Module 6 Immunizations

Question 1

Purpose of immunizations

Answer 1

-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

Question 2

Active immunity

Answer 2

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

Question 3

Two types of active immunity

Answer 3

artificial active immunity and natural active immunity

Question 4

Artificial active immunity

Answer 4

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

Question 5

Natural active immunity

Answer 5

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

Question 6

Passive immunity

Answer 6

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

Question 7

Two types of passive immunity

Answer 7

natural passive immunity and artificial passive immunity

Question 8

Natural passive immunity

Answer 8

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

Question 9

Artificial passive immunity

Answer 9

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

Question 10

Contraindications for immunizations

Answer 10

-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

Question 11

Mild Adverse effects

Answer 11

redness, swelling, and tenderness at the injection site

Question 12

Moderate adverse effects

Answer 12

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

Question 13

Severe adverse effects

Answer 13

acute encephalopathy (rare)

Question 14

Inactivated influenza vaccine adverse effects

Answer 14

mild or local reaction, guillain barre syndrome (rare)

Question 15

Live, attenuated influenza vaccine (nasal spray) adverse effects

Answer 15

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

Question 16

Live, attenuated influenza vaccine (nasal spray) contraindications

Answer 16

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

Question 17

HPV2 and HPV4 adverse effects

Answer 17

rare but can cause guillain barre syndrome

Question 18

Nursing administration for infants and children:

Answer 18

• 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

Question 19

Nursing administration for adults

Answer 19

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

Question 20

Nursing administration for clients of all ages

Answer 20

• 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

Question 21

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

Answer 21

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

Question 22

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

Answer 22

administer one dose at 11 to 12 years

Question 23

Children immunizations: Tetanus and diphtheria (Td) booster:

Answer 23

administer one dose every 10 years following Tdap

Question 24

Children immunizations: Haemophilus influenzae type B (Hib):

Answer 24

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

Question 25

Children Vaccine: Rotavirus (RV) oral vaccine

Answer 25

-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.

Question 26

Children immunizations: Inactivated poliovirus vaccine (IPV):

Answer 26

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

Question 27

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

Answer 27

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

Question 28

Children immunizations: varicella vaccine

Answer 28

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

Question 29

Children immunizations: Pneumococcal conjugate vaccine (PCV13):

Answer 29

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

Question 30

Children immunizations: hepatitis A

Answer 30

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

Question 31

Children immunizations: hepatitis B***

Answer 31

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.

Question 32

Children immunizations: Seasonal influenza vaccine***

Answer 32

- 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

Question 33

Children immunizations: Meningococcal vaccine (MenACWY):

Answer 33

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

Question 34

Children immunizations: Human papillomavirus (HPV2 or HPV4):

Answer 34

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

Question 35

Adult Immunizations: Td/dap:

Answer 35

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

Question 36

Adult immunizations: MMR

Answer 36

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

Question 37

Adult immunizations: varicella vaccine

Answer 37

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

Question 38

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

Answer 38

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

Question 39

Adult immunizations: hepatitis A

Answer 39

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

Question 40

Adult immunizations: hepatitis B

Answer 40

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

Question 41

Adult immunizations: influenza vaccine***

Answer 41

- 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

Question 42

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

Answer 42

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.

Question 43

Adult immunizations: HPV2, HPV4:

Answer 43

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

Question 44

Adult immunizations: zoster vaccine***

Answer 44

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