Assessment + Prep

Question 1

What are some important pieces of info to gather during patient assessment before injection

Answer 1

demographics: age, weight

medical history: conditions, med use, pregnancy

history of neurological or GBS: some vaccines (DTap, Tdap) are CI if history of encephalopathy within 7 days of getting vaccines with pertussis

Current health state: if flu symptoms

Previous Rxns to vaccines

Allergies

Vaccines received in last 4 weeks

Question 2

T or F: more than 1 live vaccine can be given on the same day

Answer 2

T

Question 3

If need to give 2 live vaccines on different days, how long should they be spread out?

Answer 3

28 days

Question 4

T or F: live vaccines can be given orally or via intranasal route

Answer 4

F

Question 5

T or F: all inactive vaccines can be given at any time relative to other vaccines

Answer 5

F: generally inactivated vaccines can be given at any time relative to any other type of vaccine EXCEPT oral cholera inactivated vaccines F + oral live typhoid vaccine
- these should be at least 8 hours apart

Question 6

Why do we need to know pt weight

Answer 6

to determine needle length (IM) or dose of E is anaphylactic rxn occurs

Question 7

T or F: live vaccines can always be given to pregnant people

Answer 7

F_ generally only given if B> R

Question 8

What should a patient do if they report that they have had a fever after past injections?

Answer 8

pre-treat with acetaminophen before vaccine

Question 9

Why do we need all this info from the patient

Answer 9

to ensure they have the correct indication for the vaccine + its appropriate based on their current status

Question 10

T or F: if a patient has mild illness +/ - fever before a vaccine, the vaccine should be delayed

Answer 10

F: don’t need to delay it unless the illness increases risk of AEs or interfere with vaccine response

Question 11

T or F: nasal congestion delays the delivery of influenza nasal spray

Answer 11

T: in this case —- give non-live vaccine

Question 12

T or F: egg allergies are more common in kids

Answer 12

T

Question 13

What vaccines contain egg protein ?

Answer 13

Influenza vaccines
yellow fever
rabies

MMR vaccines may contain small amounts (safe for most)

—— always check monograph

Question 14

T or F: you can immunize someone with a mild egg allergy with a vaccine containing egg protein

Answer 14

T - but must observe for 30 mins

mild rxn: can eat small amounts + only gets skin rxn OR GI upset

Question 15

T or F: you can vaccine someone with an anaphylactic rxn to eggs with the influenza vaccine (egg protein)

Answer 15

T - only one that this allowed (no longer CI)
- must watch for 30 mins

Question 16

What vaccines have neomycin

Answer 16

MMR, DTap

others: Tdap, flu, polio, hep A, hep A+B combo, varicella, rabies

• check monograph

Question 17

Where can latex be found during immunization process

Answer 17

in gloves + in rubber stopper of injection vial

Question 18

What types of food allergies indicate propensity to latex allergy

Answer 18

some fruits: apple, apricot, avocado, banana, cherry, grape, kiwi, melons, papaya, pineapple

Question 19

What are the 7 rights to check before any injection

Answer 19

right drug: expiry + appearance
right dose
right pt
right route + site
right reason
right time
right documentation

Question 20

T or F: Using hand sanitizer is not a valid alternative to washing hands before vaccines

Answer 20

F: it is an alternative

— need to happen before vaccine prep, bw recipients, and whenever hands soiled

Question 21

T or F: gloves are mandatory during injection

Answer 21

F

Question 22

What vaccines are you required to where gloves for

Answer 22

BCG and smallpox

Question 23

T or F: if giving patient multiple injections, you can reuse supplies/ needles

Answer 23

F: use separate needle + syringe for every injection

Question 24

T or F: most needles are Luer lock tips

Answer 24

T- tips where the needle twists on and off

(if non-luer lock: needle pushes onto tip + clicks in place)

Question 25

What is the gauge of the needle

Answer 25

diameter of the shaft

Question 26

T or F: higher gauge is a thicker needle

Answer 26

F - thinner needle

** always use higher gauge/thinnest needle possible for patient comfort

Question 27

What does the length of the needle measure

Answer 27

measures the distance bw the needle hub + the tip of the bevel

Question 28

BD eclipse needles

Answer 28

needles with pink cover on hinge
- you use your finger to push the cover over the needle after injection

Question 29

BD safety guide

Answer 29

cover folded in half when not activated with hinge in middle (what we used in lab)
- push forwards to unfold (less bulky then eclipse)

Question 30

BD Integra

Answer 30

doesn’t have a cover
- needle is on a spring; when pushing the syringe in all the way; the need retracts into the needle (safest + most expensive)

** don’t try to twist off needle once retracted**

Question 31

T or F: powdered gloves are recommended over non-powdered

Answer 31

F - non-powdered are better ( powder can get into air + cause respiratory irritation)

Question 32

How many times should you check med before injecting + where

Answer 32

3 times
- when get from shelf
- when drawing up
- before admin

Question 33

T or F: If reconstituting drug, you can use sterile water or saline if the manufacture doesn’t provide a diluent

Answer 33

T

Question 34

T or F: when adding diluent to vial with drug, it doesn’t matter how you inject it in

Answer 34

F: inject along side of vial to avoid creating bubbles then rotate to dissolve powder (don’t shake unless monograph tells you to)

Question 35

T or F: if the solution is thicker, you should you a lower gauge

Answer 35

T

Question 36

T or F: 1mL regular syringes and 1mL tuberculin or insulin syringes are interchangeable

Answer 36

F - not interchangeable

regular: mL increments

T+ I: marked units (both use different ones)

Question 37

Max volume of ID injection

Answer 37

</= 0.1mL

Question 38

What syringe to use for intradermal

Answer 38

1mL tuberculin syringe length of 1/2”.

gauge : 26-27

Question 39

SC needle gauge

Answer 39

25-27 vaccines

28-32 for insulin

Question 40

IM infant needle gauge

Answer 40

25-27 with max of 0.5mL of volume

Question 41

IM children needle gauge

Answer 41

22-25 (thicker) with max of 1-2mL

Question 42

IM teen or adult needle gauge

Answer 42

19-25 with max of 3mL of V