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EXAM 4: Immunization & Hematopoietic Flashcards

1
Q

Antigens are: 1) ________ on cell surgace 2) cell _________ 3) can stimulate an __________

A

1) proteins 2) identifier 3) immune response

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2
Q

Antibody: 1) produced by ___________ when exposed to an ___________ 2) able to ___________ and flag a specific ___________

A

1) B lymphocytes, antigen 2) recognize, antigen

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3
Q

Which vaccine is an inactivated microorganism

A

killed

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4
Q

Which vaccine is a weakened microorganism (ex: MMR)?

A

attenuated

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5
Q

Which vaccine is a weakened toxins (ex: etanus, diphtheria)?

A

toxoids

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6
Q

Which vaccine is for immature immune systems of yound infants (ex: Hib, meningoccal)?

A

conjugate

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7
Q

Which vaccine reproduced DNA antigen (ex: Hep B)?

A

recombinant subunit vaccines

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8
Q

What years are childhood vaccines performed?

A

younger than 7

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9
Q

What years are adolescent vaccines performed?

A

7-18 year of age

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10
Q

What years are adult vaccines performed?

A

19 and older

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11
Q

What are 4 special populations that might fall into a catch up schedules for vaccines or need additional vaccines?

A

1) pregnancy 2) military 3) travelers 4) chronically ill & elderly

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12
Q

What is cocooning?

A

immunizing adults in close contact with newborns & young babies

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13
Q

What is the season for flu vaccine?

A

fall to spring

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14
Q

How long does it take to build protection after getting the flu vaccine?

A

2 weeks

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15
Q

In the first two weeks after getting the flu vaccine - 1) is special protection needed? 2) is there a higher susceptability to other infections

A

1) No 2) Yes

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16
Q

What are expected side effects of the flu vaccine?

A

localized inflammation at site, fever, cough, malaise, aches, v/d

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17
Q

What is the indication for the IIV flu vaccine (inactivated/killed influenza)?

A

everyone older than 6 months (& pregnant)

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18
Q

What are three contraindications for the IIV flu vaccine?

A

1) less than 6 months 2) egg allergy 3) guillain-barre syndrome

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19
Q

What is the indication for LAIV flu vaccine (live attenuated influenze vaccine)? and route?

A

2-49 yrs healthy and nonpregnant / nasal spray

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20
Q

What are additional contraindications for LAIV in addition the ones for IIV?

A

pregnancy, with antiviral, with aspirin, asthma, immunocompromised, acute phase of disease like stuffy nose, other vaccines in last 4 wks. NURSING IMPLICATION specific: working with at risk populations

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21
Q

Since there are greater than 90 known serotypes of streptococcus pneumonia, therefor a previous infection ___________.

A

does not protect

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22
Q

What is indication for the pneumococcal polysaccharide vaccine (PPSV23)?

A

19 years and older IF immunocompromised, chronic disease, smokers, live in long term care AND 65 or older (but only dose if already given prior to 65 = booster after 65)

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23
Q

What is contraindication for the pneumococcal polysaccharide vaccine (PPSV23)?

A

children < 2 years, pregnancy

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24
Q

What is the indication for the pneumococcal conjugate vaccine (PCV13)?

A

same as PPSV23 except can be given to children under 2, but NOT under 6 months

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25
Key things to remember when getting informed consent for vaccines:
provide info (side effect, risk, benefit), vaccine info statement approved by CDC, edu safety of vaccines, edu to keep immunization records
26
For children, consent is obtained from who for vaccines?
legal gaurdian
27
For children, ASSENT is obtained from?
child AFTER obtaining consent from legal gaurdian
28
Nursing consideration, be prepared for s/s of adverse reactions and be prepaired for emergency anaphylactic reaction (ABC) - what are 5 drugs to be prepared with in these events?
1) epinephrine 2) diphenhydramine 3) glucocorticoids 4) acetaminophen 5) NSAID
29
Who do you report adverse effects of vaccines to?
National DHHA
30
Who do you report vaccine-preventable diseases to?
VDH (or the local dept.)
31
If a patient is taking glucocorticoids and you know they have a weak immune system - what should you do if a vaccine is orderd?
hold and call the provider
32
How long should you seperate live attenuated (like MMR) from other vaccines by?
4 weeks
33
What are three instances where vaccines should be avoided?
1) immunosuppressants 2) blood tranfusions 3) intravenous immunoglobulin
34
Should vaccines be mixed?
NO - use separate site and syringe (and keep in refrige till ready to admin)
35
Safe IM vaccine site on infants and children?
vastus lateralis or ventrogluteal muscle
36
When should you never administer an injection in a child?
child is asleep
37
What are the three hematopoietic growth factors groups (blood producing)?
1) erythropoietic 2) leukopietic 3) thrombopoietic
38
What is the erythropoietic drug that INCREASES RBC production?
epoietin alfa
39
What is the leukopoietic drug (specific to neutrophils or generally WBC)?
filgrastim
40
What is the thrombopoietic (platelets) drug?
oprelvekin
41
Hgd is the ________ of Hgb in the whole blood (volume) g/dl
amount
42
Hct is the ________ volume of ________ in the whole blood
percentage, RBC
43
In the H&H, that is the adult man value for Hgb?
16 (+ or - 2)
44
In the H&H, that is the adult man value for Hct?
47 (+ or - 6)
45
In the H&H, that is the adult woman value for Hct?
13 (+ or - 2)
46
In the H&H, that is the adult woman value for Hct?
40 (+ or - 6)
47
In the H&H, that is the adult postmenopausal woman value for Hct?
14 (+ or - 2)
48
In the H&H, that is the adult postmenopausal woman value for Hct?
42 (+ or - 6)
49
What are the indications for erythropoietic (increasing RBC production) drug, epoetin alfa?
1) low RBC count secondary to CKD 2) replacement of blood cell after chemo and HIV drug 3) hasting of bone marrow function after bone marrow transplant
50
What are three side effects for erythropoietic (increasing RBC production) drug, epoetin alfa?
1) HTN (monitor BP) 2) increase H&H (contact provider if Hgb is GREATER than 11 g/dl) 3) low iron and B12
51
What are adverse effects for erythropoietic (increasing RBC production) drug, epoetin alfa?
seizure, thromboembolic event, DVT
52
What are two main contraindications of erythropoietic (increasing RBC production) drug, epoetin alfa?
pregnancy, uncontrolled HTN
53
Normal WBC count?
4,000 - 11,000 / mm^3
54
Normal absolute neutrophil count?
1,500 to 8,000 / mm^3
55
Neutropenia count?
absolute neutrophil LESS than 1000 = increased risk of infection (nursing: reverse isolation)
56
What are the two indications for leukopoietic (increasing neutrophil production) drug, filgrastim?
1) neutropenia from antineoplastic drugs, HIV, neonatal neutropenia 2) increase WBC level prior to harvesting (autologous transplant)
57
What are the two side effects for leukopoietic (increasing neutrophil production) drug, filgrastim?
1) bone/joint/muscle pain 3) leukocytosis asbolute neutrophil GREATER than 10,000 (monitor CBC)
58
What is the main adverse effect for leukopoietic (increasing neutrophil production) drug, filgrastim?
splenomegaly,rupture (long term use) - REPORT nay abd/back/shoulder pain
59
What is the contraindication for leukopoietic (increasing neutrophil production) drug, filgrastim?
pregnancy C
60
Normal platelet count?
150K to 400K / unit L (measured in CBC)
61
What is LOW platelet caused by things like CA, meds, chemo, kidney disease, ETOH abuse called?
thrombocytopenia
62
The three main functions of platelets when aggregated: 1) primary ___________ 2) release hormone to produce ________ 3) release hormone to aggregate __________
1) platelet plug 2) vasoconstricton 3) other platelets
63
What is the indication for thrombopoietic (increase platelet production) drug, oprelvekin?
chemotherapy-induced thrombocytopenia
64
What are the adverse effects for thrombopoietic (increase platelet production) drug, oprelvekin?
fluid retention & HF (essentially, same thing), tachydysrhythmia, MI, conjunctival injection, papilledema
65
What is the contraindication for thrombopoietic (increase platelet production) drug, oprelvekin?
pregnancy

Pharmacology (7 decks)

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