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2013-04-30 11:52:59
Pediatric Nursing

Diagnostic Tests, Medication Information, Immunizations, & Other Therapy for NURS 155 OB Exam #3
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  1. Live Virus Vaccines
    • Rubella
    • Flu Shots
    • Polio/Smallpox
    • MMR
    • Varicella (Chickenpox)
    • Varicella Zoster (Shingles)
    • Nursing Implications:
    • Live virus vaccines should not be given to immunocompromised/immunosuppressed patients (Prednisone), or Pregnant women
  2. Hepatitis B Vaccine
    • Class: Viral Vaccination
    • Action: Produces Active Immunity by inducing antibody production
    • Indications: To prevent infection & used simultaneously with Hep-B Immunoglobulin (HBIG) for post exposure prophylaxis
    • Adverse Reactions: Mild local tenderness at injection site, local inflammatory reaction (Several Other Side Effects)
    • Nursing Implications:
    • Pregnancy/Lactation Safety has not been established.
    • Use cautiously if patient has a compromised cardiopulmonary status, serious active infection, fever, thrombocytopenia/bleeding disorders
    • Administer in the deltoid muscle in adults, vastus lateralis in neonates.
    • Careful Aspiration should be used to assure that med avoids blood vessels
    • Shake vial well before administering
    • Monitor Temperature after administration (Some people develop a low grade fever that may last 1-2 days)
    • Epinephrine should be readily available to treat possible anaphylaxis
    • Store unopened vials at 36-46oF
    • Avoid freezing(Destroys potency)
  3. Rubella Vaccine
    • Live Virus Vaccine
    • Injected SubQ in the upper outer aspect of arm
    • Causes Active Immunity (Not communicable) through the formation of antibodies by the immune system
    • Mothers may lose their immunity during pregnancy (Additional shot may be required to prevent rubella in mother and future babies) 
    • Adverse Reactions: lymphadenopathy, rash, urticaria, fever, malaise, sore throat, H/A, dizziness, nausea, vomiting, arthralgia, arthritis
    • Contraindications: Immunocompromised individuals (Especially current respiratory or febrile infection) or individuals recieving immunosuppressive therapy such as Prednisone)
    • Pregnancy
    • Neomycin/Egg Allergies
    • Nursing Implications:
    • Travels through breast milk, but will not negatively effect the newborn (it will actually help them gain antibodies)
    • Avoid pregnancy for 3 months after vaccination (Fetus may be affected by the live virus vaccine)
    • Ask them if they are allergic to eggs or immunocompromised prior to administering
  4. Phytonadione (Vitamin K) Neonatal
    • Initial dose given within 1 hour of birth to develop clotting factor
    • Additional dose may be given if mother took anticonvulsives during pregnancy or if newborn shows bleeding tendencies
    • Action: Promotes clotting factors 2(Prothrombin), 7, 9, & 10 by the liver. Provides vitamin K which is not synthesized in newborns intestine until 5-8 days after birth
    • Indications: Prevention/Treatment of hemorrhagic disease of the newborn
    • Adverse Reactions: Pain/Edema at injection site. Hemolysis or hyperbilirubinemia (especially in preterm infants or when large doses are used)
    • Nursing Implications:
    • Don't give to infants with severe liver disease
    • Protect the drug from light until just before injection (Light makes it less potent)
    • Apply gentle pressure after injection
    • Assess newborn for vitamin K deficiency (Eccymoses or bleeding from any site)
    • Give IM in Vastus Lateralis of the newborn
  5. Herd Effect
    • Radicalization of communicable diseases due to a mass increase in Immunizations (Examples: Epiglottitis & Polio)
    • A Negative herd effect can take place if masses of people stop getting vaccinations due to rumors, ect. The disease may come back strong, with an increase in incidents.