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NR-NUR123 | Community Health Nursing (CHN) > [12] MIDTERMS | NATIONAL IMMUNIZATION PROGRAM (NIP) > Flashcards

[12] MIDTERMS | NATIONAL IMMUNIZATION PROGRAM (NIP) Flashcards

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1
Q

An organizational component of DOH charged with preventing disease, disability, and death from vaccine-preventable diseases in children and adults.

A

National Immunization Program

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2
Q

How long does it take for the body to produce antibodies after vaccine administration?

A

28 DAYS

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3
Q

Launch of EPI

A

1976

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4
Q

EPI

Orginal objectives, decrease morbidity and mortality among infants and children caused by ____

A

Orginal objectives, decrease morbidity and mortality among infants and children caused by 6 immunizable diseases

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5
Q

EPI PRINCIPLES

  • The program is based on ____ situation; schedules are drawn on the basis of the ____ and ____ of epidemiological features of the disease
  • The whole community rather than just the individual is to be protected, thus ____ approach is utilized
  • ____ is a basic health service and integrated into the health services being provided by the RHU
A
  • The program is based on epidemiological situation; schedules are drawn on the basis of the occurence and characteristics of epidemiological features of the disease
  • The whole community rather than just the individual is to be protected, thus mass approach is utilized
  • Immunization is a basic health service and integrated into the health services being provided by the RHU
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6
Q

STRATEGIES

  • Conduct routine immunization for infants/children/women through the ____ strategy
  • ____ (SIA)
A
  • Conduct routine immunization for infants/children/women through the Reaching Every Barangay (REB) strategy
  • Supplemental Immunization Activity (SIA)
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7
Q

STRATEGIES

  • Strengthening Vaccine-Preventable ____
  • Procurement of adequate and potent ____ to all health facilities nationwide
A
  • Strengthening Vaccine-Preventable Diseases Surveillance
  • Procurement of adequate and potent vaccines and needles and syringes to all health facilities nationwide
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8
Q

TARGET SETTING

  • Essential for effective planning and implementation
  • Includes infants, children ____ y/o, and women
A
  • Essential for effective planning and implementation
  • Includes infants, children < 5 y/o, and women
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9
Q

Mandatory Infants and Children Health Immunization Act of 2011

A

Republic Health Act No. 10152

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10
Q

R.A. 10152

Basic immunization for children under ____ including other types that will be determined by the Secretary of Health

A

Basic immunization for children under 5 including other types that will be determined by the Secretary of Health

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11
Q

GUIDELINES OF COLD CHAIN MANAGEMENT

  • All vaccines refrigerators or freezeers shall be ____
  • Vaccines are stored according to the ____ for each antigen
  • Regular temp. monitoring
  • ____ for emergency measures
A
  • All vaccines refrigerators or freezeers shall be used exclusively for EPI vaccines
  • Vaccines are stored according to the temp. requirement for each antigen
  • Regular temp. monitoring
  • Contingency plan for emergency measures
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12
Q

COLD CHAIN LOGISTUC MANAGEMENT

Provided to each midwife for temporary storage and transport of the vaccines to their catchment areas

A

VACCINE CARRIERS

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13
Q

COLD CHAIN MANAGEMENT

COMBINATION REFRIGERATOR / FREEZER UNIT

  • No vaccines on ____. Fill the space with frozen packs and water bottles
  • No vaccine in ____ or on the ____ of the refrigerator. Fill the space with cold packs or water jugs
  • No vaccine near cold ____
  • No vaccine on the ____ shelf
A

COMBINATION REFRIGERATOR / FREEZER UNIT

  • No vaccines on doors. Fill the space with frozen packs and water bottles
  • No vaccine in drawers or on the floor of the refrigerator. Fill the space with cold packs or water jugs
  • No vaccine near cold air vents
  • No vaccine on the top shelf
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14
Q

COLD CHAIN MANAGEMENT

FOR ALL UNITS

  • Keep vaccines ____ inches away from walls and other boxes
  • Post ____ stickers on electrical outlets. Plug in only 1 unit per outlet
  • Place the thermometer probe in the ____ of the unit. Post a temperature log on the door
A

FOR ALL UNITS

  • Keep vaccines 2-3 inches away from walls and other boxes
  • Post Do Not Unplug stickers on electrical outlets. Plug in only 1 unit per outlet
  • Place the thermometer probe in the center of the unit. Post a temperature log on the door
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15
Q

VACCINES MOST SENSITIVE TO HEAT (3)

A

ORAL POLIO, MEASLES, MMR (-15C TO -25C)

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16
Q

VACCINES LEAST SENSITIVE TO HEAT (6)

A

PENTAVALENT, BCG, TETANUS TOXOID, PCV-10, IPV, ROTAVIRUS, HPV (+2C TO +8C)

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17
Q

OPEN VIAL POLICY

  • Multi-dose liquid vaccines (OPV, DPT, TT, and Hepa B) may be used in the next immunization sessions for up to a max of ____ weeks provided that all the proper conditions are met
A
  • Multi-dose liquid vaccines (OPV, DPT, TT, and Hepa B) may be used in the next immunization sessions for up to a max of 4 weeks provided that all the proper conditions are met
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18
Q

OPEN VIAL POLICY

FOR MULTI-DOSE LIQUID VACCINES

  • Expiry date has not passed
  • The vaccine has not been contaminated
  • The vials have been stored under appropriate cold chain conditions
  • The vaccine vial septum has not been ____
  • The ____ on the vial, if attached, has not reached the discard point
A

FOR MULTI-DOSE LIQUID VACCINES

  • Expiry date has not passed
  • The vaccine has not been contaminated
  • The vials have been stored under appropriate cold chain conditions
  • The vaccine vial septum has not been submerged in water
  • The vaccine vial monitor on the vial, if attached, has not reached the discard point
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19
Q

looks like a square inside a circle

A

VACCINE VIAL MONITOR (VVM)

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20
Q

VACCINE VIAL MONITOR (VVM)

  • As the vaccine vial is exposed to more heat, the ____ becomes darker
  • Use only vials with inner square that are ____ in color than the outside circle
  • Inner squares that have begun to ____ should be used before vials with lighter inner square
  • VVMs do not measure exposure to ____ for freeze-sensitive vaccines
  • A VVM not at the discard point does not exclude the possibility that the vaccine was frozen. Before use, make sure that the freeze-sensitive vaccine with good VVM has not been frozen
A
  • As the vaccine vial is exposed to more heat, the square becomes darker
  • Use only vials with inner square that are lighter in color than the outside circle
  • Inner squares that have begun to darken but still lighter than outer circle should be used before vials with lighter inner square
  • VVMs do not measure exposure to freezing temperatures for freeze-sensitive vaccines
  • A VVM not at the discard point does not exclude the possibility that the vaccine was frozen. Before use, make sure that the freeze-sensitive vaccine with good VVM has not been frozen
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21
Q
  • Freeze-dried vaccines (AMV and BCG) should be discarde ____ hours after reconstitution or at the end of the immunization session
A
  • Freeze-dried vaccines (AMV and BCG) should be discarde 6 hours after reconstitution or at the end of the immunization session
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22
Q

LEGAL BASIS

Compulsory Basic Immunization for Infants and Children below 8 y/o

A

PRESIDENTIAL DECREE NO. 996

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23
Q

LEGAL BASIS

Implementing a UN goal on Universal Child Immunization by 1990

A

PRESIDENTIAL PROCLAMATION NO. 6

24
Q

LEGAL BASIS

Reaffirming the commitment of the Philippines to the Universal Child and Mother Immunization goal of the WHA

A

PRESIDENTIAL PROCLAMATION NO. 46

25
Q

LEGAL BASIS

Compulsory Immunization against Hepa B for Infants and Children below 8 y/o

A

REPUBLIC ACT 7846

26
Q

LEGAL BASIS

Providing for Mandatory Basic Immunization Services for Infants and Children up to 5 y/o

A

REPUBLIC ACT 10152

27
Q

LEGAL BASIS

Policies on the Nationwide Implementation of EPI

A

DOH ADMINISTRATIVE ORDER NO. 39 S. 2003

28
Q

LEGAL BASIS

Implementing Guidelines on Hepa B Immunization for Infants

A

DOH ADMINISTRATIVE ORDER NO. 2006-0015

29
Q

LEGAL BASIS

Administration of Rotavirus Vaccine for Infants

A

DOH MEMORANDUM NO. 2012-0153

30
Q

LEGAL BASIS

Administration of Pneumococcal Conjugate Vaccine-13 (PCV 13)

A

DOH MEMORANDUM NO. 2014-0155

31
Q

LEGAL BASIS

Administration of Inactivated Poliomyelitis Vaccine

A

DOH MEMORANDUM NO. 2015-164

32
Q

LEGAL BASIS

Guidelines in the Implementation of School-Based Immunization

A

DOH MEMORANDUM NO. 2015-0146

33
Q

LEGAL BASIS

Guidelines in the Implementation of School-Based Immunization

A

DOH MEMORANDUM NO. 2015-0238

34
Q

Designated as Immunization Day

A

WEDNESDAY

35
Q

GENERAL PRINCIPLES OF IMMUNIZATION

  • Safe & immunologically effective to administer all EPI vaccines on the ____ at ____.
  • Measles vaccine should be given as soon as the child is ____ months old.
  • Vaccination schedule should not be ____.
A
  • Safe & immunologically effective to administer all EPI vaccines on the same day at different sites of the body.
  • Measles vaccine should be given as soon as the child is 9 months old.
  • Vaccination schedule should not be restarted from the beginning.
36
Q

GENERAL PRINCIPLES OF IMMUNIZATION

  • Vaccine should be given with the recommended ____ weeks interval
  • Strictly follow principle of never, ever reconstituting the freeze dried vaccine in anything other than the ____ supplied with them.
A
  • Vaccine should be given with the recommended 4 weeks interval
  • Strictly follow principle of never, ever reconstituting the freeze dried vaccine in anything other than the diluent supplied with them.
37
Q

GENERAL PRINCIPLES OF IMMUNIZATION

  • False contraindications to immunization:
    ____ grade fever
    m____
    mild ____ infections
    d____
    other minor illnesses
  • Repeat BCG vaccination if the child does not develop a ____ after the first injection.
A
  • False contraindications to immunization:
    low grade fever
    malnutrition
    mild respiratory infections
    diarrhea
    other minor illnesses
  • Repeat BCG vaccination if the child does not develop a scar after the first injection.
38
Q

GENERAL PRINCIPLES OF IMMUNIZATION

  • Generally, one should immunize unless the child is so sick that he needs to be hospitalized.

Absolute contraindications to immunization :
* Severe ____ reaction to previous dose of vaccine

  • With known ____ to vaccine component
  • A child with a sign and symptoms of severe ____
  • Fever of ____ C and above
A
  • Generally, one should immunize unless the child is so sick that he needs to be hospitalized.

Absolute contraindications to immunization :
* Severe hypersensitivity reaction to previous dose of vaccine

  • With known allergy to vaccine component
  • A child with a sign and symptoms of severe dehydration
  • Fever of 38.5 C and above
39
Q

GENERAL PRINCIPLES OF IMMUNIZATION

Absolute contraindications to immunization:

a. DPT vaccine:
* over ____ years of age
* suffered a severe reaction to previous dose (convulsion or shock w/in 3 days of the most recent dose)
* recurrent ____
* active ____ disease

A

Absolute contraindications to immunization:

a. DPT vaccine:
* over 5 years of age
* suffered a severe reaction to previous dose (convulsion or shock w/in 3 days of the most recent dose )
* recurrent convulsions
* active neurological disease

40
Q

GENERAL PRINCIPLES OF IMMUNIZATION

Absolute contraindications to immunization:

b. BCG vaccine:
* with ____ or other immune deficiency diseases
* i____
* therapy with immunosuppressive agents or ____
* after ____ y/o

A

Absolute contraindications to immunization:

b. BCG vaccine:
* with AIDS or other immune deficiency diseases
* immunosuppressed
* therapy with immunosuppressive agents or irradiation
* after 1 y/o

41
Q

GENERAL PRINCIPLES OF IMMUNIZATION

Absolute contraindications to immunization :
c. IPV:
* severe allergic reaction (anaphylaxis) to a previous dose or to any component of the vaccine.

  • Infants w/ moderate or severe illness temp. ≥ ____°C should not be vaccinated until they have improved.
A

Absolute contraindications to immunization :
c. IPV:
* severe allergic reaction (anaphylaxis) to a previous dose or to any component of the vaccine.

  • Infants w/ moderate or severe illness temp. ≥ 39°C should not be vaccinated until they have improved.
42
Q

GENERAL PRINCIPLES OF IMMUNIZATION

Absolute contraindications to immunization :
d. PCV 13:
* severe allergic reactions to a prior dose or to any component of the vaccine, including ____

  • Infants with moderate or severe illness (temp. ____ °C) should not be vaccinated until they improved.
A

Absolute contraindications to immunization :
d. PCV 13:
* severe allergic reactions to a prior dose or to any component of the vaccine, including diphtheria toxoid

  • Infants with moderate or severe illness (temp. 39 °C) should not be vaccinated until they improved.
43
Q

GENERAL PRINCIPLES OF IMMUNIZATION

Absolute contraindications to immunization :
e. Rotavirus vaccine:
* Hypersensitivity to any of their components

  • History of ____ or intestinal malformations, predisposition to ____.
  • Vaccination should be postponed in case of ongoing acute ____ or serious febrile illness.
A

Absolute contraindications to immunization :
e. Rotavirus vaccine:
* Hypersensitivity to any of their components

  • History of intussusceptions or intestinal malformations, predisposition to intussusceptions.
  • Vaccination should be postponed in case of ongoing acute gastroenteritis or serious febrile illness.
44
Q

GENERAL PRINCIPLES OF IMMUNIZATION

  • Low birth wt. or prematurity are NOT contraindications to hepatitis B vaccination
    (wt. less than ____ gm.: birth dose, & 3 additional
    doses)
  • Safe & effective with mild side effects after vaccination
  • Doses of a vaccine less than the recommended ____ weeks interval may lessen the antibody response.
A
  • Low birth wt. or prematurity are NOT contraindications to hepatitis B vaccination
    (wt. less than 2000 gm.: birth dose, & 3 additional
    doses)
  • Safe & effective with mild side effects after vaccination
  • Doses of a vaccine less than the recommended 4 weeks interval may lessen the antibody response.
45
Q

GENERAL PRINCIPLES OF IMMUNIZATION

  • ____ must be given to children/mother who missed a dose of DPT/OPV/TT/ Hepatitis B.
  • Use ____ syringe one needle per child during vaccination.
A
  • No extra doses must be given to children/mother who missed a dose of DPT/OPV/TT/ Hepatitis B.
  • Use one syringe one needle per child during vaccination.
46
Q

TETANUS TOXOID IMMUNIZATION

TT1

A

Time: Anytime during pregnancy

47
Q

TETANUS TOXOID IMMUNIZATION

TT2

A

Time: 1 month after dose 1
Duration of Protecion: 3 years

48
Q

TETANUS TOXOID IMMUNIZATION

TT3

A

Time: 6 months after dose 2
Duration of Protecion: 5 years

49
Q

TETANUS TOXOID IMMUNIZATION

TT4

A

Time: 1 year after dose 3
Duration of Protecion: 10 years

50
Q

TETANUS TOXOID IMMUNIZATION

TT5

A

Time: 1 year after dose 4
Duration of Protecion: lifetime

51
Q

TETANUS DIPTHERIA IMMUNIZATION SCHEDULE

Number of Doses

  • Pregnant women who had received ____ childhood DPT/Pentavalent doses should receive ____ doses of Td
  • Pregnant women w/ no previous DPT/Pentavalent immunization or unreliable immunization information should receive ____ Td
  • Dosage: ____ ml
  • Site: upper outer part of the arm
  • Method of Administration: IM
A

Number of Doses

  • Pregnant women who had received 3 childhood DPT/Pentavalent doses should receive 3 doses of Td
  • Pregnant women w/ no previous DPT/Pentavalent immunization or unreliable immunization information should receive 5 Td
  • Dosage: 0.5 ml
  • Site: upper outer part of the arm
  • Method of Administration: IM
52
Q

SCHOOL-BASED IMMUNIZATION

1.MCV (Measles-containing vaccine), Td (Tetanus-diphtheria), and MR (Measles-Rubella) vaccines

  • All school children enrolled in Grade ____ shall be vaccinated w/ the appropriate vaccines as specified
  • Screened for their measles vaccination history at the time of school entry and vaccinate if evidences show either zero or only ____ dose to ensure that these students received at least ____ MCV by school entry.
  • Administered w/ 1 dose of ____ vaccines.
  • Students enrolled in grade 7 regardless of age shall be vaccinated w/ ____ dose each of measles-rubella (MR) and Td vaccines on the same immunization session.
A

1.MCV (Measles-containing vaccine), Td (Tetanus-diphtheria), and MR (Measles-Rubella) vaccines

  • All school children enrolled in Grade 1 & 7 shall be vaccinated w/ the appropriate vaccines as specified
  • Screened for their measles vaccination history at the time of school entry and vaccinate if evidences show either zero or only 1 dose to ensure that these students received at least 2 MCV by school entry.
  • Administered w/ 1 dose of Tetanus-diphtheria (Td) vaccines.
  • Students enrolled in grade 7 regardless of age shall be vaccinated w/ 1 dose each of measles-rubella (MR) and Td vaccines on the same immunization session.
52
Q

SCHOOL-BASED IMMUNIZATION

2.Human Pappilomavirus (HPV) Vaccine

  • A component strategy in the prevention of cervical cancer.
  • All ____ years old female school children enrolled in Grade 4 shall be vaccinated w/ two doses of quadrivalent HPV vaccine following the DOH recommended immunization schedule.
  • Dosage: HPV ____ ml, IM, ____ deltoid arm
  • All students who received the first dose of HPV shall be given the second dose after ____ months
A

2.Human Pappilomavirus (HPV) Vaccine

  • A component strategy in the prevention of cervical cancer.
  • All 9 to 13 years old female school children enrolled in Grade 4 shall be vaccinated w/ two doses of quadrivalent HPV vaccine following the DOH recommended immunization schedule.
  • Dosage: HPV 0.5 ml, IM, left deltoid arm
  • All students who received the first dose of HPV shall be given the second dose after 6 months
53
Q

HEALTH TEACHINGS

BCG
* Deep ____ at vaccination - refer to the physician for incision and drainage.

  • Do not ____ the area of injection.
  • A scar will form ____ weeks after injection
A

BCG
* Deep abscess at vaccination - refer to the physician for incision and drainage.

  • Do not massage the area of injection.
  • A scar will form 12 weeks after injection
54
Q

HEALTH TEACHINGS

MMR
* If the child has fever give ____ or any appropriate antipyretic every four hours after immunization.

Rotavirus
* Reassure parents and instruct them to give ____ to the child

A

MMR
* If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization.

Rotavirus
* Reassure parents and instruct them to give antipyretic to the child

55
Q

HEALTH TEACHINGS

Measles Vaccine
* If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization

  • Alternating ____ for 24 hours for pain and soreness

Tetanus Toxoid
* No medication for ____
* For pain ____ compress 24 hours

A

Measles Vaccine
* If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization

  • Alternating cold and warm compress for 24 hours for pain and soreness

Tetanus Toxoid
* No medication for pregnant
* For pain cold compress 24 hours

NR-NUR123 | Community Health Nursing (CHN) (20 decks)

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