Infectious Disease Objectives Flashcards
What are some psychological and SDOH factors that affect vaccine hesitancy?
- Personal / familial experience with vaccination
- Distrust government and of healthcare system
- Political views
- Cost
- Historical context of discrimination
- Religious views
- Misinformation
- Education
- Perceived risk of disease
- Side effects of vaccine
- Geographic barriers
Describe vaccine administration techniques.
- Infants and toddlers best held in parent’s arms—make sure the parent or HCP is HOLDING all the child’s limbs
- Older children best held in parents’ lap
- For older children distraction and calming techniques are helpful
- Be prepared for vaso-vagal responses (from children and parents)
What are some nursing considerations for IM injection sites?
- Younger than 12 months: Vastas Lateralis (anterolateral thigh)
- Older than 12 months: Vastas Lateralis (anterolateral thigh) or IF WALKING preferably Deltoid muscle
- Adolescents: Deltoid muscle
List mild to moderate reactions to vaccine administration.
Soreness, redness, itching, swelling
List severe reactions to vaccine administration.
Anaphylaxis:
hoarseness, wheezing, airway constriction, difficulty breathing, pale or mottled skin, hypotension, altered mental status, fever, redness, rash
Describe Precautions vs. Contraindications to vaccination.
Precautions:
- Moderate or severe acute illness with or without fever
Contraindications:
- Severe allergic reaction (i.e., anaphylaxis)
- Severe immunodeficiency (CD4 < 200)
- Live vaccines and pregnancy
Which vaccine is given at birth?
Hepatitis B
Which vaccines are given at 12 months?
- Measles, Mumps, Rubella (MMR)
- Varicella
- Hepatitis A
Which vaccines are given at 4-6 years?
- Diphtheria, tetanus, acellular pertussis (DTaP) < 7 years
- Inactivated poliovirus (IPV)
- Measles, Mumps, Rubella (MMR)
- Varicella
Which vaccines are given at 11-12 years?
- Tetanus, diphtheria, acellular pertussis (Tdap) > 7 years
- Human papillomavirus (HPV)
- Meningococcal
List some vaccine preventable disease.
- Measles (Rubeola)
- Varicella (Chickenpox)
- Pertussis
- Influenza
- Pneumonia
- Rotavirus
List some common pediatric live vaccines.
- MMR
- Varicella
- Intranasal influenza
- Rotavirus
Who cannot receive live vaccines?
Infants with severe combined immunodeficiency
Describe agent, transmission, and isolation precautions of measles (rubeola).
- Agent: Paramyxovirus
- Transmission: Nasopharynx droplets
- Isolation Precautions: Airborne
Measles clinical manifestations?
Prodrome:
- 3 “Cs” – cough, coryza, and conjunctivitis (Coryza - inflammation and congestion of mucous membranes in the nose)
- Fever (103°F–105°F)
- Koplik spots (blue-white spots) on buccal mucosa in the mouth
Rash:
- Begins at hairline, then involves face and upper neck
- Progresses downward and outward to hands and feet
Measles complications?
- Otitis media
- Diarrhea and related dehydration
- Pneumonia
- Encephalitis
- Most common cause of death is from respiratory and/or neurological complications
How do you manage measles?
- Administer Vitamin A
- Assess neuro signs
- Assess lung sounds
- Acetaminophen or ibuprofen for fever
- Antibiotics for secondary infections
Describe agent, transmission, and isolation precautions for chicken pox (varicella).
- Agent: varicella-zoster virus
- Transmission: Direct contact, droplet secretions
- Precautions: Contact and Airborn
Chicken Pox (Varicella) clinical manifestations?
- Prodromal stage: fever, malaise
- Pruritic rash begins a macule, becomes vesicle, then erupts
Chicken Pox (Varicella) complications?
- Secondary bacterial infection of skin lesions
- Pneumonia
- Central nervous system manifestations
~ Meningitis
~ Encephalitis
~ Seizures
Chicken Pox (Varicella) treatment?
- Supportive, prevent skin infections
- Prevention: Varicella vaccine
Describe agent, transmission, and isolation precautions of erythema infectiosum (fifth disease).
- Agent: Parvovirus B19
- Transmission: Respiratory secretions
- Precautions: Contact
Erythema infectiosum (fifth disease) clinical manifestations?
- Persistent fever for 3-7 days
- “Slapped Cheek” appearance
Describe agent and transmission/precautions for pertussis (whooping cough).
- Agent: Bordetella pertussis
- Transmission/Precautions: Droplet
Pertussis (whooping cough) clinical manifestations?
- URI symptoms 1-2 weeks
- Paroxysmal, short, rapid cough followed by high-pitched “whoop” or gasp. Cyanosis may occur
Pertussis (whooping cough) complications?
Respiratory distress
Pertussis (whooping cough) treatment?
Supportive during hospitalization with oxygen, hydration, careful feedings, and antibiotics
Describe agent and transmission/precautions for scarlet fever.
- Agent: Group A Beta-hemolytic streptococci
- Transmission/Precautions: Droplets
Scarlet Fever clinical manifestations?
- Abrupt high fever, halitosis
- Tonsils large, edematous, covered with exudate
- “Strawberry tongue”
- Sandpaper-like pink rash to body
Scarlet Fever complications?
- Acute rheumatic fever – heart, brain, joints
- Acute glomerulonephritis
- Pneumonia
Scarlet Fever treatment?
Penicillin (if allergic Azithromycin)
Lyme Disease clinical manifestations?
- Rash (Erythema migrans)
- Malaise
- Lymphadenopathy
Lyme Disease complications?
- Carditis
- Arthritis
Lyme Disease treatment?
- Doxycycline > 8 yrs
- Amoxicillin < 8 yrs
How is Rocky Mountain Spotted Fever transmitted?
Infected tick bite
Rocky Mountain Spotted Fever clinical manifestations?
- Severe headache
- Petechial rash on palms, soles of feet
Rocky Mountain Spotted Fever treatment?
IV Doxycylcine 1st line therapy
Describe the etiology of Infectious Mononucleosis.
Epstein Barr Virus or “EBV”
Infectious Mononucleosis clinical manifestations?
- Fatigue, pharyngitis, lymphadenopathy (TRIAD)
- Splenomegaly (~50%)
Infectious Mononucleosis management?
Avoid contact sports and strenuous activities for 4 weeks or while splenomegaly is present
