Health Promotion and Disease Prevention

Question 1

Hepatitis B (Trmt)

Answer 1

• Routine testing for HBsAG not needed; only for those @ high risk & poor immune response
• Boosters for dialysis, those with levels less than 10 mIU/mL
• Post exposure prophylaxis prevents

Question 2

Hepatitis B (Patho)

Answer 2

• Transmitted thru exchange of blood/body fluids
• Vaccine - not a live virus; not for those with anaphylactic rxn to baker’s yeast; 3 doses with at lease 8 wks b/w 2nd and 3rd (series does not need to be repeated if 3rd dose delayed)
• Can lead to liver failure, hematoma, carcinoma, cirrhosis
• All preg women should be screened for HBsAG

Question 3

Smallpox (Patho)

Answer 3

• Direct deposit of infective droplets onto the nasal, oral, or pharyngeal mucosal membrane; prolonged face-to-face contact
• Most contagious with onset of rash; until last scab falls off; Incubation 7-17 days
• S/S=fever, malaise, HA, body aches, poss vomit
• Rash-small red spots on tongue/mouth to face, arms, legs, hands, and then feet; same stage

Question 4

Smallpox (Trmt)

Answer 4

• Supportive; Isolation
• Vaccination w/in 3 days of exposure reduces severity; after 4-7 days some protection from disease
• Live vaccine (vaccinia) - red, itchy bump in 3-4 days; lrg draining pustule then scab - shed virus until scab off
• Rxn - sore, body aches, poss fever

Question 5

VZV (Info)

Answer 5

• Vesicular lesions, fever, itch, fatigue
• Natural infection - lifetime immunity
• Greatest mortality rate in 30-49 yo
• Confirm immunity through titers esp for healthcare workers

Question 6

VZV vaccination

Answer 6

• Birth and repeat b/w 4-6 yrs
• Older - 2 shots 4-8 wks apart
• Pregnancy - after birth, 4-8 wks later
• May experience mild pox
• Exposure - w/in 3-5 days
• VZIG for those at risk with contraind for vaccine - pooled blood that is safe

Question 7

Live attenuated vaccines

Answer 7

Look up

Question 8

Tetanus

Answer 8

• Found in soil
• Painful muscle weakness, spasm
• 3 vaccine injections with boosters every 10 yrs
• Td for primary series and boosters in adults (one may be Tdap); Child - Tdap
• Rxn - redness and warmth
• TIG if unclean wound and unknown vaccine

Question 9

Hepatitis A

Answer 9

• Fecal-oral route
• US - 50% have no cause
• Risk factors - men with men, illegal drugs, international travel
• Peak infectivity during 2 wks before jaundice
• Inactivate - heat/cook foods, disinfecting
• Coinfection with Hep B or C can lead to decline

Question 10

Hepatitis A vaccine

Answer 10

• Those with Hep B or C or any chronic liver disease
• Those with clotting factor disorders and are receiving clotting factor concentrates
• Not live virus
• 4-6 wks prior to travel

Question 11

Hepatitis A vaccine

Answer 11

• Havrix - 2 dose at 0 and 6-12 mos
• Vaqta - 2 dose at 0 and 6-18 mos
• Twinrix - 3 dose at 0, 1, 6 mos or 4 dose at 0, 7, 21-30 mos followed by booster at mos 12
• HAV IG may be given w/in 2 wks to minimize risk of infection

Question 12

Stages of Change Model/

Transtheoretical Model

Answer 12

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance/relapse