Assessment + Prep Flashcards
What are some important pieces of info to gather during patient assessment before injection
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
T or F: more than 1 live vaccine can be given on the same day
T
If need to give 2 live vaccines on different days, how long should they be spread out?
28 days
T or F: live vaccines can be given orally or via intranasal route
F
T or F: all inactive vaccines can be given at any time relative to other vaccines
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
Why do we need to know pt weight
to determine needle length (IM) or dose of E is anaphylactic rxn occurs
T or F: live vaccines can always be given to pregnant people
F_ generally only given if B> R
What should a patient do if they report that they have had a fever after past injections?
pre-treat with acetaminophen before vaccine
Why do we need all this info from the patient
to ensure they have the correct indication for the vaccine + its appropriate based on their current status
T or F: if a patient has mild illness +/ - fever before a vaccine, the vaccine should be delayed
F: don’t need to delay it unless the illness increases risk of AEs or interfere with vaccine response
T or F: nasal congestion delays the delivery of influenza nasal spray
T: in this case —- give non-live vaccine
T or F: egg allergies are more common in kids
T
What vaccines contain egg protein ?
Influenza vaccines
yellow fever
rabies
MMR vaccines may contain small amounts (safe for most)
—— always check monograph
T or F: you can immunize someone with a mild egg allergy with a vaccine containing egg protein
T - but must observe for 30 mins
mild rxn: can eat small amounts + only gets skin rxn OR GI upset
T or F: you can vaccine someone with an anaphylactic rxn to eggs with the influenza vaccine (egg protein)
T - only one that this allowed (no longer CI)
- must watch for 30 mins
What vaccines have neomycin
MMR, DTap
others: Tdap, flu, polio, hep A, hep A+B combo, varicella, rabies
- check monograph
Where can latex be found during immunization process
in gloves + in rubber stopper of injection vial
What types of food allergies indicate propensity to latex allergy
some fruits: apple, apricot, avocado, banana, cherry, grape, kiwi, melons, papaya, pineapple
What are the 7 rights to check before any injection
right drug: expiry + appearance
right dose
right pt
right route + site
right reason
right time
right documentation
T or F: Using hand sanitizer is not a valid alternative to washing hands before vaccines
F: it is an alternative
— need to happen before vaccine prep, bw recipients, and whenever hands soiled
T or F: gloves are mandatory during injection
F
What vaccines are you required to where gloves for
BCG and smallpox
T or F: if giving patient multiple injections, you can reuse supplies/ needles
F: use separate needle + syringe for every injection
T or F: most needles are Luer lock tips
T- tips where the needle twists on and off
(if non-luer lock: needle pushes onto tip + clicks in place)
What is the gauge of the needle
diameter of the shaft
T or F: higher gauge is a thicker needle
F - thinner needle
** always use higher gauge/thinnest needle possible for patient comfort
What does the length of the needle measure
measures the distance bw the needle hub + the tip of the bevel
BD eclipse needles
needles with pink cover on hinge
- you use your finger to push the cover over the needle after injection
BD safety guide
cover folded in half when not activated with hinge in middle (what we used in lab)
- push forwards to unfold (less bulky then eclipse)
BD Integra
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**
T or F: powdered gloves are recommended over non-powdered
F - non-powdered are better ( powder can get into air + cause respiratory irritation)
How many times should you check med before injecting + where
3 times
- when get from shelf
- when drawing up
- before admin
T or F: If reconstituting drug, you can use sterile water or saline if the manufacture doesn’t provide a diluent
T
T or F: when adding diluent to vial with drug, it doesn’t matter how you inject it in
F: inject along side of vial to avoid creating bubbles then rotate to dissolve powder (don’t shake unless monograph tells you to)
T or F: if the solution is thicker, you should you a lower gauge
T
T or F: 1mL regular syringes and 1mL tuberculin or insulin syringes are interchangeable
F - not interchangeable
regular: mL increments
T+ I: marked units (both use different ones)
Max volume of ID injection
</= 0.1mL
What syringe to use for intradermal
1mL tuberculin syringe length of 1/2”.
gauge : 26-27
SC needle gauge
25-27 vaccines
28-32 for insulin
IM infant needle gauge
25-27 with max of 0.5mL of volume
IM children needle gauge
22-25 (thicker) with max of 1-2mL
IM teen or adult needle gauge
19-25 with max of 3mL of V
