Vaccines Flashcards

1
Q

Natural Active Immunization

A

Person acquires immunity by surviving the disease
itself and producing antibodies to the disease causing organism

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2
Q

Artificial Active Immunization

A

The immune system is stimulated and
“remembers” this antigen if subsequent
exposures occur
 Does not cause
a full-blown infection

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3
Q

Active Immunizing Drugs: Examples

A

BCG vaccine (tuberculosis), Hepatitis A and B virus vaccines

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4
Q

Active Immunizing Drugs: Examples (I actively have pneumonia)

A

Pneumococcal bacterial vaccines,  Human papilloma virus vaccine (Gardasil®), Rabies virus vaccine. Measles, mumps, and rubella virus vaccine, live - several forms. Poliovirus vaccine; several forms

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5
Q

Passive Immunization - long or short lived?

A

more short-lived than other immunizations

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6
Q

Passive Immunization

A

The substances needed to fight off invading
microorganisms are given directly to a person
 The immune system is bypassed

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7
Q

Naturally acquired passive immunity

A

From mother to fetus through the placenta

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8
Q

 Artificially acquired passive immunity (vaccines are passive)

A

Acquired from an external source (vaccine), such as injection of
antibodies or immunoglobulins

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9
Q

Passive Immunizing Drugs: Examples (rhogaine is passive)

A

Rho (D) immune globulin (RhoGAM) - RhoGAM is used for women who are RH negative that have an RH positive baby.

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10
Q

RhoGAM given when? (Rhouge at 28 weeks)

A

28 weeks -IV, and 2nd dose no later than 72 hrs after delivery

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11
Q

adverse affect - immunization - serious (serum is serious)

A

 Serum sickness - usually w/ anti-toxins. its a rash about 5 - 10 days after vaccination. can only treat the symptoms.

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12
Q

to treat mild symptoms of immunization reactions, use

A

tylenol, not NSAIDs.

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13
Q

Toxoids - ex. (T for toxoids, T for TDAP)

A

Artificial active immune response. Stimulate one’s immune system. ex. TDAP.

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14
Q

Vaccinations with live bacteria or virus provide

A

lifelong immunity

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15
Q

Vaccinations with killed bacteria or virus provide

A

partial immunity, and booster shots are needed
periodically

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16
Q

A physically and medically neglected 15-month-old child has been placed
in foster care. The foster parents come in with the child today for
immunization updates. They have no idea what, if any, vaccines the child
has previously received. Today, the nurse would most likely consider
which of the following?

A

DTaP, Hib, hepatitis B, MMR, IPV, PCV, and varicella

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17
Q

Parents of a client tell the nurse that they want their child
to receive scheduled vaccines, but that they are concerned
because their friends say that children are always very
irritable after they receive vaccines. The nurse teaches the
parents to

A

Provide acetaminophen (Tylenol) before and every 4 hours after vaccination as needed.

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18
Q

before you travel, how long to get immunization?

A

at least 2 months

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19
Q

At birth, the nurse prepares to administer which
immunization to the neonate?

A

Hep B

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20
Q

Nursing Implications

A

pregnancy status, immunosuppression, Do not give aspirin to children

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21
Q

early signs of transplant rejection

A

tired, achy, fever

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22
Q

immunosupressants ex. (suppress this vicious cycle)

A

cyclosporine (Sandimmune®) azathioprine (Imuran®) muromonab-CD3 (Orthoclone®)
tacrolimus (Prograf®)
corticosteroids

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23
Q

orthoclone (Muromonab-CD3) (clone my organ rejection)

A

is the only drug indicated for reversal of organ rejection once rejection of a transplanted organ has started.

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24
Q

orthoclone (Muromonab-CD3) (immunosuppression) - check for what? (fat clones)

A

fluid volume before adminstering, can cause flash edema.

25
Q

Azathioprine (Imuran®) (immunosupression) (Azathropine = Arthritis)

A

 Used as an adjunct medication to prevent rejection of
kidney transplants
 Also used in the treatment of rheumatoid arthritis  Risks!!

26
Q

cyclosporine (Sandimmune®)
(immunosuppression)

A

cyclosporine (Sandimmune®)
 Primary drug used for the prevention of kidney, liver,
heart, and bone marrow transplant rejection  May be used for other autoimmune disorders

27
Q

(Sandimmune®)
(immunosuppression) (keep sand in a glass)

A

always keep in a glass container. don’t use a plastic cup to adminster to patient

28
Q

tacrolimus (Prograf®) (liver rejection is tacky)

A

Used only for the prevention of liver transplant rejection
 Others uses are unlabeled uses

29
Q

(Sandimmune®)
(immunosuppression) - don’t give with

A

grapefruit juice

30
Q

Glatiramer acetate (Copaxome®) (immunosuppressant) (glat I don’t have MS)

A

The only immunosuppressant drug used for the treatment of
multiple sclerosis (MS)
Used to reduce the frequency of MS relapses (exacerbations) in relapsing-remitting
multiple sclerosis (RRMS)

31
Q

Glatiramer acetate (Copaxome®) (immunosuppressant) (gladiators need food)

A

administered sub q, can cause some flushing and stomach upset, so take with food.

32
Q

immunosupressants - important to check WBC - how low?

A

Monitor WBC counts throughout therapy; if the count drops below 3000/mm3, discontinue the drug, but only after contacting the physician

33
Q

Oral antifungal drugs are usually given with

A

immunosuppressant drugs to treat oral candidiasis that may occur

34
Q

Patients taking immunosuppressants should be encouraged to take measures to reduce the risk of infection

A

Avoiding crowds
 Avoiding people with colds or other infections

35
Q

A patient must be treated immediately for acute organ transplant rejection. The nurse anticipates that muromonab-CD3 (Orthoclone OKT3) will be ordered. What is the priority assessment before beginning drug therapy with muromonab-CD3? (fluids are critical to a clone)

A

Fluid volume status

36
Q

Some practitioners recommend that patients who take cyclosporine also drink grapefruit juice to increase blood levels of the cyclosporine.

A

false

37
Q

A patient is experiencing graft rejection. Which medication will he receive to reverse this problem? (the clone is #1)

A

muromonab-CD3 (Orthoclone OKT3)

38
Q

A patient who has had a kidney transplant is receiving cyclosporine PO in maintenance doses. What action would decrease the potency of this drug?

A

Using a Styrofoam container to administer the drug

39
Q

Which potential problem is of most concern for the patient receiving immunosuppressant drugs?

A

Increased susceptibility to infections

40
Q

Artificial Active
Immunization

A

The immune system is stimulated and “remembers” this antigen if subsequent exposures occur
 Does not cause
a full-blown infection (this is vaccine)

41
Q

active immunizing drugs

A

BCG vaccine (tuberculosis), Diphtheria, tetanus, and pertussis toxoids, several forms, Haemophilus influenzae type B conjugate vaccine, Hepatitis A and B virus vaccines

42
Q

active immunizing drug

A

Active immunization is the term used when the infective agent is modified in some way to eliminate its harmful effects without loss of antigenicity.

43
Q

active immunizing drugs

A

Smallpox virus vaccine
* Tetanus toxoid
* Varicella virus vaccine (chickenpox)
* Yellow fever
virus vaccine
* Many others

44
Q

Passive Immunization

A

 Serum or concentrated immune globulins from humans or animals are injected into a person
 The substances needed to fight off invading microorganisms are given directly to a person
 The immune system is bypassed
 Short-lived compared with active immunization, but works faster

45
Q

Passive Immunizing Drugs

A

 Immunoglobulins
 Antitoxins
 Snake and spider antivenins (antivenom)

46
Q

Immunizing Biologicals

A

Biological antimicrobial agents  Also called biologicals
 Antitoxins  Antisera

47
Q

Passive Immunizing Drugs: Examples

A

Antivenins
 Pit viper, coral snake  Black widow spider
 Hepatitis B immune globulin
 Immunoglobulin, various forms  Rabies immunoglobulin (human)

48
Q

Passive Immunizing Drugs: Examples

A

 Rho(D) immune globulin (RhoGAM)  Tetanus immunoglobulin

49
Q

Passive immunization - when to use? (passively fast)

A

Provides quick immunity before a person’s own immune
system has a chance to make antibodies (such as in cases of exposure to hepatitis B or rabies viruses)

50
Q

adverse effects of passive immunization

A

Range from mild and transient to very serious or life threatening
 Minor effects
 Fever, minor rash, soreness at injection site, itching,
adenopathy
 Severe effects
 Fever higher than 103° F, encephalitis, convulsions, anaphylactic reaction, dyspnea, others

51
Q

Toxoids

A

Antigenic (foreign) preparations of bacterial exotoxins
* Detoxified with chemicals or heat
* Weakened or “attenuated”
* Cannot revert back to a toxic form

52
Q

toxoids are what type of immune response? (Toxins are artificial)

A

Artificial active immune response

53
Q

“Tetanus Toxoid

A

Adults: “TdaP” and
 Children: “DtaP”
 Tetanus is caused by a toxin produced by bacteria found worldwide in soil, dust, and manure
 Approximately 10 to 20 percent of reported cases of tetanus are fatal

54
Q

Active immunization

A

 Prevents infection caused by bacterial toxins or viruses  Provides long-lasting or permanent immunity
 “Herd immunity”

55
Q

vaccines

A

 Active immunity
 Body produces antibodies
 Acquired immunity  Exposed to antigen
 Passive immunity
 Receives antibodies from another source

56
Q

Recommendation for childhood immunizations

A

DTaP, tetanus & diphtheria (Td), polio (IPV), varicella, measles-mumps-rubella (MMR), Hib, Hep-A, Hep-B, pneumococcal conjugate, meningococcal congugate, human papillomavirus, rotavirus.

57
Q

Recommended adult immunizations

A

 Tetanus-diphtheria-pertussis, tetanus-diphtheria  Influenza
 Pneumococcal polysaccharide
 Human papillomavirus
 MMR
 Varicella
 Zoster

58
Q

If discomfort occurs at the injection site

A

apply warm compresses and give acetaminophen