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Peds > Immunizations and Communicable Disease > Flashcards

Immunizations and Communicable Disease Flashcards

1
Q

Pediatric Differences

A
  • Immune system immune at birth: IgM at 20 wks gestation
  • Passive immunity from mothers ( does not equal lasting immunity, IgA from breast milk)
  • Immunizations help boost immunity (IgG)
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2
Q

Types of vaccines

A
  1. Inactivated ( used a killed version of virus/bacteria)
  2. Live- attenuated ( a live vaccine but it has been weakened)
  3. Messenger RNA/mRNA (covid vaccine)
  4. Subunit, recombinant, polysaccharide, conjugate (use specific parts of germ or virus to trigger immune response )
  5. Toxoid (use the toxin from germ/virus)
  6. Viral vector ( when genetic material from virus /germ is inserted into unrelated/harmful virus)
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3
Q

Immunization: things to remember

A
  • start at 2 months (when immune system can reproduce antibodies)
  • vaccines take 2 weeks to work
  • If pt receives IG therapy, blood, or immunosuppressed they will have to wait 12 months after therapy to get vaccines
  • there is a catch up schedule
  • must obtain written consent for each vaccine
  • must provide VIS (vaccine information station)
  • must document
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4
Q

Adverse Effects

A
  1. Local reactions= redness, swelling, pain at injection site, can give tylenol or ibuprofen
  2. Systemic reaction: fever, rash, malaise, seizures, anaphylaxis
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5
Q

Contraindications

A
  • allergic reaction
  • active malignant disease, chemo, pregnancy, HIV (NO LIVE VACCINES)
  • acute severe/moderate febrile illness (precaution)- DONT GIVE VACCINE WHEN PT IS SICK
  • immunosuppressed drug therapy- NO LIVE VACCINES
  • IG therapy (wait 12 months for live vaccines)
  • leukemia, lymphoma
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6
Q

Can give vaccine

A

Misconception- “may cause autism” “diseases arent that bad” - FALSE
- prematurity, mild illness (sniffles)
- previous local reaction (redness, swelling, pain)- can still give
- family member w/ adverse reaction
- religious beliefs (preference)
- missinformation

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7
Q

Vaccine Hesitancy

A

Types:
1. unquestioning acceptor
2. cautions acceptor
3. hesitant
4. late/selective acceptor
5. refuser

To help: be clear, honest, and transparent while debunking misinformation

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8
Q

Nursing Considerations

A
  1. assess vaccine status (are they up to date?)
  2. storage and expiration
  3. reconstitute
  4. site
  5. comfort of child + parent
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9
Q

Isolation Standards

A
  1. Universal precautions (gloves, mask, wash hands)
  2. Contact (gloves, gowns, wash hands)
  3. Droplet (mask, gloves, gowns)
  4. Airborne ( N95, negative airflow room)
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10
Q

Diptheria ( Tdap)

A

Cause: bacterial ( C. diptheriae ), produces endotoxins - myocarditis, ascending paralysis

Spread via resp. droplet and secretions

S/Sx: adherent, gray lesions in pharynx, sore throat, enlarged lymph nodes

Tx: antitoxins and antibiotics

Nursing: * REPORTABLE DISEASE ( CONTAGIOUS ), VACCINE PREVENTABLE

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11
Q

Tetanus (Tdap)

A

Cause: Bacterial ( C. tetani ), endotoxins causes CNS problems

Spread via contact w/ contaminated soil, animal waste, metal, burns

S/SX: stiff neck “lock jaw”, muscle spasm, opisthotonos ( head + back is arched ) –> resp. failure

Tx: Tetanus immune globulin ( if exposed )

Nursing: NO CURE - ICU supportive care, VACCINE PREVENTABLE

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12
Q

Pertussis “Whooping Cough” ( Tdap )

A

Cause: bacterial ( B. pertussis )

Spread via resp. droplet

S/SX: nasal congestion, fever, cough, STRIDOR = narrowed glottis “whoop”, gagging, gasping, apnea

TX: antibiotics

Nursing: * REPORTABLE DISEASE ( CONTAGIOUS ), VACCINE PREVENTABLE, FATAL FOR INFANTS

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13
Q

Rubeola “Measles” (MMR)

A

Cause: viral

Spread via resp. droplet and airborne

S/SX: fever, cough, nasal congestion, conjunctivitis,
KOPLICK SPOTS = rash inside the mouth
rash starts of the face, spreads to the trunk and extremities (red/purple blotchy spots)

TX: is supportive

Nursing: AIRBORNE PRECAUTIONS
Vaccine preventable

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14
Q

Parotitis “Mumps” (MMR)

A

Cause: viral

Spread via resp. droplet

S/SX: malaise, fever, swelling of parotid glands (salivary)
CAN LEAD TO - deafness, meningitis, orchitis (inflammation of the testes)

TX: is supportive

Nursing: REPORTABLE DISEASE (contagious)
Vaccine preventable

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15
Q

Rubella (MMR)

A

Cause: viral

Spread via resp. droplet

S/SX: fever, malaise, nasal congestion, sore throat, red spots on soft palate
PINK RASH to face, then trunk, then to the legs. Fades in the same order

TX: Supportive

Nursing: Vaccine preventable, risk to fetus (can kills the fetus )

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16
Q

Poliomyelitis (Polio)

A

Cause: Viral

Spread via fecal-oral + resp. droplets

S/SX: fever, sore throat, then –> aseptic meningitis, paresthesia, paralysis

TX: is supportive

Nursing: REPORTABLE DISEASE
Vaccine preventable

17
Q

Varicella (Chicken Pox)

A

Cause: viral ( contagious until all lesions are crusted over)

Spreads via contact with lesions and airborne

S/SX: fever, malaise, HA, FLUID FILLED VESICULAR ITCHY RASH
can lead to: cellulitis, meningitis encephalitis, pneumonia, reye syndrome ( w/ ASA use )

TX: supportive + immune globulin

Nursing: Vaccine preventable

18
Q

Rotavirus

A

Cause: Viral (most common cause of severe diarrhea < 5 years old )

Spread via fecal-oral

S/SX: fever, N/V/D, dehydration, electrolyte imbalance

TX: supportive ( IV fluids)

Nursing: vaccine preventable

19
Q

H. Influenza Type B (HIB)

A

Cause: Bacterial - H. influenzae ( happens after URI )

Spread via resp. droplets and contact w/ secretions

S/SX: URI sx then invasive illness –> meningitis, epiglottitis, pneumonitis

TX: IV antibiotics

Nursing: Vaccine preventable

20
Q

Human Papilloma Virus (HPV)

A

Cause: STI

Spread via sexual contact

S/SX: GENITAL WARTS, some strains cause cancer

Nursing: Give vaccine before sexual activity starts
vaccine preventable

21
Q

Meningococcal

A

Cause: bacterial (outbreaks in daycare, college dorms )

Spread via direct contact with resp. droplets

S/SX: fever, malaise, achy, rash, purpura (red/purple)
can lead to –> seizure, coma, death, septic shock, DIC, gangrene necrosis

TX: Antibiotics

Nursing: REPORTABLE DISEASE (contagious)
Vaccine preventable

22
Q

Pneumococcal

A

Cause: Bacterial - S. pneumoniae

Spread via direct contact with resp. droplets

S/SX: otitis media, sepsis, meningitis, hearing loss, developmental delays, pericarditis, death

TX: antibiotics

Nursing: many strains are vaccine preventable

23
Q

Coronavirus (COVID -19)

A

Cause: viral

Spread via airborne droplets

S/SX: cold and flu like sx, HA, cough, achy, loss of smell and taste, N/V/D, resp., and organ failure
Clotting concerns - strokes, PE, MI

TX: Monoclonal antibodies over age 12, PAXLOVID

Nursing: MIS- C = Multisystem inflammatory syndrome in children

24
Q

MIS- C

A

Multisystem inflammatory syndrome in children

Seen in coronavirus infection

S/SX: fever, chest pain, dyspnea, increased WBC/PLT, abdominal pain , confusion, CRP will show inflammation

TX: IV IG, DIGOXIN, anticoagulation

25
Q

Mononucleosis

A

Cause: Viral - EPSTEIN BARR

Spread via direct contact w/ body fluids (kissing)

S/SX: fever, malaise, anorexia, pain , hepatomegaly (enlarged liver)

TX: supportive

Nursing: NO VACCINE

26
Q

HIV / AIDS

A

Cause: viral - human immunodeficiency virus ( destroys the ability to fight infection )

Spread via contact w/ body fluids (perinatal transmission , risky behaviors )

S/SX: swollen lymph nodes, hepatosplenomegaly, thrush, weight loss, chronic diarrhea, recurrent bacterial infection , TB, pneumonia

TX: antiretroviral therapy for mother and infant - ZIDOVUDINE ( help decrease chance to get it )

27
Q

Juvenile Idiopathic Arthritis

A

Patho: autoimmune? chronic inflammation of joints > 6 weeks

DX: before 16 year old

S/Sx: pain, stiffness, loss of motion, fever, rash

TX: PT/OT to increase strength and mobility, isometric exercise, ROM exercise (passive and active splints ), NSAIDS, METHOTREXATE , Steroids, MAB

28
Q

Sepsis

A

Patho: response to infection, toxins from pathogens cause organ failure, vasodilation, DIC

S/SX: feeding issues, color changes, (pale, mottled, gray), decrease muscle tones, hyperthermia the hypothermia, tachycardia/pnea, delayed capp refill, resp. distress, apnea, decreased LOC

DX: CBC,CRP, Cultures, CT scans, XR

TX: O2, IV fluid ( 20ml/kg/bolus - can do this 3 times ), vasopressors (DOPAMINE, NOREPI ), antibiotics, fever control, watch for DIC ( bleeding around IV sites ), I/O, nutrition concerns (make sure they eat )

Nursing: SIRS = systemic inflammation response syndrome w/infection (body attempts to protect itself, precursor to sepsis )

Education: wash hands, clean, when to call doctor

29
Q

Fever management

A

Patho: increased body temp, most common sign of infection, response to pathogen, increased HR/RR/ metabolic rates, increased fluid loss

  • infants <3 = emergency
  • acetaminophen, ibuprofen (over 6 months )
  • remove heavy clothing, increased fluid intake
  • DANGEROUS - 105.9 F / 41 C
  • NEVER GIVE ASPIRIN

Peds (20 decks)

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