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Module 5 (Pediatrics) > Immunizations/Infectious Diseases > Flashcards

Immunizations/Infectious Diseases Flashcards

1
Q

Vaccines stimulate

A

immune system to produce antigens
- same antigens as disease (killed or weakened)

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2
Q

What happens to the antibodies after destroying the antigens of the vaccine?

A

memory cells formed

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3
Q

Who decides what vaccines are needed?

A

CDC - pink book
American Academy of Pedi - red book

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4
Q

What are the best ways to prevent infectious diseases?

A

immunizations
handwashing
isolations (reduce cross-transmissions)
infection control
sneeze and cough etiquette

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5
Q

What is the best way to prevent complications of individuals at high risk? (steroids, immunodeficiency, hemolytic disease -sickle cell)

A

vaccinate

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6
Q

Why should a society vaccinate?

A

decrease/eliminate the infectious disease

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7
Q

Herd Immunity

A

85% majority with vaccine

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8
Q

If not enough people are vaccinated, what could potentially happen?

A

reemergence
example) measles, mumps, polio

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9
Q

Active Immunity

A

endogenous production of antibodies
long-lasting
months to develop

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10
Q

Natural Active Immunity

A

survive infection

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11
Q

Acquired Active Immunity

A

vaccination

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12
Q

Passive immunity

A

antibodies given to a person
immediate and short-lived

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13
Q

What is the most common passive immunity?

A

last 1-2 months of pregnancy mother passes gamma globulin to the baby and lasts up to a year

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14
Q

Antibody sources

A

blood products
immune globulins (diff. people in one)
hyperimmune globulins (specific antibody)
Antitoxins (horses)

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15
Q

What is a complication of antitoxin?

A

serum sickness from horses

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16
Q

Live Attenuated Vaccines

A

a weakened form of live
same as the infection itself
must replicate (can get the disease)

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17
Q

Live attenuated vaccines have how many doses?

A

1-2

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18
Q

Live attenuated vaccine effectiveness issues

A

circulating antibody (blood transfusion)
damage to organ (extreme temps and sunlight)

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19
Q

What vaccines are live attenuated?

A

MMR
Varicella
Rotavirus
Intranasal Influenza

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20
Q

How many doses do inactivated vaccines have to gain immunity?

A

2-3

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21
Q

Inactivated Vaccines are produced in

A

culture media

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22
Q

Inactivated Vaccines replication

A

cannot replicate ( does not cause disease)

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23
Q

Inactivated Vaccines is less affected by

A

circulating antibodies

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24
Q

Antibody titer

A

antibody levels in the blood

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25
Q

Which vaccine is most likely needed for a “booster”?

A

inactivated vaccine

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26
Q

Inactivated Vaccines types

A

Polio,
Hepatitis A and B
Rabies,
Influenza,
Acellular pertussis,
Human papillomavirus,
Diphtheria,
Tetanus,
Pneumococcal,
Meningococcal

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27
Q

Haemophilus influenzae type b (Hib)
BEFORE INTRODUCTION OF THE VACCINE

A

the leading cause of bacterial meningitis
invasive bacterial disease among children younger than 5 years
epiglottis

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28
Q

The Hib vaccine prevents against

A

epiglottitis

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29
Q

Haemophilus influenzae type b (Hib) has how many doses?

A

multiple no number
99% decrease with vaccine

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30
Q

Vaccine Factor for failure

A

Age/maternal antibody
Dose
Route
Storage and handling – lose potency or contaminated
Nutritional status – malnutrition low
Coexisting disease
Genetics

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31
Q

What is prepared for administering vaccines?

A

Immunization history every visit
Recommended schedule
Screening
Discuss benefits/risks - VIS
After-care instructions
Appropriate doses of ibuprofen and tylenol

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32
Q

National Childhood Vaccine Injury Act of 1986 (NCVIA)
includes

A

Injury compensation
adverse event reporting (DATE GIVEN and EDITION)
- any effect even if unsure it caused the event
VIS

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33
Q

Nursing Considerations for Vaccines

A

accurate user friendly
parent concern (empathy and participate with them)
avoid judgment
Give VIS before vaccination and answer questions
Tylenol and EMLA to minimize adverse effects
respect ultimate wishes
flexibility for different vaccines

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34
Q

Documentation for Vaccinations

A

Date
Manufacturer
Lot #
Who administered the vaccine with the address
VIS received date and edition
Route, Dose, Site
Informed Consent or Refusal

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35
Q

If vaccines are given too close together, what increases

A

adverse effects, spacing is important

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36
Q

Timing of antibody-containing blood products (Ig) should be scheduled appropriately for what vaccines?

A

live

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37
Q

Screening helps

A

identify contraindications and precautions
increases the risk of adverse effects

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38
Q

Live doses of vaccines should only be given after

A

1 year (MMR, Varicella)

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39
Q

Hib Vaccine
contraindications

A

severe allergic reaction after a previous dose or to a vaccine component
less than 6 weeks

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40
Q

Hib Vaccines allergic reaction to what

A

dry natural latex

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41
Q

Hib Vaccine
Precautions

A

moderate to severe acute illness with or without fever

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42
Q

MMR vaccine
contraindications

A

severe allergic reaction to the previous dose
severe immunodeficiency (chemo, sickle cell, HIV infection, immunocompromised)
pregnancy

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43
Q

MMR vaccine
precautions

A

recent (<11 months) receipt of antibody-containing blood product
moderate to severe acute illness with/without fever

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44
Q

Rotavirus
contraindications

A

severe allergic reaction after the previous dose
severe combined immunodeficiency
Hx of intussusception

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45
Q

Rotavirus
precautions

A

moderate to severe acute illness with or without fever
- chronic GI disease

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46
Q

Varicella
contraindications

A

Severe allergic reaction after previous doses
severe immunodeficiency and pregnancy

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47
Q

When a contraindication is present in vaccines, a vaccine should ________ administered

A

NOT be administered

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48
Q

When a vaccine precaution is present, vaccinations should generally be

A

deferred but if the risks outweigh the benefits

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49
Q

Varicella
precautions

A

recent (<11 months) receipt of antibody-containing blood product
moderate to severe acute illness with or without fever

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50
Q

Live attenuated Vaccine vs. inactivated Vaccine

Is it contraindicated, vaccinated, or precautioned for an Allergy to vaccine or component?

A

contraindicated; contraindicated

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51
Q

Live attenuated Vaccine vs. inactivated Vaccine

Is it contraindicated, vaccinated, or precautioned for an encephalopathy?

A

Not known in live; contraindicated in inactivated

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52
Q

Live attenuated Vaccine vs. inactivated Vaccine

Is it contraindicated, vaccinated, or precautioned for pregnancy?

A

Live= contraindicated
Inactived = Vaccinate (some exceptions)

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53
Q

Live attenuated Vaccine vs. inactivated Vaccine

Is it contraindicated, vaccinated, or precautioned for immunosuppression?

A

Live= contraindicated
Inactived = Vaccinate (some exceptions)

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54
Q

Live attenuated Vaccine vs. inactivated Vaccine

Is it contraindicated, vaccinated, or precautioned for moderate to severe illness?

A

precaution on both

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55
Q

Live attenuated Vaccine vs. inactivated Vaccine

Is it contraindicated, vaccinated, or precautioned for recent blood products?

A

Live: precaution till after 3-4 months
Inactivated = vaccinate

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56
Q

Invalid “contraindications” for vaccines

A

Mild illness
Antimicrobial/antibiotics therapy
Pregnant or immunosuppressed person in the household
Breastfeeding except small-pox
Preterm birth once to 2 kg
Allergy to products not in vaccine
Multiple vaccines

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57
Q

Local Adverse Events

A

Mild/self-limited
Pain/swelling/redness at the injection site
Within hours of injection

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58
Q

Local adverse reactions are common with

A

inactivated vaccines

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59
Q

Systemic reactions to vaccine

A

Fever/malaise/headache/myalgia/loss of appetite
Reactions following live vaccines may be similar to mild form of disease

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60
Q

Systemic reactions can occur how many days after administration

A

7-21

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61
Q

Which adverse reactions can be life-threatening?

A

allergic (anaphalaxis)
s/s and preparations are needed

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62
Q

How long should you observe the patient after vaccination for allergic reactions?

A

15 minutes

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63
Q

What s/s should be watched out for after vaccinations?

A

Respiratory distress, wheezing, shock like, hives, swelling in mouth and throat

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64
Q

What treatment is needed for allergic reactions?

A

IM Epipen

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65
Q

What vaccines are given SubQ?

A

MMR
Varicella
-live-

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66
Q

What vaccines could be IM or SubQ?

A

IPV (Inactivated Polio Vaccine)
PCV (Pneumococcal Vaccine)
MCV (Meningococcal Vaccine)

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67
Q

What vaccines are given IM?

A

DTaP/Tdap (Diphtheria, Tetanus, Acellular Pertussis)
Hepatitis A
Hepatitis B
Hib (Haemophilus Influenzae type B)
HPV (Human Papillomavirus)

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68
Q

Do you aspirate on a vaccine?

A

not required
- experience less pain when given rapidly without aspiration

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69
Q

Why are vaccines not given IVP?

A

veins and arteries are too small

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70
Q

If a child has a bleeding disorder, what could happen during the IM injection and how can it be prevented?

A

hematoma; 23 g or finer and firm pressure for 2 minutes (NO RUBBING)

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71
Q

Hemophilia needs what after receiving a vaccine IM.

A

factor replacement on last dose
recent the better

72
Q

Atraumatic Care during vaccinations

A

Distraction (developmentally appropriate)
Parent cuddling/holding, pacifiers
Sweet-tasting solutions (oral sucrose)
Breastfeeding
Injection technique
Order of injections – painful last
Tactile stimulation (rub/stroke near injection site; buzzy)
Topical anesthetic

73
Q

Macule

A

flat discoloration of the skin

74
Q

Papule

A

solid raised lesion of the skin

75
Q

Vesicular

A

small fluid-filled sac

76
Q

Pertussis means

A

whooping cough

77
Q

Pertussis transmission

A

Respiratory secretions (direct/indirect)
Most contagious during catarrhal stage (before harsh coughing)

78
Q

S/S of Pertussis
- Catarrhal stage

A

Respiratory symptoms –
Mild occasional cough
Low-grade fever
Lasts 1-2 weeks

79
Q

The pertussis catarrhal stage lasts how long

A

1-2 weeks

80
Q

S/S of Pertussis
- Paroxysmal stage

A

Bursts of numerous, rapid coughs
Sudden inspiration creates high pitched “whoop”
Might not occur in younger babies
Cheeks become flushed or cyanotic
Eyes may bulge/tongue protrude
May continue until thick mucous plug dislodged
Vomiting
Exhaustion
More common at night

81
Q

What are the stages of pertussis?

A

catarrhal
paroxysmal
convalescent

82
Q

How long does the paroxysmal stage last in pertussis?

A

4-6 weeks

83
Q

S/S of Pertussis
- Convalescent stage

A

Coughing gradually stops
Single cough may continue
Paroxysmal cough may return it cold or respiratory illness occurs

84
Q

How long does the convalescent stage last

A

2-3 weeks

85
Q

Complications of pertussis

A

Pneumonia
Apnea - give O2
Neurological - seizures
Pressure effects of paroxysms

86
Q

Complications of pertussis in adolescents

A

Syncope, sleep disturbances, rib fractures, incontinence

87
Q

Interventions for Pertussis

A

Continuous assessment of respiratory status
Remain with child during coughing spells
Ensure adequate oxygenation - blowby
Suction prn
Reduce factors that promote cough–calmness
Small, frequent meals (maybe NG Tube)
Refeed a few minutes for recovery after emesis
Droplet precautions
5-7 days after antibiotics start

88
Q

What isolation do pertussis need to have and for how long?

A

Droplet
5-7 days after antibiotics start

89
Q

Pertussis vaccinate
5 doses

A

DTaP - 5 doses
2 months
4 months
6 months
15-18 months
4-6 years
Tdap
11-12 years

90
Q

DTaP gives the individual an

A

active immunity against pertussis

91
Q

Varicella

A

chickenpox

92
Q

Varicella-Zoster Virus

A

primary - chickenpox
reactivation of latent - shingles

93
Q

Shingles

A

herpes zoster

94
Q

Transmission of varicella

A

respiratory secretions
contact

95
Q

Varicella is what level of contagious

A

HIGHLY
- away from immunocompromised
1-2 days before rash appears

96
Q

How long is an individual contagious with varicella

A

1-2 days before rash
until all lesions have crusted over

97
Q

Varicella in the hospital

A

Airborne and Contact
assignments need to not be high risk

98
Q

Children the 1st sign of chickenpox

A

rash

99
Q

In adults the 1st sign of chickenpox

A

1-2 days of fever
malaise

100
Q

The chickenpox rash looks like starts and transforms into

A

Macule → Papule → Vesicle → Crust

101
Q

The chickenpox rash starts where

A

Head → Trunk → Extremities
Most lesions on trunk
Can occur on mucous membranes

102
Q

The rash occurs in

A

crops
- 200-500 lesions in 2-4 crops

103
Q

The rash causes the patient to

A

itch = pruritis

104
Q

S/S of varicella
healthy children

A

mild
Malaise
Temperature up to 102°F for 2-3 days
Vesicular rash on skin and mucous membranes
Itching!!

105
Q

Complications of varicella

A

Secondary bacterial infection FROM ITCHING
Pneumonia
CNS Manifestations = meningitis and

106
Q

Varicella on an immunosuppressed patient

A

high risk for disseminated disease
- multisystem involvement
- hemorrhagic

107
Q

Varicella on an immunosuppressed patient
Frequent complications

A

pneumonia
encephalitis

108
Q

Varicella Children with HIV infection have an increased risk for

A

morbidity

109
Q

Acyclovir (Zovirax)

A

Decreased number of lesions
Shortens duration of fever
Decreased itching, lethargy, and anorexia

110
Q

Post-exposure Prophylaxis for Varicella

A

Varicella vaccine
- within 5 days of exposure for pts w/o immunity
Control outbreaks in child facilities and schools

111
Q

Chickenpox Interventions

A

Skin Care – Luke-warm bath without soap
- Aveno, oatmeal
Apply pressure (no scratching)
Topical calamine
Distraction
Fingernails short (or mittens, etc.)
Keep cool
No aspirin associated with Rene’s syndrome

112
Q

Why do you not give aspirin to a child?

A

Rene’s syndrome

113
Q

Prevention of Chickenpox

A

maternal up to 1 year
2 doses of VAR or MMRV vaccine
- 12-15 months, 4-6 years

114
Q

Chickenpox is what type of immunity after the infection

A

active

115
Q

If a healthcare personnel is looking after a Chickenpox and MMR pt then they need?

A

documented immunity

116
Q

Rubeola

A

measles

117
Q

Transmission of rubeola

A

respiratory (droplet)

118
Q

Communicability of measles

A

HIGHLY
High-risk populations (colleges, healthcare providers, travelers)

119
Q

S/S of measles before the rash

A

fever peak ar 103-105

120
Q

s/s of rubeola

A

Fever 103-105
3 C’s (cough, coryza, and conjunctivitis)
Koplik spots
Photophobia
red maculopapular rash

121
Q

Coryza

A

runny nose

122
Q

Koplik spots

A

bluish-white spots (mouth)

123
Q

Rash of Rubeola

A

red maculopapular rash (raised discolored)

124
Q

The rash start and ends where

A

Hairline→Downward→Outward
- fades in order of appearance

125
Q

The rash becomes

A

confluent

126
Q

Associated s/s of Rubeola

A

Anorexia
Malaise
Diarrhea – infants
Generalized lymphadenopathy

127
Q

Rubeola occurs in

A

less than 5 y/o and 20 y/o

128
Q

Rubeola complications

A

Otitis Media
Pneumonia
Encephalitis in adults
More severe in malnourished
Vitamin A deficiency

129
Q

Rubeola complications are more severe in deficiency of what Vitamin causing malnutrition

A

A

130
Q

Rubeola Interventions

A

**Vitamin A for severe measles – decreases morbidity and morality **
- High doses - may experience vomiting & headache
Antipyretics
Cool Mist Vaporizer
Eye Care
Dim lights
Clean eyelids with warm saline solution if drainage
Skin Care
Airborne Precautions – hangs out for 2 hours after exposure

131
Q

What precautions are taken for Measles?

A

airborne
- hangs in the air 2 hours after exposure

132
Q

Post-exposure Prophylaxis for Measles

A

Immune globulin after exposure for
- Immunocompromised persons
- Susceptible household contacts

133
Q

Vaccination of Rubeola

A

maternal immunization up to 1 year
MMR - 2 doses (12-15 months and 4-6 years)

134
Q

Mumps transmission

A

respiratory (direct or indirect)

135
Q

Early s/s of Mumps

A

non-specific (muscle aches, low fever)

136
Q

s/s Mumps

A

“Earache” within 24 hours
- Jaw line in front of ear lobe (Parotid gland)
- Swell the chin and jaw line

137
Q

Complications of Mumps

A

Orchitis – testicular inflammation
Oophoritis/Mastitis – inflammation of breast or ovaries
Pancreatitis
Encephalitis
Meningitis
Deafness

138
Q

Mumps asymptomatic percentage

A

20-30

139
Q

Mumps Interventions

A

Analgesics
Antipyretics
supportive care
Soft or liquid foods
Warm or cool compresses
Droplet Precautions

140
Q

Mumps Preventions

A

maternal immunity up to 1 year
MMR - 2 dose (12-15 months, 4-6 years)

141
Q

If the patient has an MMR vaccine, the s/s of mumps is

A

milder

142
Q

Rubella

A

German measles

143
Q

Rubella means

A

little red

144
Q

Rubella transmission

A

Direct contact
Respiratory (primary)
-Blood
-Stool
-Urine
Mom if pregnant passes to baby

145
Q

S/S Children rubella

A

rash 1st

146
Q

S/S before rash for older children/adults rubella

A

Low-grade fever
Headache
Malaise
Mild conjunctivitis
Lymphadenopathy
Sore throat
Upper respiratory symptoms

147
Q

Rash for Rubella

A

Pinkish-red maculopapular rash
Begins on face then head to foot
- more prominent in hot shower
Lasts 3 days
Occasionally pruritic

148
Q

Rubella rash lasts for

A

3 days

149
Q

Rubella Complications

A

Arthritis/arthralgia
Thrombocytopenic purpura (rare)
Encephalitis (rare)

150
Q

Rubella Pregnancy Complications and greatest reason for vaccinations

A

Miscarriages
Fetal death/stillbirth
Birth defects (congenital rubella syndrome)

151
Q

Rubella Interventions

A

Avoid contact with pregnant women
Antipyretics
Comfort measures
Droplet precautions

152
Q

Precaution for Rubella

A

droplet

153
Q

Prevention of Rubella

A

maternal immunity for 1 year
MMR - 2 dose
12-15 months, 4-6 years

154
Q

Scarlet Fever Transmission

A

Direct or indirect contact with nasopharyngeal secretions

155
Q

Scarlet fever is most common in

A

school-aged children

156
Q

Initial s/s of Scarlet Fever

A

High fever/chills
Sore throat
Headache
Malaise
Abdominal pain/vomiting

157
Q

s/s after the rash appears of Scarlet Fever

A

Enanthema – internal
Exanthema - outward
avoids the face

158
Q

Enanthema

A

Tonsils red, swollen, and covered with exudate
throat red/swollen
white (1-2 days) to red (4-5 days) strawberry tongue
palate - pinpoint red lesions

159
Q

Exanthema

A

Flushed face with circumoral pallor
Red pinpoint rash
Absent on face
Feels like sandpaper
More intense in folds of joints bends
Desquamation begins by end of first week
Pealing of the skin

160
Q

Complications of scarlet fever

A

Retropharyngeal abscess
Sinusitis
Otitis media
Acute and/or long-term
- Glomerulonephritis
- Rheumatic fever

161
Q

Scarlet Fever Interventions

A

Antibiotics – PCN,
Bedrest – FEBRILE STAGE
Encourage fluids – FEBRILE STAGE
Relieve discomfort of sore throat
Prevent spread
Handwashing, discard toothbrush, avoid sharing food/drinks
Droplet Precautions
Until 24 hours after starting antibiotic

162
Q

Scarlet Fever in Febrile stage

A

bedrest
encourage fluids

163
Q

Scarlet Fever precautions

A

Droplet until after 24 hours of ANTIBIOTICS

164
Q

COVID-19 Transmission

A

respiratory (direct and indirect)

165
Q

COVID-19 Communicability

A

Highly contagious even if asymptomatic

166
Q

COVID-19 s/s

A

Asymptomatic (no s/s, normal CXR) = 4%
Mild (fever, fatigue, myalgia, cough) = 5%
Moderate (symptomatic pneumonia/abnormal CXR) = 39%
Severe (dyspnea, central cyanosis, hypoxia) = 5%
Critical (ARDS, Resp. failure, shock, MOD) = 0.6%

167
Q

COVID-19 Complications

A

Short-term and long-term
Underlying medical conditions = ↑ risk for severe illness – duh!
Post-COVID Multisystem Inflammatory Syndrome in Children (MIS-C)

168
Q

COVID-19 in Children’s Complication

A

Post-COVID Multisystem Inflammatory Syndrome in Children (MIS-C)

169
Q

COVID-19 Interventions

A

Airborne precautions + gown, gloves & goggles/faceshield
Supportive Care
Rest
Adequate hydration
Analgesics
Antipyretics
Source Control – mask, distancing, hand hygiene, etc.

170
Q

COVID-19 Precautions

A

Airborne precautions + gown, gloves & goggles/faceshield

171
Q

COVID-19 Vaccination

A

6 months and older can get it

172
Q

Isolation Precautions for Airborne/Contact

A

Varicella (Chickenpox)
Rubeola (Measles)
Coronavirus (COVID-19)

173
Q

Airborne/Contact PPE

A

N95
gloves
gown

174
Q

Isolation Precautions for Droplet

A

Rubella (German Measles)
Pertussis (Whooping Cough)
Mumps
Scarlet Fever

175
Q

Droplet Precaution PPE

A

MASK

176
Q

Nursing Priorities of Infectious Diseases

A

Prevent spread
Provide comfort
Ear, nose, and throat symptoms
Urticaria -
Fever
Pain
Irritability
Family support

177
Q

Urticaria

A

itchy welts

Module 5 (Pediatrics) (27 decks)

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