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Pharmacology > EXAM 4: Immunization & Hematopoietic > Flashcards

EXAM 4: Immunization & Hematopoietic Flashcards

1
Q

Antigens are: 1) ________ on cell surgace 2) cell _________ 3) can stimulate an __________

A

1) proteins 2) identifier 3) immune response

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2
Q

Antibody: 1) produced by ___________ when exposed to an ___________ 2) able to ___________ and flag a specific ___________

A

1) B lymphocytes, antigen 2) recognize, antigen

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3
Q

Which vaccine is an inactivated microorganism

A

killed

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4
Q

Which vaccine is a weakened microorganism (ex: MMR)?

A

attenuated

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5
Q

Which vaccine is a weakened toxins (ex: etanus, diphtheria)?

A

toxoids

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6
Q

Which vaccine is for immature immune systems of yound infants (ex: Hib, meningoccal)?

A

conjugate

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7
Q

Which vaccine reproduced DNA antigen (ex: Hep B)?

A

recombinant subunit vaccines

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8
Q

What years are childhood vaccines performed?

A

younger than 7

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9
Q

What years are adolescent vaccines performed?

A

7-18 year of age

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10
Q

What years are adult vaccines performed?

A

19 and older

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11
Q

What are 4 special populations that might fall into a catch up schedules for vaccines or need additional vaccines?

A

1) pregnancy 2) military 3) travelers 4) chronically ill & elderly

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12
Q

What is cocooning?

A

immunizing adults in close contact with newborns & young babies

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13
Q

What is the season for flu vaccine?

A

fall to spring

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14
Q

How long does it take to build protection after getting the flu vaccine?

A

2 weeks

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15
Q

In the first two weeks after getting the flu vaccine - 1) is special protection needed? 2) is there a higher susceptability to other infections

A

1) No 2) Yes

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16
Q

What are expected side effects of the flu vaccine?

A

localized inflammation at site, fever, cough, malaise, aches, v/d

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17
Q

What is the indication for the IIV flu vaccine (inactivated/killed influenza)?

A

everyone older than 6 months (& pregnant)

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18
Q

What are three contraindications for the IIV flu vaccine?

A

1) less than 6 months 2) egg allergy 3) guillain-barre syndrome

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19
Q

What is the indication for LAIV flu vaccine (live attenuated influenze vaccine)? and route?

A

2-49 yrs healthy and nonpregnant / nasal spray

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20
Q

What are additional contraindications for LAIV in addition the ones for IIV?

A

pregnancy, with antiviral, with aspirin, asthma, immunocompromised, acute phase of disease like stuffy nose, other vaccines in last 4 wks. NURSING IMPLICATION specific: working with at risk populations

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21
Q

Since there are greater than 90 known serotypes of streptococcus pneumonia, therefor a previous infection ___________.

A

does not protect

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22
Q

What is indication for the pneumococcal polysaccharide vaccine (PPSV23)?

A

19 years and older IF immunocompromised, chronic disease, smokers, live in long term care AND 65 or older (but only dose if already given prior to 65 = booster after 65)

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23
Q

What is contraindication for the pneumococcal polysaccharide vaccine (PPSV23)?

A

children < 2 years, pregnancy

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24
Q

What is the indication for the pneumococcal conjugate vaccine (PCV13)?

A

same as PPSV23 except can be given to children under 2, but NOT under 6 months

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25
Q

Key things to remember when getting informed consent for vaccines:

A

provide info (side effect, risk, benefit), vaccine info statement approved by CDC, edu safety of vaccines, edu to keep immunization records

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26
Q

For children, consent is obtained from who for vaccines?

A

legal gaurdian

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27
Q

For children, ASSENT is obtained from?

A

child AFTER obtaining consent from legal gaurdian

28
Q

Nursing consideration, be prepared for s/s of adverse reactions and be prepaired for emergency anaphylactic reaction (ABC) - what are 5 drugs to be prepared with in these events?

A

1) epinephrine 2) diphenhydramine 3) glucocorticoids 4) acetaminophen 5) NSAID

29
Q

Who do you report adverse effects of vaccines to?

A

National DHHA

30
Q

Who do you report vaccine-preventable diseases to?

A

VDH (or the local dept.)

31
Q

If a patient is taking glucocorticoids and you know they have a weak immune system - what should you do if a vaccine is orderd?

A

hold and call the provider

32
Q

How long should you seperate live attenuated (like MMR) from other vaccines by?

A

4 weeks

33
Q

What are three instances where vaccines should be avoided?

A

1) immunosuppressants 2) blood tranfusions 3) intravenous immunoglobulin

34
Q

Should vaccines be mixed?

A

NO - use separate site and syringe (and keep in refrige till ready to admin)

35
Q

Safe IM vaccine site on infants and children?

A

vastus lateralis or ventrogluteal muscle

36
Q

When should you never administer an injection in a child?

A

child is asleep

37
Q

What are the three hematopoietic growth factors groups (blood producing)?

A

1) erythropoietic 2) leukopietic 3) thrombopoietic

38
Q

What is the erythropoietic drug that INCREASES RBC production?

A

epoietin alfa

39
Q

What is the leukopoietic drug (specific to neutrophils or generally WBC)?

A

filgrastim

40
Q

What is the thrombopoietic (platelets) drug?

A

oprelvekin

41
Q

Hgd is the ________ of Hgb in the whole blood (volume) g/dl

A

amount

42
Q

Hct is the ________ volume of ________ in the whole blood

A

percentage, RBC

43
Q

In the H&H, that is the adult man value for Hgb?

A

16 (+ or - 2)

44
Q

In the H&H, that is the adult man value for Hct?

A

47 (+ or - 6)

45
Q

In the H&H, that is the adult woman value for Hct?

A

13 (+ or - 2)

46
Q

In the H&H, that is the adult woman value for Hct?

A

40 (+ or - 6)

47
Q

In the H&H, that is the adult postmenopausal woman value for Hct?

A

14 (+ or - 2)

48
Q

In the H&H, that is the adult postmenopausal woman value for Hct?

A

42 (+ or - 6)

49
Q

What are the indications for erythropoietic (increasing RBC production) drug, epoetin alfa?

A

1) low RBC count secondary to CKD 2) replacement of blood cell after chemo and HIV drug 3) hasting of bone marrow function after bone marrow transplant

50
Q

What are three side effects for erythropoietic (increasing RBC production) drug, epoetin alfa?

A

1) HTN (monitor BP) 2) increase H&H (contact provider if Hgb is GREATER than 11 g/dl) 3) low iron and B12

51
Q

What are adverse effects for erythropoietic (increasing RBC production) drug, epoetin alfa?

A

seizure, thromboembolic event, DVT

52
Q

What are two main contraindications of erythropoietic (increasing RBC production) drug, epoetin alfa?

A

pregnancy, uncontrolled HTN

53
Q

Normal WBC count?

A

4,000 - 11,000 / mm^3

54
Q

Normal absolute neutrophil count?

A

1,500 to 8,000 / mm^3

55
Q

Neutropenia count?

A

absolute neutrophil LESS than 1000 = increased risk of infection (nursing: reverse isolation)

56
Q

What are the two indications for leukopoietic (increasing neutrophil production) drug, filgrastim?

A

1) neutropenia from antineoplastic drugs, HIV, neonatal neutropenia 2) increase WBC level prior to harvesting (autologous transplant)

57
Q

What are the two side effects for leukopoietic (increasing neutrophil production) drug, filgrastim?

A

1) bone/joint/muscle pain 3) leukocytosis asbolute neutrophil GREATER than 10,000 (monitor CBC)

58
Q

What is the main adverse effect for leukopoietic (increasing neutrophil production) drug, filgrastim?

A

splenomegaly,rupture (long term use) - REPORT nay abd/back/shoulder pain

59
Q

What is the contraindication for leukopoietic (increasing neutrophil production) drug, filgrastim?

A

pregnancy C

60
Q

Normal platelet count?

A

150K to 400K / unit L (measured in CBC)

61
Q

What is LOW platelet caused by things like CA, meds, chemo, kidney disease, ETOH abuse called?

A

thrombocytopenia

62
Q

The three main functions of platelets when aggregated: 1) primary ___________ 2) release hormone to produce ________ 3) release hormone to aggregate __________

A

1) platelet plug 2) vasoconstricton 3) other platelets

63
Q

What is the indication for thrombopoietic (increase platelet production) drug, oprelvekin?

A

chemotherapy-induced thrombocytopenia

64
Q

What are the adverse effects for thrombopoietic (increase platelet production) drug, oprelvekin?

A

fluid retention & HF (essentially, same thing), tachydysrhythmia, MI, conjunctival injection, papilledema

65
Q

What is the contraindication for thrombopoietic (increase platelet production) drug, oprelvekin?

A

pregnancy

Pharmacology (7 decks)

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