Peds vaccine Flashcards
Vaccines that are live
- Rotavirus
- Influenza = Nasal (flu mist)
- Measles-Mumps-Rubella
- Varicella
Contraindications of Influenza
- anaphylaxis with egg
- pregnancy
- immunodeficiency
- chronic disease (asthma, renal, cardiac)
Contraindications of MMR
- pregnancy
- immunodeficiency
Contraindications of Varicella
- pregnancy
- immunodeficiency
Common side effects of Influenza
- 5% myalgia, malaise, fever
- Guillain-Barre Syndrome
Guillain-Barre Syndrome
- rate 1 case: 1 million adult vaccinations
- rate 4-7 cases: 100,000 adults with influenza
Measles-Mumps-Rubella Vaccine Common Side Effects
-none in >80% most common -local swelling/tenderness -mild fever/rash -joint discomfort
Common side effects of Varicella
chicken-pox like lesions at injection site or elsewhere 1 to 3 weeks after dose
Common side effects of HPV
local pain and dizziness
Which vaccine has the side effect of hypotonia
pertussis
Most common reactions associated with vaccine administration
erythema, tenderness at injection site, low-grade fever, fussiness
How do you administer multiple vaccines and what accommodations to provide for multiple vaccines
- inject in different sides of the body
- use combination vaccines when you can
Common administration sites for children less than 3 years old
- intramuscular in thigh
- subcutaneous shot in upper arm or fatty area of thigh
Common administration sites for children greater than 3 years old
- intramuscular in deltoid muscle
- subcutaneous shot on the back of the upper arm
Influenza vaccination preferred doses and times
Inactivated influenza vaccine
-greater than 6 months
Live attenuated influenza vaccine
-between ages 2 and 50 years
Guidelines for catch up and contraindications to these
- older children may receive fewer vaccine doses than if they had started at birth
- when available, use combination vaccines
Possible complications of injections
Anaphylaxis Medication errors "Right" stuff Infection or abscess Lipodystrophy or atrophy Injection site pain
Possible complications of IV injections specifically
Infiltration Hematoma Embolism Catheter Shear Thrombosis Endarteritis
Basic anatomy of a syringe and needle
Plunger Barrel Hub Needle - smaller gauge number = larger needle bore diameter Bevel - ALWAYS UP
What is/are the site of intradermal injections?
Forearm
What gauge needle is used with intradermal injections?
26 or 27
How far under the skin should the needle be inserted with intradermal injections?
1/8 inch
What is/are the site of subcutaneous injections?
Infants - thigh
Children - deltoid
Adults - anterior/posterior upper arm, anterior/posterior lower abdomen, anterior upper thigh
What gauge needle is used with subcutaneous injections?
24-26
What size needle should be used with subcutaneous injections?
3/8 to 1 inch
What size syringe should be used with subcutaneous injections?
2-3cc
What is/are the site of intramuscular injections?
Infants and Children - anteriolateral thigh and deltoid (NEVER use gluteal muscles in children less than 3 years old or children who started walking less than a year prior to injection)
Adults - deltoid, ventrogluteal (careful b/c of sciatic nerve), dorsogluteal, vastus lateralis
What gauge needle is used with intramuscular injections?
18-23
What size needle should be used with intramuscular injections?
1-2 inch
What size syringe should be used with intramuscular injections?
2-5mL
What injection type do you use the Z-track method with?
Intramuscular
What injection type do you insert until “flash back” appears?
Intravenous
What does a smaller gauge number indicate?
Larger needle bore diameter
