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Flashcards in Module 6 Immunizations Deck (44)
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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


Active immunity

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


Two types of active immunity

artificial active immunity and natural active immunity


Artificial active immunity

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


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


Passive immunity

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


Two types of passive immunity

natural passive immunity and artificial passive immunity


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


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


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


Mild Adverse effects

redness, swelling, and tenderness at the injection site


Moderate adverse effects

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


Severe adverse effects

acute encephalopathy (rare)


Inactivated influenza vaccine adverse effects

mild or local reaction, guillain barre syndrome (rare)


Live, attenuated influenza vaccine (nasal spray) adverse effects

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


Live, attenuated influenza vaccine (nasal spray) contraindications

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


HPV2 and HPV4 adverse effects

rare but can cause guillain barre syndrome


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


Nursing administration for adults

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


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


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


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

administer one dose at 11 to 12 years


Children immunizations: Tetanus and diphtheria (Td) booster:

administer one dose every 10 years following Tdap


Children immunizations: Haemophilus influenzae type B (Hib):

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


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.


Children immunizations: Inactivated poliovirus vaccine (IPV):

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


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

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


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


Children immunizations: Pneumococcal conjugate vaccine (PCV13):

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


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


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.


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


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.


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


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


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


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


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+


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


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


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


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.


Adult immunizations: HPV2, HPV4:

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


Adult immunizations: zoster vaccine***

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