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NURS 4540: Community Health > Week 8 > Flashcards

Week 8 Flashcards

1
Q

how is immunity developed?

A
  • as a response to protect the body from attacks by foreign antigens, typically proteins
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2
Q

what are different kinds of immunity? (4)

A
  • innate (natural/native)
  • acquired
  • resistance
  • herd immunity (community)
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3
Q

what is innate immunity? what type of response does it provide?

A
  • immunity present at birth
  • provides a nonspecific response
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4
Q

what is acquired immunity?

A
  • immunity protection gained after birth
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5
Q

what is active acquired immunity

A
  • develops after the introduction of a foreign antigen resulting in the formation of antibodies or sensitized T lymphocytes
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6
Q

what is artifical active acquired immunity

A
  • exposure due to immunization
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7
Q

what is passive acquired immunity

A
  • intro of preformed antibodies such as transfusion of antibodies
  • or passed from mother to fetus
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8
Q

what is resistance immunity

A
  • the ability to limit pathogen burden
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9
Q

what is herd immunity

A
  • the resistance of a group to invasion and spread of an infectious agent, based on high proportion of individual members of the group being resistant to infection
  • ie. if a sufficient proportion of a group is vaccinated, both vaccinated and unvaccinated are protected from the disease
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10
Q

for the guideline “immunization services should be readily available”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: decrease barriers (ex. opening hours)
  • acute care nurse: give vaccines at access points to care
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11
Q

for the guideline “vaccine providers should facilitate timely receipt of vaccine & eliminate unnecessary prepreqs to the receipt of vaccines”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: appointment only is a barrier
  • ACN: no written order should be necessary
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12
Q

for the guideline “vaccine providers should use all clinical opportunities to screen for needed vaccines and to administer all vaccine doses for which a vaccine recipient is eligible at the time of each visit”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: always go over vaccine status (ie. during home visits)
  • ACN: we should be allowed to check if someone is up to date on vaccination in clinical settings
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13
Q

for the guideline “vaccine providers should communicate current knowledge about immunization using an evidence based approach”, how is this relevant to CHN? to acute care nurse?

A
  • CHN & ACN: evidence informed communication
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14
Q

for the guideline “vaccine providers should inform vaccine recipients and parents in specific terms about the risks and benefits of vaccines that they or their children are to receive”, how is this relevant to CHN? to acute care nurse?

A
  • CHN and ACN: evidence informed communication
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15
Q

for the guideline “vaccine providers should ensure that all vaccinations are accurately and completed recorded”, how is this relevant to CHN? to acute care nurse?

A
  • CHN and ACN: record appropriately
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16
Q

for the guideline “vaccine providers should maintain easily retriveable summaries of immunization records to facilitate age-appropriate vaccination”, how is this relevant to CHN? to acute care nurse?

A
  • CHN and ACN: document
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17
Q

for the guideline “vaccine providers should report clinically significant adverse events following immunization promptly, accurately, and completely”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: report adverse events promptly, analyze, and evaluate
  • ACN: report adverse events promptly
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18
Q

for the guideline “vaccine providers should report all cases of vaccine preventable diseases as required under provincial or territorial legislation”, how is this relevant to CHN? to acute care nurse?

A
  • CHN : report all cases, keep an eye on epidemiological data, advocate for vaccination services
  • ACN: report
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19
Q

for the guideline “vaccine providers should adhere to appropriate procedures for the storage and handling of immunizing agents”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: keep eye on storage chain
  • ACN: check lot number, etc.
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20
Q

for the guideline “vaccine providers should maintain up to date, easily retrievable immunization protocols at all locations where vaccines are administered”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: create protocols, know where they are
  • ACN: know where protocols are
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21
Q

for the guideline “vaccine providers should be properly trained and maintain ongoing education regarding current immunization recommendations”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: train and keep up to date
  • ACN: train
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22
Q

for the guideline “immunization errors and immunization related incidents should be reported by vaccine providers to their local jurisdiction”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: report errors, analyze
  • ACN: report errors
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23
Q

for the guideline “vaccine providers should operate an immunization tracking system”, how is this relevant to CHN? to acute care nurse?

A
  • CHN: track
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24
Q

for the guideline “audits should be conducted in all immunization services to assess the quality of immunization records and the degree of immunization coverage “, how is this relevant to CHN? to acute care nurse?

A
  • CHN: audit
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25
Q

what is important to overcome vaccine hesitancy

A

-communication

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26
Q

vaccine hesitancy can be caused by… (5)

A
  • lack of understanding
  • conflicting info
  • mistrust of source of info
  • perceived risks of serious adverse events
  • lack of appreciation of the severity and incidence of the disease and sociocultural beliefs
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27
Q

how can communication help overcome vaccine hesitancy? (4)

A
  • adopt a vaccine recipient-centered approach
  • respect differences of opinion about immunization
  • represent the risk and benefits of vaccines fairly & openly
  • clearly communicate current knowledge using an evidence-based approach
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28
Q

what are general principles of vaccine interchangeability

A
  • when possible, use the same manufacturer of all doses in a series
  • vaccines are interchangable when authorized for the same indications, with similar schedule, same population, comparable type & quality, similar in terms of safety, reactogenicity, immunogenicity, and efficacy
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29
Q

should aspiration be done with immunizations?

A
  • contraindicated as it can be painful & there are no large blood vessels at the recommended immunization sites
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30
Q

how are vaccines handled/stored?

A
  • cold chain during transport, stroage, and handling (this is monitored)
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31
Q

age recommendations for vaccines are based on…

A
  • when the risk of the disease is the highest and for which vaccine safety & efficacy has been demonstrated
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32
Q

vaccine doses given before the recommended age may lead to…

A
  • less than optimal immune response
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33
Q

can more than one vaccine be given at the same time?

A
  • yes , especially when these vaccines are inactivated
  • with site rotation, live vaccines can be given together with other injection vaccines
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34
Q

if live vaccines are not given at the same time, live vaccines should be given at least __ weeks apart

A
  • 4 weeks apart
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35
Q

what has been found to interfere w effectiveness of parental live vaccines?

A
  • blood products
  • human immune globulin
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36
Q

vaccines should be adminstered ____ before admin of blood products & human immune globulin

A

14 days prior , but preferably months

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37
Q

who recommends vaccine schedules?

A
  • canada recommends but provinces and territories can determent the best schedule for their region
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38
Q

describe the prep of single dose vials

A
  • can be reconstituted or drawn up immediately before admin
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39
Q

describe the prep of multidose vials

A
  • can be reconstituted & marked with date & time
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40
Q

vaccines should be stored at what temps?

A

+2 to +8 degrees
- and based on manufacturer guidelines

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41
Q

when should vaccines be removed from fridge?

A
  • only when using
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42
Q

when are vaccines discarded?

A
  • discarded within a manufacturer set time frame
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43
Q

what does a missed appointment/interrupted vaccine doses mean?

A
  • in general, does not require restarting of the series
  • schedules can be delayed or accelerated and full immunization can still be achieved
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44
Q

what does CARD stand for?

A

Comfort
Ask
Relax
Distract

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45
Q

what is CARD?

A
  • an evidence based framework that teaches how to prepare for vaccination
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46
Q

what are the benefits of CARD (3)

A
  • reduces stress-related reactions (such as fear, pain, dizziness, and fainting during vaccination)
  • improves the vaccination experience for people receiving a vaccine and for those who support them (ex. parents, HCP, educators)
  • teaches lifelong coping skills that can be used for other stressful situations
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47
Q

what organism causes diphtheria?

A

cornebacterium diptheria

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48
Q

what is the mode of transmission for diphtheria

A
  • direct contact
  • indirect contact
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49
Q

what is the incubation period of diphtheria

A
  • 2-5 days
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50
Q

what is the communicability of diphtheria for both treated & untreated

A
  • untreated = 2 weeks to several months
  • treated = 2-4 weeks
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51
Q

what is the reservoir for diphtheria

A

human carriers

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52
Q

what is the clinical presentation of diphtheria (6)

A
  • greyish spots on tonsils
  • sore throat
  • enlarged lymph nodes
  • swelling & edema of neck
  • fever
  • difficulty breathing
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53
Q

when does immunization occur for diphtheria (6)

A
  • 2m
  • 3m
  • 6m
  • 18m
  • 4-6 yo
  • every 10 years
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54
Q

what are complications of diphtheria (4)

A
  • damage to heart muscles
  • breathing problems
  • paralysis
  • 1 in 10 die (5-10%) case fatality rate
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55
Q

what are control measures for diphtheria (3)

A
  • immunization
  • abx
  • isolation and disinfection of contact articles
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56
Q

what organism causes poliomyelitis?

A
  • poliovirus, types 1, 2, and 3
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57
Q

what is the mode of transmission for poliomyelitis (3)

A
  • fecal-oral contact
  • contaminated food or water
  • pharyngeal (during epidemics) (salivia)
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58
Q

what is the incubation period of poliomyelitis

A

3-21 days

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59
Q

what is the communicability for poliomyelitis

A
  • 7-10 days after onset of symptoms –> up to 6 weeks or longer
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60
Q

what is the reservoir for poliomyelitis

A
  • human carriers
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61
Q

what is the clinical presentation of poliomyelitis (7)

A
  • fever
  • sore throat
  • drowsiness
  • headache
  • NV
  • stiffness of neck & back, with or without flaccid paralysis
  • muscle aches
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62
Q

what % of people are asymptomatic with poliomyelitis? minor illness for few days? viral mengingitis? flaccid paralysis?

A
  • 90% asymptomatic
  • 4-8% minor illness for few days
  • 1-5% viral meningitis
  • 1% flaccid paralysis
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63
Q

what are complications of poliomyelitis (3)

A
  • paralysis
  • death
  • post-polio syndrome
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64
Q

what are control measures for poliomyelitis (2)

A
  • vaccination
  • isolation & disinfection of contact articles
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65
Q

what is the global goal for poliomyelitis

A
  • eradication of polio
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66
Q

where is poliomyelitis eradicted?

A
  • in western hemisphere in 1994, but not worldwide
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67
Q

what factors contributed to the re-emergence of polio in newyork

A
  • pandemic related declines in childhood vaccinations (missed appts, delayed appts)
  • vaccine hesitancy and misinformation (reinforced thru pandemic, strong anti-vaccine sentiment)
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68
Q

what are the 2 types of polio vaccine

A
  • inactivated (injectable)
  • oral polio vaccine (oral drops)
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69
Q

the inactivated polio vaccine is the vaccine of choice for…. and protects against…

A
  • choice for routine immunization in polio-free countries
  • protects against three strains of polio (1,2, and 3)
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70
Q

describe the production of antibodies with the inactivated polio vaccine

A
  • produced in blood stream
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71
Q

describe the protection offerred by the inactivated polio vaccine

A
  • does not fully block polioviruses from infecting the gut = people inoculated with IPV can still transmit polio
  • protects the individual but not the community
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72
Q

what is the main tool in the global eradication of polio

A
  • oral polio vaccine
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73
Q

what kind of vaccine is the oral polio vaccine

A
  • live but weakened strains of polio (1,2,3)
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74
Q

describe how the oral polio vaccine works

A
  • vaccine virus replicated and stimulates immunity in both gut & blood
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75
Q

the oral polio vaccine protects…

A
  • the individual and community
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76
Q

what is one con with the oral polio vaccine

A
  • cases of vaccine derived polio emerged in developing world (type 2)
  • in 2016, bOPV (only strain 1 and 3) introduced… not well coordinated consequently, vaccine derived polio surged (type 2)
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77
Q

describe the “polio perfect storm” in new york (3)

A
  • rockland county immunization rates = 60%
  • IPV given = may allow greater transmission of virus
  • vaccine derived poliovirus exposure to unvaccinated individual
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78
Q

describe the new york response to polio (4)

A
  • one case signals many infections = declared “state of emergency”
  • vaccination efforts in affected communities
  • enhanced surveillance (waste water, reporting all vaccines given)
  • US added to list of countries w circulating vaccine derived poliovirus
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79
Q

what organism causes pertusis

A
  • bacteria bordetella pertussis
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80
Q

what is the mode of transmission of pertussis

A
  • direct contact w resp secretions
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81
Q

what is the incubation period of pertussis

A
  • 6-20 days, usually 7-10 days
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82
Q

what is the communicability of pertussis

A
  • to 3 weeks after onset of paroxysmal cough, if not treated
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83
Q

what is the reservoir of pertussis

A
  • humans
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84
Q

what is the clinical presentation of pertussis (4)

A
  • begins with low grade fever
  • runny nose
  • mild cough (7-10 days)
  • progresses to violent coughing & whooping which lasts up to 10 weeks
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85
Q

what are complications of pertussis (5)

A
  • apnea
  • seizures
  • pneumonia
  • 1-3 deaths in Canada yearly
  • 1/400 deaths in infancy
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86
Q

when does immunization of pertussis occur (5)

A
  • 2m
  • 4m
  • 6m
  • 18m
  • 14-16y
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87
Q

what are control measures of pertussis (3)

A
  • immunization
  • exclusion 5 days after treatment with antibiotics
  • treatment of close contacts
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88
Q

what organism causes tetanus

A
  • bacteria clostridium tetani
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89
Q

what is the mode of transmission of tetanus

A
  • bacterial spores thru contaminated puncture wounds, burns, cuts
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90
Q

what is the incubation period of tetanus

A
  • 3-21 days, average 10
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91
Q

what is the communicability of tetanus

A
  • not transmitted person to person
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92
Q

what is the reservoir of tetanus

A
  • soil or fornites contaminated with soil/feces
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93
Q

the clinical presentation of tetanus (3)

A
  • muscle rigidity & spasm
  • lockjaw
  • respiratory and largyngeal spasm
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94
Q

what are complications of tetanus (1)? what is case fatality?

A
  • bone fractures
  • case fatality ranges from 10-90%
95
Q

what are control measures of tetanus (3)

A
  • immunization
  • TIG (immunoglob)
  • wound care
96
Q

what organism causes haemophilus influenze

A
  • bacteria –> H. influenza type B (hib), several types
97
Q

is the mode of transmission of haemophilus influenze (3)

A
  • droplet infection
  • sneezing
  • coughing
98
Q

what is the incubation period of haemophilus influenze

99
Q

what is the communicability of haemophilus influenze

A

1 week prior to illness & until treated

100
Q

what is the reservoir of haemophilus influenze

101
Q

what is the clinical presentations of haemophilus influenze (8)

A
  • sudden onset
  • fever
  • vomitting
  • lethargy
  • meningeal irritation
  • otitis media
  • sinusitis
  • pneumonia
102
Q

when does immunization of haemophilus occur (4)

A
  • 2m
  • 4m
  • 6m
  • between 12-23 months
103
Q

what are complications of haemophilus influenze (3)

A
  • neurological sequelae (10-15%0
  • deafness (15-20%)
  • case fatality rate (5%)
104
Q

what are control measures for haemophilus influenze (2)

A
  • immunization
  • antibiotic prophylaxis
105
Q

what organism casues meningococcal (type c)

A
  • bacteria –> neisseria meningtides
106
Q

what is the mode of transmission of meningococcal (type c) (2)

A
  • direct contact w resp droplets
  • 25% carriers
107
Q

what is the incubation period of meningococcal (type c)

108
Q

what is the communicability period of meningococcal (type c)

A

7 days prior to symptoms, until 24 hours of effective therapy

109
Q

what is the reservoir for meningococcal (type c)

110
Q

what are clinical presentations of meningococcal (type c) (5)

A
  • sudden onset
  • fever
  • vomitting
  • stiff neck
  • rash
111
Q

what are complications of meningococcal (type c) (3)

A
  • hearing loss
  • amputations
  • death (case fatality rate 15%)
112
Q

what are control measures for meningococcal (type c) (2)

A
  • immunization
  • abx prophylaxis
113
Q

what organism causes MMR (mumps)

A
  • mumps virus
114
Q

what is the mode of transmission of MMR (mumps) (2)

A
  • droplet
  • direct contact w salivia
115
Q

what is the incubation period of MMR (mumps)

A

14-25 days

116
Q

what is the communicability of MMR (mumps)

A
  • 2 days before onset of symptoms up to 4 days after
117
Q

what are symptoms of MMR (mumps) (4)

A
  • swelling of salivary glands (usually parotid)
  • fever
  • aches
  • sometimes aymptomactic in children
118
Q

when does immunization of mumps occur

119
Q

what are complications of MMR (mumps) (5)

A
  • encephalitis (1-2/10000 cases)
  • sterility rare
  • orchitis (20-30% of postpubertal males)
  • deafness
  • fatality (1/10,000)
120
Q

what are mumps cases in canada/year

A

1950s = 34,000

2004 = 32

121
Q

what organism causes measles

A
  • morbillivirus (measles virus)
122
Q

what is the mode of transmission of measles (2)

A
  • airborne by droplet spread
  • direct contact with infected nasal or throat secretions
123
Q

what is the incubation period of measles

124
Q

what is the communicability of measles

A
  • 1/2 day before onset of symptoms to 4 days after appearance of rash
125
Q

what is the clinical presentation of measles (4)

A
  • fever
  • conjuctivitis
  • cough
  • rash beginning on face –> body
126
Q

what are complications of measles (3)

A
  • otitis media
  • pneumonia
  • encephalitis (1:1000 cases)
127
Q

who are complications more common in with measles

A
  • infants & adults
128
Q

what is the case fatality rate of measles

A

2-3/1000 cases
- can be up to 30% in developing countries

129
Q

what are nursing considerations for measles (3)

A
  • immunization
  • symptom relief
  • isolation
130
Q

what organism causes rubella

A

rubella virus

131
Q

what is the mode of transmission of rubella (2)

A
  • direct droplet
  • congenital via placenta
132
Q

what is the incubation period of rubella

A

14-21 days

133
Q

what is the communicability of rubella

A
  • 7 days before to 4 days after onset of rash
134
Q

what are control measures for rubella (2)

A
  • avoid contact with pregnant women
  • exclude from school
135
Q

what is the clinical presentation of rubella (5)

A
  • fever
  • rash
  • joint pain
  • lymphadenopathy
  • conjuctivitis
136
Q

when does immunization of rubella occur (5)

A
  • 12m
  • 18m
  • childcare workers
  • healthcare workers
  • travellers
137
Q

what are complications of rubella (10)

A
  • congenital rubella syndrome
  • cataracts, glaucoma, blindness, deafness
  • malformations
  • cardiac problems
  • diabetes
  • hypothyroidism
  • hepatitis
  • chronic pneumonia
  • CNS defects
  • encephalitis
138
Q

what were rubella cases in canada/year from:
- 1971-1982
- 1998-2004

A
  • 1971-1982 = 5300
  • 1998-2004 = 30
139
Q

most rubella cases now occur amongst which populations?

A
  • those who refuse immunization
140
Q

there have been no CRS cases since…

141
Q

what organism causes varicella (chicken pox)

A
  • varicella zoster virus
142
Q

what is the mode of transmission of varicella (chicken pox) (3)

A
  • direct contact
  • airborne
  • household transmission amongst susceptible contact high
143
Q

what is the incubation period of varicella (chicken pox)

A

10-21 days

144
Q

what is the communicability of varicella (chicken pox)

A

2-5 days before onset of rash and until skin lesions have crusted

145
Q

what is the clinical presentation of varicella (chicken pox) (4)

A
  • slight fever
  • maculopapular rash in trunk, face, scalp, mucous membrane of mouth
  • then change to vesicular for 3-4 days
  • lesions occur in successive crops
146
Q

what are complications of varicella (chicken pox) (4)

A
  • viral or bacterial pneumonia
  • hemorrhagic complications
  • encephalitis
  • congenital varicella syndrome
147
Q

who are at the greatest risk of complications from varicella (chicken pox)

A
  • children with acute leukemia
148
Q

what are control measures for varicella (chicken pox) (3)

A
  • exclude from childcare, work, etc.
  • avoid contact with immunosuppressed persons
  • immunoglobulin for close contacts
149
Q

what type of vaccine is the varicella (chicken pox) vaccine

A
  • live vaccine
150
Q

what can be checked for exposure to varicella (chicken pox)

151
Q

what organism causes rotavirus

A
  • viruses… several serotypes
152
Q

rotavirus makes up _____% of all childhood GI illness

153
Q

what is the mode of transmission of rotavirus

A

fecal oral

154
Q

what is the incubation period of rotavirus

A

18hrs - 3 days

155
Q

what is the communicability of rotavirus

A
  • viral shedding few days before onset of illness & up to 21 days after onset of symptoms
156
Q

what is the reservoir of rotavirus

157
Q

what is the clinical presentation of rotavirus (3)

A
  • acute onset fever
  • vomitting
  • followed by 5-7 days diarrhea
158
Q

what % of people see a physician, visit an ER, and are hospitalized with rotavirus

A
  • 36% of cases see a physician
  • 15% ER visit
  • 7% hospitalized
159
Q

what are control measures of rotavirus (3)

A
  • immunization (syrup)
  • routine practices
  • antivirals
160
Q

the rotavirus is only given to under…

161
Q

what causes pneumococcal pneumonia

A
  • bacteria –> streptococcus pneumonia
162
Q

what is the mode of transmission of pneumococcal pneumonia (3)

A
  • droplet spread
  • direct oral contact
  • indirect contact w contaminated articles
163
Q

what is the incubation period of pneumococcal pneumonia

164
Q

what is the communability of pneumococcal pneumonia

165
Q

what are symptoms of pneumococcal pneumonia (5)

A
  • sudden onset
  • fever
  • chest pain
  • dyspnea
  • productive cough
166
Q

what are complications of pneumococcal pneumonia (3)

A
  • pneumonia bacteremia
  • meningitis
  • death occurs in infants & elderly
167
Q

what are control measures for pneumococcal pneumonia

A
  • immunization
168
Q

what organism causes hep B

A
  • hepatitis B virus (HBV)
169
Q

what is the mode of transmission of hep B (6)

A
  • sexual
  • perinatal
  • percutaneous via blood
  • serum fluids
  • vaginal fluids
  • carriers
170
Q

what is the incubation period of hep B

A

45-180 days, usually 60-90 days

171
Q

what is the communicability of hep B

A
  • many weeks before onset of symptoms
  • may persist for life
172
Q

what is the reservoir for hep B

173
Q

what is the clinical presentation of hep B in adults (4)

A
  • nausea
  • vomitting
  • rash
  • jaundice
174
Q

what is the clinical presentation of hep B in children

A
  • asymptomatic
175
Q

what are complications of hep B (4)

A
  • chronic hepatits
  • cirrhosis
  • liver failure
  • liver cancer
176
Q

what are control measures for hep B (3)

A
  • immunization
  • HGIB to contacts
  • routine precautions to prevent blood & blood products
177
Q

what organism causes human papillomavirus (HPV)

A
  • human papillomavirus (16 & 18) (>130 types exist)
178
Q

human papillomavirus (HPV) is one of the most common…

A
  • STIs (70%)
179
Q

what is the mode of transmission of human papillomavirus (HPV) (2)

A
  • vaginal, oral, and/or anal intercourse
  • skin to skin transmission
180
Q

what is the incubation of human papillomavirus (HPV)

A

1-8 months

181
Q

what is the communicability of human papillomavirus (HPV)

A
  • active lesions
  • clears with 1-2 years of infection
182
Q

what is the reservoir for human papillomavirus (HPV)

183
Q

what is the clinical presentation of human papillomavirus (HPV) (2)

A
  • painless, warty growths on genital skin or mucous membrane
  • may have no symptoms
184
Q

what are complications of human papillomavirus (HPV)

A
  • cervical cancer (20 year window)
185
Q

what are control measxures of human papillomavirus (HPV)

A
  • immunization
  • screening for cervical cancer (pap smear)
186
Q

who is eligible for the seasonal influenza vaccine

A
  • everyone older than 6 months
187
Q

high dose flu vaccine is given to..

A
  • anyone over 65
188
Q

what is the reservoir for influenza

189
Q

what organism causes influenza

A
  • influenza A, B, or C virus
190
Q

what is the mode of transmission of influenza

A
  • direct contact with resp secretions or contaminated articles
191
Q

what is the incubation period of influenza

192
Q

what is the communicability of influenza for adults vs children

A
  • 24 hrs before onset of symptoms to 5 days (adults)
  • up to 7 days children
193
Q

what is the clinical presentation of influenza (6)

A
  • sudden onset
  • fever
  • chills
  • headache
  • malaise
  • cough
194
Q

what is the recovery period for influenza

A
  • 10-14 days
195
Q

what are complications of influenza (4)

A
  • pneumonia
  • bronchitis
  • worsening of pre-existing chronic illness
  • death
196
Q

what are control measures for influenza (3)

A
  • immunization
  • routine practices
  • antivirals
197
Q

with monkeypox, WHO declared…

A
  • public health emergency of international concern (July 2022)
198
Q

what organism causes monkeypox

A
  • viral zoonotic infection (orthopoxvirus)
199
Q

what is the reservoir for monkeypox

A
  • rodents (dormice, striped mice Gambian rats, African rope squirrels)
200
Q

how does the orthopoxvirus (monkeypox virus) enter the body?

A
  • thru the skin, resp tract, or mucous membranes
201
Q

describe transmission of monkeypox (3)

A
  • animal to human
  • person to person
  • formites
202
Q

what is the incubation period of monkeypox

A

5-21 days (average 6-13 days)

203
Q

what is the period of communicability of monkeypox

A
  • 5 days prior to rash until all lesion scabs have fallen off & intact skin is underneath (3-4 weeks)
204
Q

what are the 2 phases of monkeypox

A
  • invasion (prodromal)
  • skin eruption
205
Q

describe the invasion (prodormal) phase of monkeypox (9)

A
  • fever
  • chills
  • lymphadenopathy
  • headache
  • mylagia
  • arthralgia
  • back pain
  • weakness
  • fatigue
206
Q

how long does the invasion phase of monkeypox last

207
Q

when does the skin eruption phase of monkeypox occur

A

1-3 days after onset of fever & lasts 2-4 weeks

208
Q

describe the skin eruption phase of monkeypox

A
  • face or extremities, hands, feet, mouth, genital, and perianal area
  • rash –> macules to papules to vesicles to pustules… scab over
209
Q

describe the diagnosis of monkeypox

A
  • swab skin lesions (presence of MPX virus DNA by PCR or isolation of MPX virus)
210
Q

what is the role of the PHN r/t monkey pox (4)

A
  • mngmt of case
  • mngmt of contacts
  • pre-exposure protocol vaccination (PrEP)
  • post exposure protocol (PEP)
211
Q

describe the PHN mngmt of case r/t monkeypox (3)

A
  • isolation while awaiting diagnosis
  • isolation precautions during period of communicability (3-4 weeks)
  • active monitoring by public health thru isolation period
212
Q

describe the PHN’s mngmt of contacts r/t monkeypox (4)

A
  • self isolation not required if asymptomatic
  • monitor for 21 days
  • consult w occupational health if work in high-risk setting
  • PEP with Imvamune vaccine
213
Q

describe the PrEP vaccination r/t monkeypox

A
  • 2 doses imvamune 28 days apart
214
Q

what is the eligibility for PrEP

A
  • cisgender, transgender, or two-spirit people who self identify as part of the gbMSM community & meet one of the following criteria:
    —> dx of STI in past year
    —> 2 or more sexual partners in last 90 days
    —> attended locations for sexual contact
    —> anonymous sex in past 90 days
  • any sexual contacts of individuals described above
  • individuals who self-identify as sex workers
  • staff/volunteers in sex-on-premises venues where workers may have contact with objects/material that may be contaminated with MPX virus without PPE
215
Q

describe PEP for monkeypox

A
  • close contacts of confirmed/probably case
216
Q

what are challenges r/t monkeypox (4)

A
  • pandemic fatigue
  • lack of knowledge
  • vaccine supply
  • communication strategy
217
Q

describe the history of monkeypox vs polio

A
  • monkeypox = little/no history
  • polio = history of disease
218
Q

describe the vaccines for monkeypox vs polio

A
  • monkeypox = gbMSM population, limited vaccine
  • polio = unvaccinated populations, vaccine supply ++
219
Q

describe community engagement for monkeypox vs polio

A
  • monkey pox = reduce stigma and misinfo, global coordination & collab
  • polio = address misinformation, global coordination & collab
220
Q

what organism causes hep A

A
  • hep a virus
221
Q

what is the mode of transmission of hep A

A
  • contaminated food, water (fecal-oral)
222
Q

what is the incubation period of hep A

A
  • 14-28 days
223
Q

what are indicators of hep A

A
  • acute hepatitis
224
Q

what are nursing considerations for hep A (4)

A
  • vaccination (travel)
  • bed rest
  • avoiding hepato toxins
  • nutrition
225
Q

describe vaccine document administration (3)

A
  • the personal immunization record held by the vaccine recipient, or his or her parent/guardian
  • the record maintained by the HCP who administered the vaccine
  • the local provincial or territorial immunization registry (if one has been restablished)
226
Q

pre vaccine/admin checklist

A

https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-12-immunization-records.html#p1c11a3

227
Q

when is the diphtheria, tetanus, pertussis, polio, haemophilus influenza type b (DTaP-IPV-Hib) vaccine given

A
  • 2m
  • 4m
  • 6m
  • 18m
228
Q

when is the pneumococcal conjugate 13 valent vaccine given

229
Q

when is the rotavirus vaccine given

230
Q

when is the measles, mupms, rubella, varicells (MMRV) vaccine given

231
Q

when is the meningococcal C conjugate vaccine given

232
Q

when is the Tetanus, Diphtheria, Pertussis, Polio (Tdap-IPV) vaccine given

233
Q

when is the flu vaccine given

A
  • all Manitobans 6 months of age and older are eligible each year

NURS 4540: Community Health (12 decks)

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