Vaccines & Sera

Question 1

Use of Biologicals across the lifespan of children

Answer 1

• Parents should have a copy of immunization record
• All adverse effects should be reported
• 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 for specific exposure

Question 2

Use of Biologicals across the lifespan of adults

Answer 2

• Travel (typhoid or hepatitis A)
• Yearly vaccines
• Boosters (tetanus - every 10 yrs)
• High risk groups
• Immune sera for specific exposure

Question 3

Use of Biologicals across the lifespan of older adults

Answer 3

• Pneumonia
• Yearly influenza
• Tetanus booster
• Travel
• Immune sera for specific exposure
- Increased risk for adverse effects
- Monitor closely

Question 4

What are the indications for vaccines?

Answer 4

• 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

Question 5

What are the contraindications of vaccines?

Answer 5

*Absolute Contraindication
• Severe or life-threatening allergic reaction to any component in the vaccine

*Relative Contraindications
• Presence of immune deficiency (they can contract the disease the vaccine is for)
• Pregnancy (TDAP and influenza vaccine is recommended during pregnancy)
• Mild/Moderate allergic reaction to any component of the vaccine (eggs)
• Patients receiving immune globulin or who have received blood or blood products within the
last 3 months

Question 6

What are the cautions of vaccines?

Answer 6

*Caution with history of:
• febrile convulsions or cerebral injury
• conditions in which high fever would be dangerous
• acute infection (vaccines can case an immune response)

Question 7

What are adverse effects of vaccines?

Answer 7

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

any vaccine that has been INJECTED is inactivated and CANNOT give you the illness

Question 8

What are the drug-drug interactions of vaccines?

Answer 8

Immunosuppressants
pts on lifelong immunosuppressants (transplant pts) are safe to get vaccines
^avoid live virus or pathogen vaccines

Question 9

Vaccines: The Nursing process
Assessment:

Answer 9

-Hx: allergy, pregnancy, recent administration of immune globulin or blood products; immune
deficiency; acute infection
-Phys: assess skin, check temperature, VS, lung sounds, level of orientation and affect
-Evaluate ROM of extremity to be used- assess tissue perfusion

Question 10

Vaccines: The Nursing process
Nursing Diagnoses:

Answer 10

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

Question 11

Vaccines: The Nursing process
Implementation:

Answer 11

• Do not use to treat acute infection
• Do not administer if the patient exhibits signs of acute infection or immune deficiency
• Do not administer if the patient has received blood, blood products, or immune globulin within the last 3 months
• Arrange for proper preparation and administration of the vaccine; check on the timing and dose of each injection
• Maintain emergency equipment on standby, including epinephrine
• Arrange for 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
• Provide thorough patient teaching
• Provide a written record of the immunization, including the need to return for booster immunizations and timing of the boosters, if necessary

Question 12

Vaccines: The Nursing process
Evaluation:

Answer 12

• Monitor patient response to the drug (prevention of disease, appropriate antibody titer levels)
• Monitor for adverse effects (flu-like symptoms; GI upset; local pain, swelling, nodule formation at the injection site)
• Evaluate the effectiveness of the teaching plan
• Monitor the effectiveness of comfort measures and adherence to the regimen

Question 13

What is Immune Sera?

Answer 13

Sera that contain antibodies to specific bacteria or viruses

Question 14

What are the types of immune sera?

Answer 14

Types
• 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

Question 15

What is the action of immune sera?

Answer 15

• Action- Provide passive immunity to a specific antigen or disease

Question 16

What is the indication for immune sera?

Answer 16

• Used as prophylaxis against specific disease after exposure
• May lessen the severity of a disease

Question 17

What are the contraindications and cautions of immune sera?

Answer 17

-History of severe reaction to any immune sera
• Pregnancy
• Coagulation defects
• Previous exposure to the immune sera

Question 18

What are the adverse effects of immune sera?

Answer 18

• 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

Question 19

What are the drug-drug interactions of immune sera?

Answer 19

Drug-drug interactions: Immunosuppressant drugs

Question 20

Drug-drug interactions: Immune Sera
Assessment:

Answer 20

-Hx: allergy, pregnancy, previous exposure to the serum being used; thrombocytopenia or coagulation disorders (increases risk for bleeding and hypersensitivity); immunization history
-Phys: inspect skin; temperature; VS; LS; level of orientation and affect

Question 21

Drug-drug interactions: Immune Sera
Nursing Diagnoses:

Answer 21

• 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

Question 22

Drug-drug interactions: Immune Sera
Implementation:

Answer 22

• 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 the drug as indicated
• Monitor for severe reactions and have emergency equipment ready (epinephrine)
• Arrange for supportive care and comfort measures for flu-like symptoms and for the local reaction
• Provide thorough patient teaching
• Provide a written record of immune sera use, and encourage the patient or family to keep that information

Question 23

Drug-drug interactions: Immune Sera
Evaluation:

Answer 23

• Evaluate the patient’s response to the drug (improvement in disease signs and symptoms, prevention of severe disease)
• Evaluate for adverse effects (flu-like symptoms, GI upset, local inflammation, and pain)
• Evaluate the effectiveness of the teaching plan
• Evaluate the effectiveness of comfort measures and compliance with the regimen