occurrence that can cause unique problems for a person injured by it. The most common days for injury are Saturday, Sunday and Wednesday due to the higher number of people outdoors on those days. The most common time of day for injury is noon to 6 P.M., and the most dangerous time is when the victim underestimates the likelihood of injury — just before and right after the storm. Lightning may hit as far as ten miles in front of a storm, and it can be very difficult to know if the movement of clouds past one point means it’s over rather than pausing briefly as more storm clouds gather.

Knowing the weather forecast is important as you prepare for outdoor activities. You should also be aware of local thunderstorm patterns. The biggest risk factors are being out in bad weather without knowing the forecast, not paying attention to the weather, not having an evacuation plan if you are outside or not following the plan. Common geographic areas more prone to lightning are mountain ridges between 3 and 5 P.M., parts of Florida and the Gulf Coast, the East Coast and along major river valley areas.

There is danger whenever you see lightning or hear thunder. Lightning travels 10 to 12 miles in front of a storm, so clouds need not be present and there may be no rain. Your first priority in a storm should be to find shelter. School buses are excellent if you’re out on organized activities. Also look for a building strong enough to live in. Stay away from trees, small shelters, bleachers, fences and towers. Get out of the water, pools and wet areas. Come down from high areas such as mountain ridges when thunderstorms are likely. Avoid the use of telephones and electronic equipment during a thunderstorm. Do not resume activity until 30 minutes after the last lightning bolt or thunder blast.

Terea Giannetta, MSN, RN, CPNP, is a certified PNP and Chief PNP at Children’s Hospital Central California, where she has had a clinical practice in Hematology/ Oncology ambulatory clinic for the past 19 years. She is also full-time faculty and PNP Program Coordinator at California State University, Fresno.

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