Primary Prevention, Health Promotion and Immunization Flashcards Preview

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Flashcards in Primary Prevention, Health Promotion and Immunization Deck (54)
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1
Q

Primary prevention is defined as?

A

Primary prevention is aimed at preventing the health problem is the most cost-effective form of healthcare and includes immunizations, counseling about safety, injury and disease prevention.

2
Q

Secondary prevention is what?

A

Screening with a goal to detect disease early, asymptomatic, or preclinical state to minimize its impact, includes BP screenings, mammography and colonoscopy.

3
Q

Tertiary prevention is defined as?

A

Treatment that minimizes negative disease outcomes in established diseases. Examples include adjusting therapy to avoid further target organ damage.

4
Q

Counseling about the risk for sexually transmitted infection is an example of what level of prevention?

A

Primary

5
Q

Skin survey for cancerous lesions is an example of what level of prevention?

A

Secondary

6
Q

Ordering influenza vaccine for a 68-year-old with DM2 is an example of what level of prevention?

A

Primary

7
Q

Adjusting therapy to enhance glycemic control is an example of what level of prevention?

A

Tertiary

8
Q

Checking a fasting lipid profile is an example of what level of prevention?

A

Secondary

9
Q

Teaching the benefits of participating in a consistent program of moderate intensity physical activity is an example of what level of prevention?

A

Primary

10
Q

In a 76-year-old man with COPD ensuring adequate illumination at home is an example of what level of prevention?

A

Primary

11
Q

In a 76-year-old man with COPD screening for physical, emotional or financial abuse is an example of what level of prevention?

A

Secondary

12
Q

Before we had immunizations how many children were paralyzed annually with polio? how many died annually?

A

10,000 were paralyzed, 3,000 died annually

13
Q

Before we had immunizations how many newborns were born with congenital rubella syndrome, including developmental disability, blindness and hearing loss?

A

20,000

14
Q

Before we had immunizations how many children were infected with measles annually? how many died?

A

4 million children infected, 3,000 died

15
Q

What would be the worldwide death toll each year if the measles vaccine did not exist?

A

2.7 million measles-related deaths would be expected worldwide.

16
Q

How many deaths are prevented annually by vaccinating?

A

9,400 with most deaths occurring in children, elderly and pregnant women

17
Q

What is the estimated annual death toll related to pneumococcal disease (pne, septicemia, meningitis)?

A

40,000 of which 50% could be prevented with the pneumococcal vaccine.

18
Q

What do the new guidelines say in regards to pre- and post vaccines meds?

A

Don’t give NSAIDs or APAP pre or post vaccine

19
Q

When do you defer vaccines?

A

You defer for moderate to severe illness with or without fever only (think hospitalization)

20
Q

Active immunization via vaccination onset of protection usually occurs?

A

Within 1 month of vaccine dose

21
Q

What is active immunity?

A

Immunity developed in response to vaccine usually characterized by the presence of antibody in the host. Protection is on board in anticipation of possible exposure.

22
Q

What is passive immunity?

A

The immunity conferred via immunoglobulin, given post-exposure to select infecting agents.

23
Q

What is the IG duration of protection? What is IG available for?

A

6-9 months, Hep A, Hep B, tetanus, and rabies

24
Q

What is characteristic of tetanus?

A

Dirty and deep

25
Q
Joe is a 28-year-old man who presents with a 2-hour history of superficial laceration on the forearm that occurred when he was replacing a window pane and was cut by glass. P/E is consistent with history and record reveals TDAP vaccine given 2 years ago with documentation of primary tetanus series. When considering his immunization needs today, the NP appreciates that Joe should receive?
A. A TD booster
B. A TDap booster
C. A dose of TIG
D. No tetanus vaccine
A

D. No tetanus vaccine

26
Q

When do you use DTap?

A

Children under 7 years, use DT if pertussis is contraindicated.

27
Q

If a patient has a history of anaphylactic (not localized) reaction to Neomycin what vaccines are contraindicated?

A

IPV, MMR, Varicella

28
Q

If a patient has a history of anaphylactic (not localized) reaction to Streptomycin, polymyxin B and neomycin (different than Neomycin– WTH) what vaccines are contraindicated?

A

IPV, Vaccinia (smallpox)

29
Q

If a patient has a history of anaphylactic (not localized) reaction to Bakers yeast what vaccines are contraindicated?

A

Hepatitis B

30
Q

If a patient has a history of anaphylactic (not localized) reaction to Gelatin, neomycin what vaccines are contraindicated?

A

Varicella Zoster (Zostavax)

31
Q

If a patient has a history of anaphylactic (not localized) reaction to Gelatin what vaccine is contraindicated?

A

MMR

32
Q

What do you need to administer vaccines?

A

An EPI pen and a phone. All vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available.

33
Q

Define Anaphylaxis?

A

Acute life-threatening systemic reaction with varied mechanisms, clinical presentations, and severity that results from the sudden systemic release of mediators from mast cells and basophils.

34
Q

What is the most common presentation of anaphylaxis?

A

Uritcaria, angioedema, and respiratory compromise.

35
Q

What is a late sign of anaphylaxis?

A

BP or end-organ dysfunction ie collapse, syncope or incontinence

36
Q

Primary anaphylaxis procedure?

A

ABC, Supine on the floor, EMS, IM Epi, H1/H2 blocker, (IV, O2, monitor)

37
Q

What are the contraindications for EPI?

A

NO CONTRAINDICATIONS

38
Q

Prednisone- does IM or PO matter?

A

Does not matter, go oral if gut works.

39
Q

Anaphylaxis reason for admitting?

A

Can have delayed secondary response

40
Q

What do you send an anaphylactic patient home with? Referral?

A
Epi pen (with education), oral antihistamines and 5 days of systemic corticosteroids. 
Send to allergist
41
Q

True or False IG is made from pooled donated blood antibodies?

A

True

42
Q

T or F TDap should replace a single dose of Td for most adults who have not previously received a dose of Tdap in order to provide pertussis protection?

A

True

43
Q

T or F DM2 patients should be vaccinated ASAP for Hep B?

A

True

44
Q

Pneumococcal vaccine schedule fpor >65 years?

A

PCV13 followed by PCV23 one year later (PCV13 always is administered 1st in routine situations)

45
Q

Infant receives oral rotavirus vaccine- can immunocompromised Grandma change her diapers?

A

Yes, it does have viral shedding but its deemed harmless. Standard diaper hygiene and hand washing are advisable.

46
Q

When is Rotavirus contraindicated?

A

In cases of severe immunodeficiency. SCID

47
Q

Efficacy of Shingrix vs. Zostavax?

A

100% VS 50%

48
Q

Y or N– give Shingrix to 50-year-old starting Humira in 2 weeks?

A

Yes

49
Q

Y or N– give Shingrix to a 65-year-old man who received one dose of Zostavax 5 years ago?

A

Yes

50
Q

Y or N– give Shingrix to a 55-year-old man who had Shingles 3 months ago and all symptoms have resolved.

A

Yes

51
Q

When to receive the flu shot?

A

Age 6 months and older, the 1st year they get 2 vaccines 4 weeks apart.

52
Q

What surprising categories are considered high-risk groups for limited supply vaccines?

A

American indians, alaskan natives, BMI > 40

53
Q

T or F if you have experienced only hives after a flu shot should you get one?

A

True Hives following egg exposure is not a contraindication for the flu vaccine.

54
Q

Rotavirus minimum and maximum age?

A

1st dose at 6 weeks, max age for final dose is 8 months