Download Vaccine Study Guide: Immunization Schedules and Adverse Reactions and more Exams Nursing in PDF only on Docsity!
NURS 53 5 STUDY GUIDE WITH
COMPLETE SOLUTION
VAERS - ANSWER Vaccine Adverse Event Reporting System To report any adverse reactions after administration of any vaccine Barriers to immunization - ANSWER Complexity of health care system Inconvenient scheduling Language and cultural barriers Expense Parental misconceptions Inaccurate record keeping Reluctance of healthcare workers to give more than one vaccine at a visit Lack of public awareness of the need for immunizations Antigen - ANSWER A protein that, when introduced in the blood, triggers the production of an antibody Antibody - ANSWER Protein produced by B cells to destroy antigens Naturally acquired active immunity - ANSWER Develops after exposure to antigens in environment Naturally acquired passive immunity - ANSWER conferred by transfer of
maternal antibodies across placenta or in breast milk Artificially acquired immunity - ANSWER Immunity that results from a vaccination Live vaccines - ANSWER Attenuated organisms used to stimulate cell-mediated immunity and create long term protection Toxoid - ANSWER Inactivated toxin used in a vaccine MMR, Varicella, nasal influenza Inactivated virus - ANSWER A virus that is not able to replicate in a host. DtaP, IPV, Hep B, and Influenza Types of passive immunizations - ANSWER IVIG IG - IM (Hepatitis A, B, RSV, Rabies, VZIG) Hepatitis B - ANSWER B= blood and body fluids (hep c is the same) Liver disease Administrations of Hepatitis B - ANSWER Birth 2 months 4 months 18 months SE: Low grade fever Newborn Hep B vaccine: - ANSWER HbsAG status of the mother
- HbsAg positive
- Vaccinate within 12 hours of birth and administer HBIG in opposite limb
- HbsAg negative
- Vaccinate between birth and discharge
DtaP and Pregnancy - ANSWER Vaccination during the 3rd trimester or late in the second trimester (after 20 week) Use Tdap for routine tetanus and diptheria booster or wound management if no prior Tdap dose Contraindications to TdaP - ANSWER Life threatening allergic reaction Neurological reaction: Seizure or brain or nervous system alteration within 7 days after a dose Non-stop crying > 3 hrs of fever > Poliomyelitis - ANSWER A viral infection of the gray matter of the spinal cord Polio vaccine - ANSWER Inactivated (killed) poliovirus Series of four shots given at 2,4, and 6-18 months Booster at 4-6 years Generally not given after 18 years of age If it must be given for travel, schedule is 0, 1 and 6 months Given SC Side effects: redness, swelling at injection site Contraindications of Polio Vaccine - ANSWER Life threatening allergic reaction Reaction to antibiotics neomycin, streptomycin, or polymyxin B Haemophilus influenzae - ANSWER Gram negative bacti Bacterial fraction conjugated with other substances Several different formulations combined with other vaccines Generally given at 2,4,6 months & 12-
months Given IM Side effects: fever, site discomfort HIB Considerations - ANSWER Children starting late may not need entire 3 or 4 dose series Number of doses child requires depends on current age The number of doses needed to complete the series should be determined using the catch-up schedule published annually with the childhood schedule. All children 15-59 months of age need at least 1 dose Generally not recommended for persons older than 59 months of age Consider for high-risk persons: asplenia, HIV infection Pneumococcal Conjugate PCVR13 (Prevnar) - ANSWER Protects against streptococcus pneumoniae meningitis Inactivated (killed) bacterial vaccine IM Given at 2,4,6, 12-15 mos Usually not needed after age 5 Side effects: site discomfort, swelling, low fever Pneumococcal vaccine 23 PPV23 (Pneumovax) - ANSWER IM or SC
FluMist contraindications - ANSWER Contraindications: Children aged 2-4 years with asthma or recurrent wheezing that might indicate asthma within the past 12 months should not receive FluMist More expensive than Fluzone; May not be covered by insurance TIV vs LAIV - ANSWER TIV: Viruses are made noninfectious or inactivated (killed) Administered IM Licensed for use among persons aged 6 months and older, including those who are healthy and those with chronic medical conditions LAIV: Live, attenuated virus that have the potential to cause mild signs or symptoms (e.g., runny nose, nasal congestion, fever, or sore throat). Administer intranasally by sprayer Licensed for use among non-pregnant persons aged 2-49 years. Safety not established in persons with underlying medical conditions that confer a
higher risk for influenza complications. Rotavirus vaccine - ANSWER only given to infants, 6 weeks through age 14 weeks and 6 days Roatvirus Contraindications - ANSWER Allergy: a severe (life-threatening) allergic reaction to a prior dose of rotavirus vaccine, latex Uncorrected congenital G/I malformation Severe combined immunodeficiency disease Rotavirus Reactions - ANSWER Mild: Fever, runny nose, fussy, and vomiting, decreased appetite Severe: intussusception (The estimated risk is 1 intussusception case per 100,000 infants) and Kawasaki disease have been reported. MMR Vaccine - ANSWER Vaccination to protect against mumps, measles and rubella Measles starts as a fever, cough, runny nose, conjunctivitis (pinkeye), and a red, pinpoint rash that starts on the face and spreads to the rest of the body. If the virus infects the lungs, it can cause pneumonia. Measles in older children can lead to inflammation of the brain, called encephalitis, which can cause seizures and brain damage. MMR Vaccine Details - ANSWER Live virus vaccine (not transmitted to contacts) Given at 12-15 months and 4-6 years If given prior to 12 months, response dampened by maternal
First and second dose can be administered earlier (i.e. outbreak) if needed but interval needs to be at least three months a part Adolescent over 13 years old who has not had the vaccination needs 2 doses of vaccine 4-8 weeks apart A second dose of catch up vaccine is recommended for children, adolescents, and college students who previously had one dose Side effects: site discomfort, local site rash, generalized varicelliform rash Varicella Contraindications - ANSWER Allergic reaction to gelatin Neomycin or streptomycin or previous dose Severe immunosuppression, HIV +, chemo, long term steroids Pregnancy MMRV - ANSWER Measles, mumps, rubella, varicella HPV - Gardasil - ANSWER Intervals should be 0, 2 months after first dose, and 6 months after first dose Vaccination should start at 11-12 years of age but can be started in females (and males) as young as 9 years of age, and catch up vaccination to age 26 Can be given at same visit when other age appropriate vaccines are provided such as Tdap, Hep B, or MCV
Cervarix - ANSWER Given starting typically at age 11 (but can be given as early as nine) 3 dose series- st dose: now; 2nd dose:1- months; 3rd dose: 6 months Hepatitis A - ANSWER inflammation of the liver caused by the hepatitis A virus (HAV), usually transmitted orally through fecal contamination of food or water Kids should receive a vaccine at 12 months and a booster at 18 months Neisseria Meningitidis - ANSWER MCV4 (Menactra/Menveo) Licensed in 2005 preferred vaccine for ages 2-55 years of age 2011 ACIP recommendation:
- Routine vaccination for all persons 11-12, with a booster given at age 16
- Recommend a 2-dose primary series administered 2 months apart for persons aged 2 through 54 years with persistent complement component deficiency and functional or anatomic asplenia, and for adolescents with human immunodeficiency virus (HIV) infection.
- Predictions are hopeful that the vaccine efficacy will last somewhere between 8-10 years Serogroup B Meningoccal Vaccines (Bexsero and Trumenba)
- These vaccines may also be given to anyone 16 through 23 years old to provide short term protection against most strains of serogroup B meningococcal disease; 16 through 18 years are the preferred ages for vaccination.
Breastfeeding Are pre participation physicals mandatory? - ANSWER Yes Clearing an athlete for participation - ANSWER Unrestricted Clearance with the notification of coach, trainer, and team physician Deferred clearance Disqualification What are you assessing neurologically in PPE? - ANSWER Gait, Romberg's, Point to Point coordination, heel to shin test, and tandem walking Symptoms of a concussion - ANSWER Headache Nausea Balance problems or dizziness Double or fuzzy vision Feeling sluggish Feeling foggy or groggy Concentration or memory problems Confusion Head's up concussion campaign - ANSWER Don't hide it Report it Take time to recover Its better to miss one game than the whole season Extremity evaluation - ANSWER Shoulders: Shoulder shrug, abduction, internal and external rotation Elbow: Extension and flexion, pronation and supination, make a fist and spread fingers
Knees: Flexion and extension Duck walk Stand on toes and heels Common overuse injuries - ANSWER Little leaguer's shoulder Swimmer's shoulder Little leaguer's elbow Shin Splints Sudden cardiac death - ANSWER a nontraumatic, unexpected death from sudden cardiac arrest, most often due to arrhythmia; in most instances, victims have underlying heart disease HTN medications preferred for athletes - ANSWER ACE - ARBs Alpha adrenergic antagonists Ca channel blockers HTN in athletes - Evaluation - ANSWER ECG, UA, BMP, Lipid and CBC panels, echocardiography for stage 2 HTN Evaluating for murmurs - ANSWER Marfans/positive history Examine while standing, squatting, and with valsalva S1/S Thrill/heave PMI displaced Decreased femoral artery pulses 2010 working group objectives - ANSWER • Primary:
- Detect potentially life threatening or disabling
Screening for STDS-sexual history, partners Screening for alcohol abuse-CAGE Screening for depression---sadness/hopleless question
**activities provided to identify and treat asymptomatic persons who have risk factors for a given disease or preclinical disease....example: mammogram, cervical exam with pap, bp measurement, lipid panel
Tertiary prevention - ANSWER Actions taken to contain damage once a disease or disability has progressed beyond its early stages
Examples of tertiary prevention - ANSWER Cardiac rehab, PT/OT, SLP, addiction/drug rehab
Non-modifiable risk factors - ANSWER age, gender, family history/genetics
Growth patterns 0 - 6 months - ANSWER Weight increases 6-8 oz/week Length increases 1"/month HC increases 0.5"/month Posterior fontanel closes at 2 months * Double birth weight by 6 months *
Grasp reflex - ANSWER an infantile reflex in which an infant closes her hand into a fist when her palm is touched
Rooting reflex - ANSWER a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple
tonic neck reflex - ANSWER turning the head to one side, extending the arm and leg on that side, and flexing the limbs on the opposite side
Dance/Step reflex - ANSWER Infant held upright with feet touching ground, moves feet as if to walk
Babinski reflex - ANSWER Reflex in which a newborn fans out the toes when the sole of the foot is touched
Extrusion reflex - ANSWER Thrusting tongue movements that automatically push food out of the mouth
Spinal reflex - ANSWER a reflex controlled at the level of the spinal cord that may involve as few as two neurons
Milestones: 2 months - ANSWER Closure of posterior fontanel Social smile Vocalizes by 6 weeks Fixes on visual stimuli Sleeps 15-16 hours/day Lifts head when prone
Voluntary grasp Rakes objects Chewing, mouthing Tripod sit Bears weight on legs Anticipates food
Physical growth patterns: Infant 6 - 12 months - ANSWER Weight increases by 3-4 oz/week Length increases by 0.5"/month HC increases by 0.25"/month Teething begins 6-8 months Triple birth weight by 12 months Height increased by 50% by 12 months
Milestones: 7 - 8 Months - ANSWER Sits without support by 8 months* Parachute reflex* Crude pincer grasp* Object permanence* Stranger anxiety* Transfers hand-hand by 7 months*
Bangs objects together Imitates sounds Cup with assistance Combines syllables (dada, ma-ma)
Milestones: 9 - 12 Months - ANSWER Pulls to stand at 9 months* Cruises at 11 months* Walks with 1 hand held at 12 months* Crawling advancing to creeping Fine pincer grasp by 11 months* Releases/drops objects at 11 months Plays peek-a-boo, claps at 9 months* Waves bye-bye at 10 months Says 1-2 words with meaning Attempts 2 block tower
How long to breastfeed for - ANSWER Exclusively until 4 - 6 months Up until 12 months
