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NSG 434 - Peds > Childhood Immunizations > Flashcards

Childhood Immunizations Flashcards

1
Q

Vaccination

A

the administration of a small amount of antigen, which is capable of stimulating an immune response but does not typically produce the disease.

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2
Q

traditional vaccines

A

inactivated (killed) microorganism

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3
Q

Attenuated vaccine

A

live, weakened (attenuated) microorganism

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4
Q

Toxoids

A

inactivated toxins stimulate formation of antitoxins that produce active immunity (tetanus toxoid)

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5
Q

Conjugated vaccines (newer):

A

require a protein or toxoid to link with disease-causing microorganism (H. influenza type B)

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6
Q

recombinant subunit vaccines

A

insertion of genetic material (DNA) of pathogen into another cell where the antigen is produced in massive quantities (HepB)

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7
Q

Infant primary schedule: immunization requirements

A

Diphtheria, Tetanus, acellular Pertussis (DTaP)
Poliovirus
Measles, Mumps, and Rubella (MMR)
Haemophilus influenza type b (Hib)
Hepatitis A virus (HAV)
Hepatitis B virus (HBV)
Pneumococcal Conjugate Vaccine (PCV)
Influenza
Varicella-zoster virus (VZV; Chickenpox).

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8
Q

early childhood immunizations requirements

A

Primary schedule is completed; with the exception of boosters

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9
Q

where can nurses obtain recommendations for immunization requirement schedules

A

Advisory Committee on Immunizations Practices (ACIP) of the Centers for Disease Control and Prevention (CDC)
uCommittee on Infectious Diseases of the American Academy of Pediatrics (AAP)

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10
Q

reason for Hepatitis A Virus (HepA) immunization

A

Daycare - diaper changes - handwashing
Children in close proximity
(Fecal-oral route, Person-to-person contact, Ingested contaminated food or water)

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11
Q

dosage for Hepatitis A Virus (HepA)

A

Two doses: 1 year old and 6 months after first dose

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12
Q

significance of Hepatitis B Virus (HBV)

A

HBV during childhood and adolescence can lead to fatality from cirrhosis of liver cancer in adulthood

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13
Q

newborn Hepatitis B Virus (HBV) administration

A

administer before discharge

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14
Q

dosage for Hepatitis B Virus (HBV)

A

Three additional doses (after newborn dose): 1, 2, and 6 months of age

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15
Q

Hepatitis B Virus (HBV) is safe to administer with what other immunizations

A

Safe to administer at a SEPARATE SITES with DTaP, MMR, and Hib vaccines

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16
Q

IM sites for newborns

A

Vastas lateralis

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17
Q

IM sites for toddlers and children

A

deltoid

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18
Q

Diphtheria vaccine - does not produce absolute immunity, so booster is needed…

A

every 10 years

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19
Q

Tetanus vaccine provides

A

antitoxin levels for about 10 years

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20
Q

tetanus vaccine booster is needed

A

every 10 years

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21
Q

dosage for Diphtheria, Tetanus, and Pertussis (DTaP)

A

Four doses: 2, 4, and 6 months of age, and fourth dose on or after four years old

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22
Q

Inactivated Poliovirus (IPV) significance

A

Exclusive use of IPV due to rare risk of vaccine-associated polio paralysis (VAPP) from oral polio vaccine (OPV)

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23
Q

dosage for Inactivated Poliovirus (IPV)

A

2 months, 4 months, 6 to 18 months, and 4 to 6 years of age

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24
Q

PEDIARIX

A

combination vaccine containing DTaP, Hep B, and IPV

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25
Q

Measles, Mumps, and Rubella (MMR) significance

A

due to recurrence of measles in older children and young adults, susceptible individuals should be immunized if 2 doses not administered previously

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26
Q

dosage for Measles, Mumps, and Rubella (MMR)

A

Two doses: 12 to 15 months of age and 4 to 6 years of age (school entry)

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27
Q

MMR and Varicella and ProQuad are given

A

sub-Q

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28
Q

Measles, mumps, rubella, and varicella (MMRV)

A

ProQuad - attenuated live virus vaccine should not be administered to children with immune deficiencies and pregnant females

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29
Q

ProQuad label states:

A

STORE FROZEN and indicates specific temperatures for the storage. This is due to the Varicella.

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30
Q

what develops 2-3 days after symptoms begin with Measles

A

Koplik spots

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31
Q

Pneumococcal Conjugate Vaccine (PCV 13) significance

A

Streptococcal pneumococci (bacterial infection) younger than 2 years who attend day care and are immuno-compromised (septicemia, meningitis, otitis media, sinusitis, pneumonia)

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32
Q

dosage for Pneumococcal Conjugate Vaccine (PCV 13)

A

2, 4, and 6 months, and 12 to 15 months of age

33
Q

Haemophilus influenzae Type B (Hib) Significance

A

protect against serious infections (Bacterial Meningitis, Epiglottitis, Bacterial pneumonia, Septic arthritis, Sepsis)

34
Q

dosage for Haemophilus influenzae Type B (Hib)

A

2, 4, 6, and 12 to 15 months of age

35
Q

administration for Haemophilus influenzae Type B (Hib)

A

Administered by IM injection using separate syringe and a site separate from any concurrent vaccinations.

36
Q

dosage for varicella

A

two doses: 12 to 15 months and 4 to 6 years of age

37
Q

Varicella administration

A

sub-Q

38
Q

Children who do contract varicella after getting the varicella immunization…

A

have less vesicles, lower fever, and faster recovery

39
Q

antibodies for varicellla persist for

A

at least 8 years

40
Q

varicella can be given simultaneously with…

A

DTaP, IPV, HepB, or Hib vaccine

41
Q

if varicella is NOT given with MMR, how long must you wait between vaccines

A

1 month

42
Q

Influenza significance

A

especially to children with asthma, cardiac disease, HIV, diabetes, sickle cell disease that place them at risk for influenza-related complications

43
Q

when is the influenza vaccine recommended

A

annually (usually in the Fall) starting at 6 months of age

44
Q

dosage for first time recipients of influenza vaccine

A

2 separate doses 4 weeks apart

45
Q

what allergy assessment must be done before the influenza vaccine

A

egg allergies

46
Q

influenza vaccine can be given at the same time as other vaccinations if…

A

Use separate syringe
Use separate injection site

47
Q

Meningococcal Infections vaccine significance

A

highest fatalities occur in adolescents and college freshmen living in residence halls; morbidities include limb or digit amputation, skin scarring, hearing loss and neurologic disability

48
Q

dosage for Meningococcal vaccine

A

Two doses: first at 11 to 12 years of age with second at 16 to 18 years of age

49
Q

Rotavirus significance

A

Acute gastroenteritis; contagious and may be particularly severe in infants and young children

50
Q

How are the rotavirus vaccines administered

A

administered orally, by putting drops in the infant’s mouth. Each requires multiple doses:
-RotaTeq® (RV5) is given in three doses at 2 months, 4 months, and 6 months of age.
-Rotarix® (RV1) is given in two doses at 2 months and 4 months of age.

51
Q

Human Papillomavirus (HPV) significance

A

Sexually transmitted and seen as cervical, vaginal, anal, and oropharyngeal cancers and genital warts

52
Q

when does the HPV administration begin

A

Beginning at 11 or 12 years old (can start as early as age 9)

53
Q

Number of doses dependent on age at initial vaccination: Age 9-14 years at initiation: for HPV

A

2-dose series at 0 and 6-12 months.

54
Q

Number of doses dependent on age at initial vaccination: Age 15+ years at initiation: for HPV

A

3 doses at 0, 1-2 months, and 6 month

55
Q

reactions that can occur with vaccination within a few hours to days

A

-Local tenderness
-Erythema
-Swelling at the injection site - cold compress; administer acetaminophen
-Low grade fever - administer acetaminophen
-Behavioral changes: drowsiness, eating less, prolonged or unusual cry

56
Q

general contraindication for all immunizations is

A

a severe febrile illness (Minor illness such as common cold is not a contraindication)

57
Q

Live virus vaccines such as Varicella and MMR should not be administered to child who is…

A

severely immunocompromised

58
Q

patient education when child is getting a vaccine

A

Teach parent about administering acetaminophen 45 minutes before the immunizations

59
Q

Application of EMLA cream to the injection site before administration is…

A

ordered by HCP

60
Q

needle length for anterolateral thigh with infants

A

5/8 inch, 22-25G

61
Q

needle length for toddlers

A

5/8 - 1 inch, 22-25G

62
Q

needle length for older children (3-18y)

A

< 60 kg: 5/8 to 1 inch, 22–25G in the deltoid
> 60 kg: 1 to 1½ inch, 22–25G in the deltoid

63
Q

When multiple injections to be given, two may be given into the thigh at least ____ apart

A

2.5 cm (1 inch

64
Q

what site of injection should be avoided at all times for pediatric patients

A

dorsogluteal (because possibility of damaging sciatic nerve)

65
Q

site of injection for infants (not walking)

A

anterolateral thigh

66
Q

site of injection for children older than 1 year

A

deltoid

67
Q

Ventrogluteal site can be used for

A

any age

68
Q

nursing interventions for varicella vaccine

A

-Strictly adhere to vaccine storage requirements
-Upon reconstitution, administer within time limits stated in package insert
-Administer at separate sites
-Do not mix vaccines in the same syringe
-Document completely
-Observe for adverse reactions
-Keep epinephrine available for use in the case of anaphylactic reaction
-Provide patient with record of immunizations received

69
Q

patient teaching for varicella vaccine

A

-Discuss vaccine-preventable diseases
-Answer questions clearly
-Advise females to avoid pregnancy for 1 month
-Avoid contact with immunocompromised persons
-Provide VIS before administering the vaccine
-Patient or patient’s family to maintain vaccine record
-Provide return date for next immunizations
-Advise to contact health care provider if signs of reaction occur

70
Q

Birth vaccines

A

Hep B

71
Q

4 mo vaccines

A

“DR HIP”
DTaP
RV
Hib
IPV
PCV

72
Q

2 mo vaccines

A

“B DR HIP”
Hep B
DTaP
RV
Hib
IPV
PCV

73
Q

6 mo. vaccines

A

“B DR HIP”
Hep B
DTaP
RV
Hib
IPV
PCV
& annual flu

74
Q

toddler vaccines 6-18 mo.

A

“IM HPV”
IVP (if not already given at 6 mo)
MMR
Hib
PCV
Varicella

75
Q

12 - 23 months vaccines

A

Hep A (2 dose 6 mo, apart)

76
Q

15-18 mo vaccines

A

DTaP

77
Q

4-6 y/o vaccine

A

“DIM”
DTap
IPV
MMR

78
Q

11-12 y/o vaccine

A

Tdap HPV Meningitis

79
Q

16-18 y/o vaccine

A

meningitis booster

NSG 434 - Peds (17 decks)

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