TLO 1.3a Immune Flashcards

Question

What does a Killed or Inactivated vaccines do?

Answer 1

Pathogens made inactive by chemicals or heat Allows body to produce antibodies but does not cause clinical disease Tend to elicit limited immune response, requiring several doses Ex: polio, pertussis

Answer 2

``` Unique organisms that contain DNA or RNA Can't reproduce on own Need a host cell to allow virus to duplicate Ex: Rubeola (measles) Rubella (3 day measles, German measles) Fifth's disease (erythema infectiosum) Varicella Zoster (chickenpox, shingles) Roseola Infantum ```

Answer 3

Eruption or rash on the skin

Answer 4

Assess history (onset, location, color, pattern, shape) Vitals, lung sounds, physical assessment Recent exposure to illnesses Implement isolation

Answer 5

RNA virus Droplet contact or airborne (rare) Natural disease or live attenuated vaccine 3-5 days prior to rash and 4-6 days after rash appears Late winter and spring 2 doses MMR for full protection, given at 1 yr and 4-6 yr

Answer 6

Respiratory s/s 10 days after exposure fever Prodromal period: 3 C's (cough, coryza(runny nose), conjunctivitis) Koplik spots appear 2 days before rash (diagnostic) Koplik spots blue/white spots with red base near molars and buccal mucosa, lasts 3 days, slough off Next: deep red macular rash appears on face and neck, spreads down trunk and extremities, lasts 6-7 days.

Answer 7

Secondary infections: otitis media, pneumonia, croup r/t respiratory involvement CNS: encephalitis/brain death (rare)

Answer 8

Symptom management Isolation (droplet and airborne) Vaccination (prevention) Teach: risk of fever and febrile seizures 7-10 days after vaccination (slight risk)

Answer 9

``` RNA virus Airborne particles, direct contact with infectious droplets. Trans placental Natural disease or vaccine 7 days before s/s to 14 days after rash Late winter, early spring MMR 2 doses at 1 yr and 4-6 yr ```

Answer 10

German and 3 day measles Mild disease for children/adults Rash develops after 14-16 day of exposure Young child asymptomatic until rash presents Older child: coryza, diarrhea, malaise, HA, sore throat, aches, eye pain, fever, nausea Rash: pinkish maculopapular Petechiae Enlarge lymph nodes

Answer 11

``` German and 3 day measles mild arthralgias/arthritis in adults Self limiting mild thrombocytopenia Fetus has most risk when mother infected -intrauterine growth retardation -failure to thrive ```

Answer 12

German and 3 day Supportive and symptomatic Disease is self limiting No school or daycare 7 days after rash appears Infants with congenital rubella considered infectious x1 yr or until nasal and urine cultures are negative repeatedly MMR vaccine preventative

Answer 13

Parvovirus B19 Airborne particles, resp droplets, blood, blood products, trans placental Natural disease thought to provide antibodies 5-12 days from prodromal period until rash appears Winter and spring No vaccine

Answer 14

Mild systemic disease Mild HA, runny nose, fatigue, low grade fever before rash Intense fiery red edematous rash on cheeks "slapped" look Erythematous maculopapular rash on trunk and extremities develops 1-4 days after facial rash Rash last 2-39 days fades with lacy appearance Reappears when aggravated

Answer 15

Generally none | Pregnant women risk for intrauterine infection and fetal death

Answer 16

Identify and notify pregnant women of exposure Supportive care of symptoms No vaccine: wash hands, cover mouth sneeze/cough, avoid sick people

Answer 17

``` Human Herpes virus 6 Contact with secretions Unknown: from febrile period through 1st time rash appears Throughout the year, no pattern No vaccine ```

Answer 18

Sudden high fever: 103-106 Malaise/irritability Intermittent or constant fever for 3-5 days Mild cough, runny nose, ad pain, HA, vomiting, diarrhea Rash appears hours to 2 days after fever subsides Rash: pink maculopapules or macules that blanch with pressure on neck and trunk, lasts 24-48 hours

Answer 19

Uncommon | Febrile seizure may occur

Answer 20

Symptomatic | Teach fever management: no aspirin, use acetaminophen

Answer 21

Varicella zoster virus Direct contact droplet, airborne particles Natural disease, varicella vaccine 1-2 days before onset of rash until all rashes crusted over usually 5-7 days Late winter through early spring VAR 2 doses at 1 yr and 4-6yrs

Answer 22

Rash: malaise, anorexia, slightly elevated temp Rash develops on trunk and scalp followed by lesions Lesions appear in crops over 3-4 days Lesions teardrop shape with that become pustular and dry to develops a crust Very contagious Contagious until all lesions are crusted and dry

Answer 23

Secondary bacterial infections of skin lesions CNS: coma, convulsions, encephalitis, ataxia (rare) Varicella pneumonia (adults generally) Corneal problems if lesions involve the eye

Answer 24

Symptomatic/supportive Oatmeal baths, antihistamines to ease itching Acetaminophen for fever NO aspirin Hospitalization: strict airborne and contact isolation Nurse assigned should not care for immunocompromised patients Bag and label all contaminated materials before processing Acyclovir IV if child is immunocompromised

Answer 25

Paramyxovirus Airborne droplets, salivary secretions, possibly urine Natural disease or live vaccine (MMR) 7 days before swelling of lymph nodes to 9 days after onset Late winter and spring MMR 2 doses, 1 yr and 4-6 yr

Answer 26

``` Prodromal: fever, myalgia (pain in muscles), HA, malaise Parotid gland (gland by ears) swelling, classic clinical sign ```

Answer 27

Aseptic Meningitis: nuchal (neck) rigidity, lethargy, vomiting Salivary glands most affected but can involve other organs Adolescent ovarian inflammation (female), testicle inflammation (boys)

Answer 28

Symptomatic care: acetaminophen not aspirin for fever Droplet precautions until 9 days after onset of swelling Examine testes in boys (orchitis) Hand hygiene to prevent transmission Prevent with MMR vaccine

Answer 29

``` Poliovirus found in throat and feces Fecal/oral or respiratory Shortly before and after onset of illness, shed in pharynx for 1 wk and weeks to months in feces Summer and fall IPV 4 doses at 2, 4, 6 mo and 4-6 yr ```

Answer 30

Fever, malaise, nausea, HA, sore throat, generalized ab pain Flaccid paralysis especially of lower extremities Complications: Bulbar polio (cervical involvement) leads to inability to breathe

Answer 31

No specific treatment Prevent through vaccination PT helps maintain muscle integrity and prevent contractures Mechanical ventilation

Answer 32

Bordetella pertussis Direct contact with resp droplets from coughing Bacteria or vaccine DTaP 1-4 weeks Any season Dtap 5 doses at 2, 4, 6, 18 mo and 4-6 yrs

Answer 33

Three stages Catarrhal: 1-2 weeks -URI (rhinorrhea, low grade fever, mild cough, lacrimation) Paroxysmal: 2-4 weeks - repetitive cough during single expiration followed by "whoop" on inspiration - cough triggered by yawning, sneezing, eating Convalescent: 1-2 weeks -episodes of coughing, whooping and vomiting that decrease in frequency, lasts several months

Answer 34

Pneumonia (most common) Atelectasis, pneumothorax Hypoxemia leads to CNS involvement Infants <6 mo, greater risk r/t no maternal immunity and may not be completely immunized

Answer 35

Vaccinate: DTaP Antibiotics to pt and those in close contact Infants/children exposed should continue with vaccination Droplet precautions Monitor resp status Keep room quiet, calm (excitement triggers episodes) Block care, monitor nutritional status

Answer 36

``` Corynebacterium diphtheria Contact with carrier or disease droplets Vaccine (DTaP) IM, passive immunity from maternal antibodies, natural disease process 2 wk-several months Fall and winter ```

Answer 37

``` Common cold s/s initially Foul smelling mucopurulent discharge Thin gray membrane on tonsils and pharynx "Bull neck" or neck edema Respiratory compromise r/t narrowing of airway Complications: airway obstruction myocarditis, peripheral neuropathies ```

Answer 38

Diphtheria antitoxin IV and antibiotics (PCN-G, E-mycin) | Vaccinate to prevent

Answer 39

Clostridium tetani (bacterial) Through broken skin with contaminated objects. Found in soil. Bacterial infection affects nervous system= muscle spasms 3-21 days Vaccination (Tdap, DT)

Answer 40

``` HA Jaw cramping Sudden, involuntary muscle tightening (often stomach muscles) Painful muscle stiffness all over the body Trouble swallowing jerking or staring (seizures) Fever and sweating High blood pressure or fast heart rate ```

Answer 41

Laryngospasm Fractures Pneumonia (aspiration) Breathing difficulty, possibly leading to death

Answer 42

Immediate Human Tetanus Immune Globulin (TiG) Antibiotics Drugs to control muscle spasms

Answer 43

Type of bacteria, Type B causes Meningitis Respiratory droplets (cough, sneeze) At risk: Immunocompromised, younger than 5 Vaccine: 4 dose at 2, 4, 6 and 12-15 mo OR 3 doses at 2, 4, and 12-15 mo Vaccine SE: fever, redness and swelling at injection site

Answer 44

Pneumococcal meningitis and pneumonia Fussiness, sleepy, swelling at site, fever 4 doses at 2, 4, 6, and 12-15 mo Given IM

Answer 45

Protects against Hep B liver disease 3 doses at birth, 1-2 mo and 6-18 mo Given IM None or mild low temp, injection site soreness