Chp 52 Flashcards
when are parenteral injectables chosen over other methods
- pt unable to tolerate meds by moth
- other routes don’t give desired effect quickly/predictably
- oral meds would be destroyed by GI
- continuous delivery required for outcome
what syringe types do MAs commonly use
insulin, 3 mL, TB
where should you avoid giving injections
in affected arm of pts that had surgery to remove lymph nodes in armpit
what are mild/moderate reactions to injections
fever, pain, soreness @ site, hot feeling @ site, site redness
what are types of vaccination injury
anaphylaxis, shoulder injury, encephalitis
what is the needle angle for IM
90 degrees
what is the needle angle for SubQ injections
45 degrees
what is the needle angle for IV
25 degrees
what is the needle angle for intradermals
10-15 degrees
purpose of intradermals
allergy & TB testing
what is the size for intradermals
26G or 27G & 3/8-5/8 in
what are the preferred sites for intradermals
anterior forearm & mid-back
what is the size for subQ
25G to 27G & 1/2-5/8 in
what are the purpose for subQ injections
allergy injections, insulin, & immunizations
what are the preferred sites for subQ injections
deltoid, abdomen, and upper thigh
what is generally the dosage limit for subQs
2 mL
what is the size of needles used for IMs
18G-23G & 1-3 in
thicker meds require _____ gauges
smaller
when the diameter of the lumen increases, the gauge number _______
decreases
what meds are given IM
- large doses
- oil/non-water based
- thicker meds
what is the dosage range for IMs
0.5-3 mL
what are the preferred sites for IMs
- deltoid
- ventrogluteal
- vastus lateralis
- dorsogluteal
what positions should a pt be in to receive a ventrogluteal IM
- lie on side
- prone on table w/toes pointed inward/lean over treatment table & stand on non-injection site leg
what positions should a pt be in to receive a vastus lateralis IM
- sit
- lay in horizontal recumbent position
what are factors for IM injections
- pt size
- pt age
- viscosity of meds
- muscular density
what are preferred injection sites for kids and infants
vastus lateralis
what should be done when giving injections to kids/infants
gentle aspiration between 5-10 seconds
define the Vaccines for Children Program (VFC)
federally funded program for kids unable to pay for vaccines
define NATURAL IMMUNITY
inborn or from illness
define ARTIFICIAL IMMUNITY
from vaccines
what are the 3 types of vaccines
- live attenuated/changed pathogens
- pathogenic toxin
- killed pathogen
define a live attenuated/changed pathogens vaccine
pathogen altered/weakened then injected to stimulate body to produce antibodies
define a pathogenic toxin vaccine
produce toxin to kill antibody production
define a killed pathogen vaccine
pathogen inactive and injected stimulating antibodies, sometimes requiring several doses
give examples of live attenuated/changed pathogens vaccine
varicella & measles
give examples of pathogenic toxin vaccine
diptheria & tetanus
give examples of killed pathogen vaccine
pertussis, rabies, poliomyeleitis
what is the incubation for COVID-19
2-14 days
s/s: COVID19
fever, chills, coughs, SOB/difficulty breathing, fatigue, body/muscle aches, nausea/vomiting, diarrhea, new loss of taste/smell, sore throat, congestion/runny nose, headache
tx: COVID19
- antipyretics, antivirals, & steroids
- hydration
- rest
how is influenza transmitted
direct & indirect contact
what is the incubation period for influenza
1-4 days
s/s: influenza
chills, fever, headache, sore throat, runny nose, cough, muscle aches & pains, malaise, weakness
tx: influenza
- bed rest
- fluids
- antipyretics & mild analgesics
what is the incubation for pneumonia
1-3 days
s/s: pneumonia
severe chills, headache, high fever, chest pain, dyspnea, rapid pulse, cyanosis, cough w/blood-stained sputum
tx: pneumonia
- antibiotics
- bed rest
- increased fluid
- analgesics & antipyretics
- oxygen
who should get the PCV13 vaccine
- all kids younger than 2
- all ages if certain medical conditions
- some adults at least 65 yrs
who should get the PPSV23 vaccine
- all adults at least 65 yrs
- ppl 2-64 yrs with certain conditions
- ppl 19-64 yrs who smoke
how is haemophilus influenza type B (HiB) transmitted
direct/indirect contact
what is Hib caused by
bacteria
s/s: Hib
fever, sore throat, cough, muscle aches, weakness, no appetite, irritability, general malaise
tx: Hib
- bed rest
- increased fluids
- antipyretics, antibodies, & analgesics
complications of Hib?
meningitis & epiglottis
describe the vaccine for Hib (the timing)
series of 2 or 3 subQ/IM injections generally at 2, 4, and 6 months
how is measles transmitted
direct & indirect contact
s/s: measles
fever, malaise, runny nose, cough, conjunctivitis, loss of appetite, photosensitivity, sore throat, Koplik’s spots, red blotchy rash
complications of measles?
deafness, brain damage, & pneumonia
tx: measles
- bed rest
- increased fluids
- antipyretics
- cough medicine
- calamine lotion
how is mumps transmitted
direct & indirect contact
what is the incubation period for mumps
12-25 days
s/s: mumps
chills & fever, headache, muscle aches, tiredness, loss of appetite, swollen & tender salivary glands below & in front of ear, pain between ear & angle of jaw w/drinking or acidic substances
tx: mumps
- bed rest
- soft diet
- increased fluids
how is rubella transmitted
direct and indirect contact
what is the incubation for rubella
12-23 days
s/s: rubella
slight fever, enlarged lymph nodes @ back & base of neck, arthralgia, diffuse/fine/red rash
tx: rubella
- bed rest
- liquids
- antipyretics
complications of rubella?
blindness, deafness, brain damage, heart defects, enlarged liver, bone malformations
how is diphtheria transmitted
direct and indirect contact
what is the incubation period for diphtheria
2-5 days
s/s: diphtheria
headache, malaise, fever, sore throat w/yellowish white/gray membrane
tx: diptheria
- adequate liquids
- soft diet
- antibiotics
- bed rest
- tracheostomy (if necessary)
how is pertussis transmitted
direct contact
in what age group is pertussis common
kids less than 4 yrs
what is the incubation period of pertussis
7-10 days
s/s: pertussis
increased leukocytes w/lymphocytosis, respiratory drainage, sneezing, slight fever, dry cough, irritability, loss of appetite, violent cough w/whooping inspiration sound, forceful vomiting –> hemorrhaging, decreased coughing, return of appetite, trace cough
how is rabies spread
saliva & airborne
s/s: rabies
fever, pain, aggressive behavior, hallucination, extreme weakness, thirst
tx: rabies
5 injections of vaccine, but fatal when given after symptoms
incubation period of tetanus?
3-21 days & 4-5 weeks
s/s: tetanus
- stiffness of jaw/esophageal muscles/neck muscles
- fixed jaw
- altered voice
- fever
- painful spasms of all skeletal muscles
- irritability
- headache
tx: tetanus
cleansing & debridement of wound, sedation, pharmacologic control of muscle spasms, maintain fluid balance,, tracheostomy, penicillin G, oxygen, quiet environment
how is rotavirus transmitted
contact w/infected person
s/s: rotavirus
gen asymptomatic & diarrhea that starts and stops
tx: rotavirus
hydration & supportive care
describe the timing of the RV1 vaccine
2 dose series at 2 & 4 months
describe the timing of the RV5 vaccine
3 dose series at 2, 4, 6 months
how is varicella transmitted
direct contact & droplets from respiratory
aka: varicella
chicken pox
incubation of varicella?
2-3 weeks
s/s: varicella
highly pruritic rash, fever, headache, loss of appetite, and general malaise
tx: varicella
bed rest, liquids, antipyretics, oral/topical antihistamines, antipruritics/paste of baking soda
how is hepatitis A transmitted?
- ingesting food/water contaminated w/feces
- direct contact
- raw shellfish/polluted water/sex with someone who has virus
s/s: hepatitis A
fatigue, nausea & vomiting, loss of appetite, abdominal pain/discomfort especially in area of liver, low grade fever, dark urine, muscle & joint pain, clay-colored stools, jaundice, asymptomatic
describe the vaccine for hepatitis A
2 doses with the 2nd dose given 6 months after 1st dose
how is hepatitis B transmitted
bodily fluid, needles/syringes/drugs, mother to baby
incubation period for hepatitis B?
60-150 days
s/s: hepatitis B
fever, malaise, loss of appetite, nausea, vomiting, jaundice, weakness, dark urine, light-colored stool
tx: hepatitis B
eliminate alcohol & fats, same as hep A
describe the hepatitis B vaccine
1st dose given to neonates whose mothers have not had hep B, 2nd dose at 1-2 months, 3rd dose at 6-18 months, booster at 11-12 yrs
describe HPV
over 100 types, gives warts/cancers on mouth/throat/genitals
what are the 2 HPV vaccines
cervarix & gardasil
who is recommended for HPV vaccine
- all kids 11-12 yrs w/2 shots 6-12 months apart
- kids who get vaccinated at 15-26 yrs will need 3 doses over 6 months
who should not get bacterial meningitis vaccine
ppl w/altered immune system, serious condition, or pregnant
incubation period for polo?
4-35 days
how is polio transmitted
feces of infected person
what are the 3 s/s groups of polio
minor/abortive, aseptic meningitis, paralytic poliomyelitis
minor/abortive s/s: polio
fever, sore throat, nausea/vomiting, abdominal pain, constipation, flu like symptoms
aseptic meningitis s/s: polio
high fever, stiff neck, headache, muscle aches, loss of reflexes, minor illness symptoms
paralytic poliomyelitis s/s: polio
paralysis of limbs/urinary control
describe the inactivated polio vaccine (IPV)
IM/SubQ injection, receive at 2-4 months w/additional doses between 6 & 18 months
