Immunizations and Communicable Disease Flashcards
Pediatric Differences
- 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)
Types of vaccines
- Inactivated ( used a killed version of virus/bacteria)
- Live- attenuated ( a live vaccine but it has been weakened)
- Messenger RNA/mRNA (covid vaccine)
- Subunit, recombinant, polysaccharide, conjugate (use specific parts of germ or virus to trigger immune response )
- Toxoid (use the toxin from germ/virus)
- Viral vector ( when genetic material from virus /germ is inserted into unrelated/harmful virus)
Immunization: things to remember
- 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
Adverse Effects
- Local reactions= redness, swelling, pain at injection site, can give tylenol or ibuprofen
- Systemic reaction: fever, rash, malaise, seizures, anaphylaxis
Contraindications
- 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
Can give vaccine
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
Vaccine Hesitancy
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
Nursing Considerations
- assess vaccine status (are they up to date?)
- storage and expiration
- reconstitute
- site
- comfort of child + parent
Isolation Standards
- Universal precautions (gloves, mask, wash hands)
- Contact (gloves, gowns, wash hands)
- Droplet (mask, gloves, gowns)
- Airborne ( N95, negative airflow room)
Diptheria ( Tdap)
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
Tetanus (Tdap)
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
Pertussis “Whooping Cough” ( Tdap )
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
Rubeola “Measles” (MMR)
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
Parotitis “Mumps” (MMR)
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
Rubella (MMR)
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 )
Poliomyelitis (Polio)
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
Varicella (Chicken Pox)
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
Rotavirus
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
H. Influenza Type B (HIB)
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
Human Papilloma Virus (HPV)
Cause: STI
Spread via sexual contact
S/SX: GENITAL WARTS, some strains cause cancer
Nursing: Give vaccine before sexual activity starts
vaccine preventable
Meningococcal
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
Pneumococcal
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
Coronavirus (COVID -19)
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
MIS- C
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
