Vaccines Flashcards
Natural Active Immunization
Person acquires immunity by surviving the disease
itself and producing antibodies to the disease causing organism
Artificial Active Immunization
The immune system is stimulated and
“remembers” this antigen if subsequent
exposures occur
Does not cause
a full-blown infection
Active Immunizing Drugs: Examples
BCG vaccine (tuberculosis), Hepatitis A and B virus vaccines
Active Immunizing Drugs: Examples (I actively have pneumonia)
Pneumococcal bacterial vaccines, Human papilloma virus vaccine (Gardasil®), Rabies virus vaccine. Measles, mumps, and rubella virus vaccine, live - several forms. Poliovirus vaccine; several forms
Passive Immunization - long or short lived?
more short-lived than other immunizations
Passive Immunization
The substances needed to fight off invading
microorganisms are given directly to a person
The immune system is bypassed
Naturally acquired passive immunity
From mother to fetus through the placenta
Artificially acquired passive immunity (vaccines are passive)
Acquired from an external source (vaccine), such as injection of
antibodies or immunoglobulins
Passive Immunizing Drugs: Examples (rhogaine is passive)
Rho (D) immune globulin (RhoGAM) - RhoGAM is used for women who are RH negative that have an RH positive baby.
RhoGAM given when? (Rhouge at 28 weeks)
28 weeks -IV, and 2nd dose no later than 72 hrs after delivery
adverse affect - immunization - serious (serum is serious)
Serum sickness - usually w/ anti-toxins. its a rash about 5 - 10 days after vaccination. can only treat the symptoms.
to treat mild symptoms of immunization reactions, use
tylenol, not NSAIDs.
Toxoids - ex. (T for toxoids, T for TDAP)
Artificial active immune response. Stimulate one’s immune system. ex. TDAP.
Vaccinations with live bacteria or virus provide
lifelong immunity
Vaccinations with killed bacteria or virus provide
partial immunity, and booster shots are needed
periodically
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?
DTaP, Hib, hepatitis B, MMR, IPV, PCV, and varicella
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
Provide acetaminophen (Tylenol) before and every 4 hours after vaccination as needed.
before you travel, how long to get immunization?
at least 2 months
At birth, the nurse prepares to administer which
immunization to the neonate?
Hep B
Nursing Implications
pregnancy status, immunosuppression, Do not give aspirin to children
early signs of transplant rejection
tired, achy, fever
immunosupressants ex. (suppress this vicious cycle)
cyclosporine (Sandimmune®) azathioprine (Imuran®) muromonab-CD3 (Orthoclone®)
tacrolimus (Prograf®)
corticosteroids
orthoclone (Muromonab-CD3) (clone my organ rejection)
is the only drug indicated for reversal of organ rejection once rejection of a transplanted organ has started.
orthoclone (Muromonab-CD3) (immunosuppression) - check for what? (fat clones)
fluid volume before adminstering, can cause flash edema.
Azathioprine (Imuran®) (immunosupression) (Azathropine = Arthritis)
Used as an adjunct medication to prevent rejection of
kidney transplants
Also used in the treatment of rheumatoid arthritis Risks!!
cyclosporine (Sandimmune®)
(immunosuppression)
cyclosporine (Sandimmune®)
Primary drug used for the prevention of kidney, liver,
heart, and bone marrow transplant rejection May be used for other autoimmune disorders
(Sandimmune®)
(immunosuppression) (keep sand in a glass)
always keep in a glass container. don’t use a plastic cup to adminster to patient
tacrolimus (Prograf®) (liver rejection is tacky)
Used only for the prevention of liver transplant rejection
Others uses are unlabeled uses
(Sandimmune®)
(immunosuppression) - don’t give with
grapefruit juice
Glatiramer acetate (Copaxome®) (immunosuppressant) (glat I don’t have MS)
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)
Glatiramer acetate (Copaxome®) (immunosuppressant) (gladiators need food)
administered sub q, can cause some flushing and stomach upset, so take with food.
immunosupressants - important to check WBC - how low?
Monitor WBC counts throughout therapy; if the count drops below 3000/mm3, discontinue the drug, but only after contacting the physician
Oral antifungal drugs are usually given with
immunosuppressant drugs to treat oral candidiasis that may occur
Patients taking immunosuppressants should be encouraged to take measures to reduce the risk of infection
Avoiding crowds
Avoiding people with colds or other infections
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)
Fluid volume status
Some practitioners recommend that patients who take cyclosporine also drink grapefruit juice to increase blood levels of the cyclosporine.
false
A patient is experiencing graft rejection. Which medication will he receive to reverse this problem? (the clone is #1)
muromonab-CD3 (Orthoclone OKT3)
A patient who has had a kidney transplant is receiving cyclosporine PO in maintenance doses. What action would decrease the potency of this drug?
Using a Styrofoam container to administer the drug
Which potential problem is of most concern for the patient receiving immunosuppressant drugs?
Increased susceptibility to infections
Artificial Active
Immunization
The immune system is stimulated and “remembers” this antigen if subsequent exposures occur
Does not cause
a full-blown infection (this is vaccine)
active immunizing drugs
BCG vaccine (tuberculosis), Diphtheria, tetanus, and pertussis toxoids, several forms, Haemophilus influenzae type B conjugate vaccine, Hepatitis A and B virus vaccines
active immunizing drug
Active immunization is the term used when the infective agent is modified in some way to eliminate its harmful effects without loss of antigenicity.
active immunizing drugs
Smallpox virus vaccine
* Tetanus toxoid
* Varicella virus vaccine (chickenpox)
* Yellow fever
virus vaccine
* Many others
Passive Immunization
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
Passive Immunizing Drugs
Immunoglobulins
Antitoxins
Snake and spider antivenins (antivenom)
Immunizing Biologicals
Biological antimicrobial agents Also called biologicals
Antitoxins Antisera
Passive Immunizing Drugs: Examples
Antivenins
Pit viper, coral snake Black widow spider
Hepatitis B immune globulin
Immunoglobulin, various forms Rabies immunoglobulin (human)
Passive Immunizing Drugs: Examples
Rho(D) immune globulin (RhoGAM) Tetanus immunoglobulin
Passive immunization - when to use? (passively fast)
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)
adverse effects of passive immunization
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
Toxoids
Antigenic (foreign) preparations of bacterial exotoxins
* Detoxified with chemicals or heat
* Weakened or “attenuated”
* Cannot revert back to a toxic form
toxoids are what type of immune response? (Toxins are artificial)
Artificial active immune response
“Tetanus Toxoid
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
Active immunization
Prevents infection caused by bacterial toxins or viruses Provides long-lasting or permanent immunity
“Herd immunity”
vaccines
Active immunity
Body produces antibodies
Acquired immunity Exposed to antigen
Passive immunity
Receives antibodies from another source
Recommendation for childhood immunizations
DTaP, tetanus & diphtheria (Td), polio (IPV), varicella, measles-mumps-rubella (MMR), Hib, Hep-A, Hep-B, pneumococcal conjugate, meningococcal congugate, human papillomavirus, rotavirus.
Recommended adult immunizations
Tetanus-diphtheria-pertussis, tetanus-diphtheria Influenza
Pneumococcal polysaccharide
Human papillomavirus
MMR
Varicella
Zoster
If discomfort occurs at the injection site
apply warm compresses and give acetaminophen
