Growth, Development, and Stages of Life Flashcards
1
Q
Well-Check Schedule
A
Prenatal visit Newborn visit First week visit (3 to 5 days) 1, 2, 3, 4, 6, 9, 12, 15, 18 month visit 2, 2 1/2, 3 year visit Annual visits from 4 to 18 years.
2
Q
Recommended Childhood and Adolescent Immunizations
A
- Birth: HepB
- 1m: HepB
- 2m: Polio (IPV), DTaP (diphtheria, tetanus, pertussis); Influenza B (Hib); Pneumococcal (PCV), Rotavirus (RV)
- 4m: DTaP, Hib, IPV, PCV, RV
- 6m: Dtap, Hib, HeptB, IPV, PCV, RV
- 12-15m: Hib, PCV, MMR (measles, mumps, rubella), HepA, varicella.
- 15-18m: DTaP
- 18-33m: HepA
- 4-6y: DTaP, IPV, MMR, varicela.
- 11-12y: MMR (if not yet), Tdap, Meningo (MCV4) with booster at 16y. HPV (2 doses follow at 2 and 6m after first dose)
3
Q
Hepatitis B Vaccine (HepB)
A
- Intramuscular
- Birth, 1-2m, 6-18m.
- Contraind: Severe allergic reactions to previous dose or vaccine component (aluminum hydroxide, yeast protein).
- Precautions: infant less than 2kg or moderate to severe acute illness with or without fever.
- HBsAg positive mothers: infant should receive HepB and immunoglobulin (HBIG) within 12 hours of birth. Also, infants should be tested for HBsAg and antibody after completion of HepB series (9 to 18m).
- Mothers whose HBsAg status is unknown: infant should receive the first dose of HepB within 12 hours of birth. Maternal blood should be drawn ASAP, if positive, infant should receive HBIG (no later than a week).
4
Q
Rotavirus Vaccine (RV)
A
- Is a cause of of serious gastroenteritis and is nosocomial. Most severe in children 3-24m. (younger than 3 has maternal antibodies).
- Oral route (must replicate in infant’s gut)
- Rotarix: 2 doses (2 and 4m).
- RotaTeq: 3 doses (2, 4 and 6m).
- Do not start the series on or after age 15 weeks.
- The maximum age for the final dose is 8 months.
- Vaccine may be withheld if infant is experiencing severe vomiting and diarrhea. Adm on recovery.
5
Q
Diphtheria, tetanus, acellular pertussis* (DTaP)
*coqueluche
A
- Intramuscular
- 5 doses (2, 4, 6, 15-18m, 4-6y).
- DTaP <7y. Should not be adm 5th dose if 4th was given with 4y or later.
- Tdap >7y (adolescent preparation) is recommended at 11 to 12y for children who have completed the DTaP series but have not received a Td booster; children 13-18y who have not received Tdap should receive a dose.
- Td is used as a booster every 10 years after Tdap is adm at 11-18y.
- Encephalopathy is a complication.
- Contraind: encephalopathy within 7 days of a previous dose or severe allergic reaction to a previous dose or component.
6
Q
Haemophilus Influenzae type B (Hib)
A
- Protects against numerous serious infections caused by H. influenzae type B, such as bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis.
- Intramuscular
- ActHIB, Hiberix, or Pentacel: 4-dose series at 2, 4, 6, 12–15 months
- PedvaxHIB: 3-dose series at 2, 4, 12–15 months.
- Contraind: Severe allergic reaction to previous dose or component.
- Special recommendations to: HIV, chemotherapy or radiation, stem cell transplant, sickle cell disease, splenectomy, immunoglobulin deficience.
7
Q
Influenza Vaccine
A
- Recommended annually for children beginning at age 6y. (2 types: LAIV and IIV)
- LAIV should not be used in persons with the following conditions or situations:
- History of severe allergic reaction to a previous dose of any influenza vaccine or to any vaccine component (excluding egg, see details above)
- Receiving aspirin or salicylate-containing medications
- Age 2–4 years with history of asthma or wheezing
- Immunocompromised due to any cause (including medications and HIV infection)
- Anatomic or functional asplenia
- Cochlear implant
- Cerebrospinal fluid-oropharyngeal communication
- Close contacts or caregivers of severely immunosuppressed persons who require a protected environment
- Pregnancy
- Received influenza antiviral medications within the previous 48 hours
8
Q
Inactivated Poliovirus Vaccine (IPV)
A
- Subcutaneous (may be given IM)
- 4-dose series at ages 2, 4, 6–18 months, 4–6 years; administer the final dose at or after age 4 years and at least 6 months after the previous dose.
- Contraind: Severe allergic reaction to previous dose or component (formalin, neomycin, streptomycin,or polymyxin)
9
Q
Measles, Mumps, Rubella (MMR) vaccine
* Sarampo, caxumba e rubeola
A
- Subcutaneous
- 2-dose series at 12–15 months, 4–6 years. Dose 2 may be administered as early as 4 weeks after dose 1.
- The maximum age for use of MMRV is 12 years.
- Contraind: Severe allergic reaction to previous dose or component (gelatin, neomycin, eggs, pregnancy, known immunodeficiency.
- If child received immunoglobulin, the MMR should be postponed for at least 3-6m.
10
Q
Varicella Vaccine
A
- Subcutaneous
- 2-dose series at 12–15 months, 4–6 years. Dose 2 may be administered as early as 3 months after dose 1.
- Children receiving vaccine should avoid aspirin products because of the risk of Reye’s syndrome.
- Contraind: Severe allergic reaction to previous dose or component (gelatin, bovine albumin, neomycin), significant suppression of cellular immunity, pregnancy.
11
Q
Pneumococcal Conjugate Vaccine (PCV)
A
- Prevents infection with Streptococcus pneumoniae, which may cause meningitis, pneumonia, septicemia, sinusitis, and otitis media.
- Intramuscular
- 4-dose series at 2, 4, 6, 12–15 months.
- Contraind: Severe allergic reaction to previous dose or component.
12
Q
Hepatitis A vaccine (HepA)
A
- Intramuscular
- 2-dose series (minimum interval: 6 months) beginning at age 12 months.
- Contraind: Severe allergic reaction to previous dose or component.
13
Q
Meningococcal vaccine (MCV)
A
- MCV4 is the preferred type and is IM.
- 2-dose series at 11–12 years, 16 years.
- adolescents at high school entry (15y) and all college freshmen living in dormitories should be vaccinated.
- Contraindicated in children with history of Guillain-Barre syndrome.
14
Q
Human papillomavirus vaccine (HPV)
A
- Guards against type 6, 11, 16, 18 (depending on type).
- most effective before exposure through sexual contact.
- 3 injections over 6 months. Routinely recommended at age 11–12 years (can start at age 9 years).
- second dose 2m after first, and third dose 6m after first dose.
- Vaccine may cause pain, swelling, itching, and redness at the injection site, fever, nausea and dizziness.
- Contraind: pregnant women and reaction to previous vaccine.
15
Q
Reactions to vaccine
A
Local reactions:
- Tenderness, erythema, swelling.
- Low-grade fever.
- Behavioral changes, such as drowsiness, unusual crying, decreased appetite.
Minimizing local reactions:
- using appropriate needle and recommended site.
Anaphylactic reaction:
- Protect airway, restore adequate circulation, prevent further exposure.
- Mild reaction: SC injection of antihistamine.
- Moderate to severe: CPR, elevate head, adm epinephrine, fluids and vasopressors as prescribed. Monitor vital signs and urine output.
