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Pharmacology Exam 3 > Vaccines & Sera > Flashcards

Vaccines & Sera Flashcards

1
Q

What are the actions of Biologicals (include vaccines and immune seras) ?

A
  • Stimulate the production of antibodies
  • Provide preformed antibodies to facilitate an immune reaction
  • React specifically with the toxins produced by an invading pathogen
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2
Q

What does Sera produce?

A

Pre-formed antibodies to facilitate an immune reaction.

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3
Q

What does Sera’s specifically react with?

A

Toxins produced by an invading pathogen.

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4
Q

What are the 2 types of immunity?

A

Active and Passive Immunity.

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5
Q

Does vaccines cause active or passive immunity?

A

Active - When we give the vaccine, the body recognizes the foreign protein and begin to produce antibodies to react with it.

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6
Q

Is Sera, active or passive?

A

Passive - We inject antibodies in the body and then those antibodies react with the antigen or venom in the body.

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7
Q

Explain active immunity.

A

The body recognizes a foreign protein and begins producing antibodies to react with it.

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8
Q

Explain passive immunity.

A

Occurs when preformed antibodies are injected into the system and react with a specific antigen.

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9
Q

What lifespan considerations should we take into account when giving Biologicals to children?

A
  • Parents should have a copy of immunization record
  • All adverse effects should be reported to prover and CDC.
  • Vaccines may be given in divided dose to prevent adverse effects
  • Encourage parent to provide comfort measures
  • Reassurance of safety of vaccines- provide written information
  • Immune sera is for specific exposure
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10
Q

Has there been any scientific study done that links vaccines to autism?

A

No - This should also be shared with parents.

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11
Q

What is an alternative vaccine schedule?

A

its and alternative schedule for parents who are worried about their children having so many vaccines at once. This has also been developed by the CDC.

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12
Q

What lifespan considerations should we take into account when giving Biologicals to adults?

A
  • Travel - typhoid, Hep. A
  • Yearly vaccines - Flu
  • Boosters - Tetanus
  • High risk groups - Age related ones such as shingles or pneumonia.
  • It the person is going to be involved in care of infant or immunosuppressed patients - Tdap
  • Immune sera for specific exposure
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13
Q

Is past pneumonia a reason to get pneumonia vaccines in young to middle aged adults?

A

No.
You would need to suffer from lung conditions such as asthma.

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14
Q

What lifespan considerations should we take into account when giving Biologicals to older adults?

A

Pneumonia - recommended.
* Yearly influenza
* Tetanus booster every 10 yrs
* Travel
* Immune sera for specific exposure : Increased risk for adverse effects, Monitor closely

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15
Q

Define Immunization.

A
  • The process of artificially stimulating active immunity
  • Exposes the body to weakened or less toxic proteins associated with specific disease-causing
    organisms
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16
Q

What is the goal of Immunization?

A

To cause an immune response without having the patient suffer the full course of a disease.

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17
Q

What are the names of the routine childhood vaccinations?

A
  • Diphtheria, pertussis, tetanus - Tdap
  • HEP B
  • Hepatitis B, hepatitis A
  • Chickenpox - Rubella
  • Poliovirus
  • Meningitis
  • Measles, mumps, and rubella (MMR)
  • Rotavirus
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18
Q

It the HVP vaccine recommended as a routine vaccine for children age 9 and up?

A

No, it is recommended in some states, however not all.

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19
Q

What indicates the use of vaccinations?

A
  • Stimulate active immunity in people who are at risk
  • The vaccines that are needed depends on the exposure the person will have to pathogens
  • Vaccines are thought to provide life-long immunity
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20
Q

What are some examples of vaccines that doesn’t provide life long immunity?

A

Tetanus - every 10 yrs
Flu - Every flu season.

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21
Q

What are some scenarios where the use of vaccinations are absolutely contraindicated?

A

In patients who have severe immunodeficiency live vaccines are contraindicated, because they can contract the disease the vaccine is for.
Severe or life-threatening allergic reaction to any component in the vaccine such as eggs.

22
Q

Why can an allergy to eggs contraindicate the use of vaccines in a person?

A

Eggs are an component in many vaccines.
It is important to ask our patients if they are allergic to eggs.

23
Q

What are examples of live vaccines?

A

MMR
Varicella - Chicken pox.

24
Q

What are some scenarios where the use of vaccinations are relatively contraindicated?

A
  • Presence of immune deficiency
  • Pregnancy - due to the risk of the fetus.
  • Mild/Moderate allergic reaction to any component of the vaccine
  • Patients receiving immune globulin or who have received blood or blood products within the
    last 3 months - a serious immune reaction can occur.
25
Q

Which vaccines ARE recommended during pregnancy?

A

Flu and Tdap (3rd trimester)

26
Q

What are some conditions in patients that would prompt caution with the use of vaccines?

A
  • febrile convulsions or cerebral injury
  • conditions in which high fever would be dangerous
  • acute infection

This is because an vaccine may cause an immune response.

27
Q

What are some known adverse reactions to vaccines?

A
  • fever, chills, malaise, fretfulness, irritability
  • anorexia, vomiting
  • Rash
  • Pain, Redness, Swelling at injection Site
28
Q

Is the nasal spray form of the influenza vaccine an example of an inactivated or live vaccine?

A

Live vaccine.

29
Q

Is it possible to contract the disease that you are being vaccinated against by simply getting the vaccine?

A

Yes and no.

For any of the inactivated vaccines it is impossible to contract the disease.

For immunosuppressed patients, there is a slim chance of contracting the disease with live vaccines such as the Flu nasal spray, the MMR and Chicken Pox.

30
Q

When patients are telling us that they do not want the flu vaccine because last time they got the flu from it, what should we tell them.

A

The flu shot (unless given via nasal spray) is an inactivated medication and it cannot cause the disease. The patient could absolutely have felt sick with fever and sore throat (whihc mimics the flu) but this would have been due to the side effects of getting the vaccination and not flue itself.

31
Q

Are there any DDI’s to vaccines. and if so, what are they?

A

Immunosuppressants
Patients taking these medications will not have the building of the immune system response that we are trying to achieve.

32
Q

Are patients who are taking immunosuppressants for life, such as transplant patients, encouraged to still get vaccinations?

A

Yes, most vaccines are safe and some are encouraged such as the COVID vaccine, however we do avoid live virus vaccination in these patients.

33
Q

What assessments should be done prior to giving a patient a vaccine?

A
  • History
    Allergy; pregnancy; recent administration of immune globulin or blood products; immune
    deficiency; acute infection
  • Physical
    Assess skin; check temperature; VS; LS; level of orientation and affect
    Evaluate range of motion of extremities to be used; assess tissue perfusion of the arm.
34
Q

What is the specific reason for assessing range of motion and perfusion to where we are going to inject the vaccine?

A

We need the injection site to be working well so that it can absorb the medication - it can cause soreness to the arm which makes patients not want to move their arm, however the less they move their arm the more it is going to hurt.

35
Q

What is one of the reasons children feels injection soreness for a shorter duration than adults?

A

We give the medication in the legs and they’re moving their legs a constantly which makes for better absorption and makes the pain go away quicker.

36
Q

Is it better to get the vaccination in your dominant or non-dominant arm?

A

The dominant arm, because this is the arm we move more which will make for better and quicker absorption and less pain in the long run.
An exception to this rule is if the patient has shoulder injury.

37
Q

What nursing diagnoses should we expect prior to giving a patient a vaccination?

A
  • Acute pain/Impaired comfort related to injection, gastrointestinal (GI), and flu-like effects
  • Ineffective/Altered tissue perfusion if severe reaction occurs such as an anaphylactic reaction.
  • Deficient knowledge regarding drug therapy
38
Q

What implementations should we be prepared to do after giving a patient a vaccination? (long answer)

A
  • Do not use to treat acute infection (it is preventative treatment)
  • Hold if patient exhibits signs of acute infection or immune deficiency
  • Hold if the patient has received blood, blood products, or immune globulin within the last 3 months
  • Proper preparation and administration of the vaccine; check on the timing and dose of each injection (series)
  • Maintain emergency equipment on standby, including epinephrine
  • Supportive care and comfort measures for flu- like symptoms and for injection discomfort
  • Do not administer aspirin to children for the treatment of discomforts associated with the immunization due to risk of Ryes syndrome in children,
  • patient teaching
  • Provide a written record of the immunization, including the need to return for booster immunizations and timing of the boosters, if necessary.
39
Q

Define Immune Sera.

A

Sera that contain antibodies to specific bacteria or viruses.

40
Q

What two types of immune sera are there?

A

Antitoxin and antivenom

  • Immune sera that have antibodies to specific toxins that might be released by invading
    pathogens, or to venom from spider or snake bites
41
Q

When do we hear about immune Sera specifically with COVID- 19?

A

Immune sera is where we take antibodies from a person who has had and recovered from COVID-19 to a person ho is currently suffering from COVID -19.
We call this Convalescent plasma.

42
Q

What it the action of Immune Sera?

A

Provide passive immunity to a specific antigen or disease

43
Q

When would we use Immune Sera?

A
  • Used as prophylaxis against specific disease after exposure
  • May be given to someone who has the disease to lessen the severity of a disease
  • can also be used as a preventative to a disease after someone has been exposed, an example is the MMR (people who have been exposed to measles)
44
Q

What is a relative contraindication to the use of Immune Sera?

A

History of severe reaction to any immune sera

45
Q

What are some pre- existing conditions that would prompt caution with the use of Immune Sera?

A
  • Pregnancy
  • Coagulation defects
  • Previous exposure to the immune sera.

There is an increased risk of hypersensitivity in patients who have coagulation defects or bleeding disorders and people who have been previously exposed to immune sera.

46
Q

What are some known adverse reactions to immune sera?

A
  • Rash, nausea, vomiting, chills, fever
  • Allergic reaction: chest tightness, decreased blood pressure, and difficulty breathing
  • Local reaction: swelling, tenderness, pain, and muscle stiffness at injection site
47
Q

Are there any DDI’s to Immune Sera. and if so, what are they?

A

Immunosuppressant drugs

48
Q

What should we be assessing for prior to giving a patient Immune Sera?

A
  • History : Allergy; pregnancy; previous exposure to the serum being used; thrombocytopenia or
    coagulation disorders due to increased bleeding and hypersensitivity reaction; immunization history
  • Physical : Inspect skin; temperature; VS; LS; level of orientation and affect
49
Q

What nursing diagnoses should be made and prepared for prior to giving a patient immune sera?

A
  • Acute pain/Impaired comfort related to local, GI, and flu-like effects
  • Ineffective/Altered tissue perfusion related to possible severe reactions
  • Deficient knowledge regarding drug therapy
50
Q

What implementations should we be prepared to do after giving a patient Immune sera?

A
  • Do not administer to any patient with a history of severe reaction to immune globulins or to the components of the drug being used
  • Administer as indicated
  • Monitor for severe reactions and have emergency equipment ready - epinephrine and breathing equipment.
  • Supportive care & comfort measures for flu- like symptoms & local reaction
  • patient teaching
  • Provide a written record of immune sera use, and encourage the patient/family to keep information
51
Q

When may vaccines be contraindicated?

A

Vaccines are contraindicated in patients who are receiving immune globulin or who have received blood or blood products within the last 3 months because a serious immune reaction could occur

Pharmacology Exam 3 (12 decks)

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