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Flashcards in Module 6 Immunizations Deck (44)
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1

Purpose of immunizations

-Administration of a vaccine causes the immune system to produce antibodies (to prevent illness) that target a specific microbe. Vaccines are made from killed viruses or live, attenuated (weakened) viruses.
-Administer vaccines to produce antibodies and provide active immunity, may take months to take effect but confer long lasting protection against infectious diseases.
§ Eradication of infectious diseases (polio, small pox)
§ Prevention of childhood and adult infectious diseases (measles, diphtheria, mumps, rubella, tetanus, H. influenzae) and their complications

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Active immunity

Develops when the immune system produces antibodies in response to the entry of antigens into the body

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Two types of active immunity

artificial active immunity and natural active immunity

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Artificial active immunity

-Develops when a vaccine is administered and the body produces antibodies in response to exposure to a killed or attenuated virus

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Natural active immunity

Develops when an antigen enters the body naturally, w/o human assistance, stimulating the immune system to produce antibodies to the antigen

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Passive immunity

Is temporary, and develops when antibodies are created by another human or animal and then transferred to the client

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Two types of passive immunity

natural passive immunity and artificial passive immunity

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Natural passive immunity

Develops when antibodies are passed from a mother to her fetus through the placenta, and then to the newborn/infant via the colostrum and breast milk

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Artificial passive immunity

Develops after antibodies in the form of immune globulins are administered to an individual who requires immediate protection against a disease after exposure has occurred

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Contraindications for immunizations

-Anaphylactic reaction to a vaccine is a contraindication for further doses of that vaccine
-Anaphylactic reaction to any component of a vaccine is a contraindication to use of subsequent vaccines containing that substance (egg allergy)
-Do not administer live virus vaccines, such as varicella or MMR, to a client who is severely immunocompromised. Sever febrile illness is a contraindication to all immunizations
-Moderate or severe illnesses with or without fever
-The common cold and other minor illnesses are NOT a contraindication or precaution for receiving immunizations
Do not give live attenuated vaccines to those that are immuno suppressed, corticosteroids, tumors, cancer patients

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Mild Adverse effects

redness, swelling, and tenderness at the injection site

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Moderate adverse effects

fever (105 degrees F) or greater, inconsolable crying, seizures (with or without fever) with some patients, irritability, rash

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Severe adverse effects

acute encephalopathy (rare)

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Inactivated influenza vaccine adverse effects

mild or local reaction, guillain barre syndrome (rare)

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Live, attenuated influenza vaccine (nasal spray) adverse effects

fever, vomiting, diarrhea, myalgia, cough, nasal congestion, runny nose, guillain barre syndrome (rare)

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Live, attenuated influenza vaccine (nasal spray) contraindications

age less than 2 years old, 50 years old+, pregnancy, chronic disease, immuno compromised, egg allergy

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HPV2 and HPV4 adverse effects

rare but can cause guillain barre syndrome

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Nursing administration for infants and children:

-Obtain informed consent from the legal guardian prior to administration
-Administer IM immunizations in the vastus lateralis or ventrogluteal muscle in infants and young children, and in the deltoid muscle for older children and adolescents
-Provide praise afterward. With children use comfort measures like colorful bandaids
-Instruct parents to avoid administration of aspirin to children to treat fever or local reaciotn following administration of a live virus vaccine due to the risk of developing Reyes Syndrome. Use tylenol or acetaminophen

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Nursing administration for adults

Administer in the upper arm or IM immunizations into the deltoid muscle

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Nursing administration for clients of all ages

-Have emergency medications and equipment on standby in case the client experiences an allergic response such as anaphylaxis
-Document the administration of the vaccine, including the date, route, and site of immunization; type, manufacturer, lot number, and expiration date of the vaccine; evidence of informed consent form the legal guardian, and; name, address and title of the administering nurse

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Children vaccine: Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP):

administer doses at 2,4, 6, 15 to 18 months, and 4 to 6 years

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Children Vaccine: Tetanus and diphtheria toxoids and pertussis vaccine (Tdap):

administer one dose at 11 to 12 years

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Children immunizations: Tetanus and diphtheria (Td) booster:

administer one dose every 10 years following Tdap

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Children immunizations: Haemophilus influenzae type B (Hib):

administer doses at 2, 4, 6 (if a four-dose series), and 12 to 15 months

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Children Vaccine: Rotavirus (RV) oral vaccine

-Two formulations are available. The first dose of either form should bot be initiated for infants 15 weeks, o days or older.

-RV-5 vaccine should be administered as a 3 dose series at ages 2,4, and 6 months
-RV-1 vacine should be administered as 2 dose series at 2 and 4 months

Maximum age for the final dose of RV vaccine is 8 months, o days.

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Children immunizations: Inactivated poliovirus vaccine (IPV):

administer doses at 2,4, and 5 to 18 months, and 4 to 6 years

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Children immunizations: Measles, mumps, and rubella vaccine (MMR):

administer doses at 12 to 15 months and 4 to 6 years

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Children immunizations: varicella vaccine

administer one dose at 12 to 15 months and 4 to 6 years or two doses administered a minimum of 4 weeks apart if administered after age 13 years

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Children immunizations: Pneumococcal conjugate vaccine (PCV13):

administer doses at 2, 4, 6 and 12 to 15 months

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Children immunizations: hepatitis A

administer the first dose b/w 12 and 23 months. Administer the second dose 6 to 18 months after the first

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Children immunizations: hepatitis B***

administer within 12 hours after birth with additional doses at age 1-2 months and 6 to 18 months. The third dose should not be given prior to 24 weeks of age.

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Children immunizations: Seasonal influenza vaccine***

-Annually beginning at age 6 months, administer inactivated influenza vaccine (IIV) and around the time of october-december
-Starting at age 2 years the live, attenuated influenza vaccine (LAIV) nasal spray can be used.
-Children age 2 years to 4 years who have asthma or have had wheezing during the past year, or anyone who has taken an antiviral medication in the 48 hours prior to vaccine admin is contraindicated

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Children immunizations: Meningococcal vaccine (MenACWY):

administer first dose at age 11 to 12 years (earlier if specific risk factors are present). Administer a booster dose at age 16 years.

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Children immunizations: Human papillomavirus (HPV2 or HPV4):

administer three doses over a 6 month period for males and females 11 to 12 years of age (minimum age is 9 years). Administer males only HPV4 and females can get either HPV2 or HPV4. the second dose is administered 1-2 months after the first dose, and the third dose is administered 16 weeks after the second dose

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Adult Immunizations: Td/dap:

administer one dose of Tdap instead of Td, and then give Td booster every 10 years. Give one dose of Tdap to women who are pregnant (with each pregnancy) b/w 27 and 36 weeks gestation

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Adult immunizations: MMR

administer one or two doses to clients b/w the ages of 19 and 49 who lack doc. Of immunization or prior infection, or laboratory proof of immunity

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Adult immunizations: varicella vaccine

administer two doses to adults who do not have evidence of immunity. Administer a 2nd dose to adults who had only one previous dose and lack evidence of immunity. Pregnant women needing protection against varicella should wait until the postpartum period for immunization

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Adult immunizations: Pneumoccoal polysaccharide vaccine (PPSV23) and pneumococcal conjugate vaccine (PCV13):

administer to those that have certain chronic diseases, smoke cigarettes, or live in a long term care facility. For 65 years+

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Adult immunizations: hepatitis A

administer single-antigen vaccines as two doses spaced 6 to 12 months, or 6-18 months apart to high risk individuals

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Adult immunizations: hepatitis B

administer 3 doses to high risk individuals who lack completion of the series. There must be at least 1 month b/w doses one and two, and at least 2 months b/w doses two and three. A minimum of 4 months are required b/w doses one and three

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Adult immunizations: influenza vaccine***

-One dose annually is recommended for all adults
-Admin. b/w october-december
-LAIV is a nasal spray and is approved for individuals between ages 2 to 49 years who are healthy and not pregnant

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Adult immunizations: Meningococcal polysaccharide vaccine (MPSV4) and Meningococcal (MenACWY) vaccine:

administer a dose of MenACWY to students up to age 21 years entering college and living in the dormitories if a dose was not received on or after the 16th birthday.

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Adult immunizations: HPV2, HPV4:

three doses are recommended for females up to age 26 years who were not immunized as children.

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Adult immunizations: zoster vaccine***

a one-time dose is recommended for ALL ADULTS 60 years or older