Immunizations/Communicable diseases

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  1. thimerosal
    a bacteriostatic agent that was previously used in vaccines to prevent contamination. because of possible association with brain and nerve damage, it is no longer used except in the influenza vaccine
  2. Recominant
    organism genetically alltered to produce an antigen
  3. Conjugate
    organism altered and joined with another substance to heighten immune response
  4. Toxoid
    toxin treated by heat or chemicals to weaken the toxin effects but retain ability to produce an antigen
  5. Vericella spreads by
    direct contact, airborn and skin lesions
  6. Incubation period for vericella
    14-21 days
  7. Chickenpox are contagious until
    all lesions are crusted over
  8. Symtpoms of chicken pox
    fever, melaise, anorexia, irritability
  9. What type of rash with chicken pox
    macular rash-> pruretic vesicular lesions
  10. Testing for chicken pox
    lesion fluid for PCR
  11. Treatment of chicken pox

    Immunocompromised kids use IV or oral acyclovir and immune globulin with 96 hr of exposure

    Vaccine 72 hrs after exposed will reduce symptoms
  12. Erythema Infectiosum (5th disease) is also known as
    Parvo virus B-19
  13. Incidence highest for Parvo in
    5-14 years
  14. Transmission of Parvo
    resp secretions and blood
  15. Incubation period for parvo
    4-21 days
  16. What happens in Parvo
    • Mild illness followed by rash
    • Slapped face appearance
    • Lace-like erthematous, maculopapular rash, spares hands and feet
  17. 5th disease (Parvo) treatment
    Testing possitive for IgM for Parvo virus B-19

    supportive treatment
  18. What is important in Parvo?
    Keep children out of direct sunlight or cover skin with light, loose clothing (sunlight will make rush worse)
  19. Flu symptoms
    • Abrupt onset of fever, chils, runny nose, sore throat, malaise, aches, headache, anorexia
    • May develop nausea and diarrhea
    • Improves after 3-5 days
    • Complications, OM, secondary infections, febrile seizures, encephalitis, pneumonia, croup
  20. Treatment of Flu
    Viral cultural or rapid antigen testing from nose/throat; FA; indirect immunofluorescent antibody staining

    • Supportive treatment
    • Antivirals
  21. Antivirals for flu may cause nausea and vomiting and may worsen ___________ in children
  22. Homophilus influenza
    • Most common in spring and summer
    • Direct contact with resp secretions or droplets
    • Begins with URI, then invades bloodstream
    • Can cause severe illness (meningitis, epiglottitis, pneumonia, septic arthritis and cellulitis) 
    • Sever sequalae and death if untreated
  23. Hemophilus influenza treatment
    • Blood, CSF, middle ear aspirate culture
    • For invasive disease, IV antibiotics for 10 days
    • Dexamethasone may be used to reduce neurologic damage with meningitis
    • Rifampin given to protect others in household
    • Exposed children should recieve vaccine
  24. Nursing Intervensions for Hemophilus INfluenza
    • Droplet percautions until 24 hrs after initiation of antibiotics
    • Identify potential contacts and check immunization status
    • Inform family and friends that rifampin turns urin and other body fluids oragne and will cause stains
  25. Rubeola (measles)

    • Infection uncommon in US
    • Epidemic in other countries
    • Direct contact with resp droplets, airborne spread
    • Incubation 8-12 days
    • Prodrom phase (3-5 days) fever, conjunctivitis, coryza, cough, anorexia, koplik spots
  26. Measles treatment
    • Testing: IgM measles antibody
    • Supportive treatment
    • Antibiotics for secondary infections
    • Immune globulin may decide severity in infants, immunocompromised children and pregnant women 
    • Death from neuroloic or resp complications occur in 1-3 of 1000 cases
    • Reportable disease
  27. Nursing Interventions for Measles
    • Airborne precautions while child is in hospital
    • Cool mist humidifier
    • Suction gently as needed
    • Nonaspirin pyretics, antitussives for coughing, antiprurtics for itching
    • Dim lights, cover windows if child is sensitive to light
    • Bedrest with diversional activities
    • Elevate HOB
    • Avoid use of soaps, keep skin clean & dry
    • Small, cool liquids, may need blended, or pureed and mashed foods
  28. Meningococcus
    Niessa meningitdis (gram-neg diplococcus)

    Winter or early spring

    Children living in poverty at higher risk

    Most common in children under 2 and 15-18

    Drop tansmission

    Incubation 2-10 days
  29. Symtoms of Meningococcus
    Abrupt onset of fever, chills, malaise, aches, vomiting and prostration (extreme exhaustion)

    Maculopapular ras: petechial and may progress to purpura and sepsis

    septic shock may occur
  30. complications of meningitis
    necrosis with gangrene and loss of tissue/limb, DIC, hearing loss, neuro disablities, scaring
  31. Treatment of Meningococcemia
    • Cultures of blood, CSF; gram stain of lesion
    • IV penicillin 5-7 days
    • Aggressive ICU care to maintain airway, treat shock
    • 10% of children will die
    • Close contacts are given rifampin, ceftriaxone, cipro or Z-pack
    • Vaccine may be given to prevent secondary cases
    • Reportable disease
  32. Interventions for meningococcemia
    • Standard & droplet precautions until antibiotic therapy for 24 hrs
    • Observe for shock & resp failure
    • Identify close contacts & provide prophylaxis
    • Educate them about any med side effects
    • Teach close contacts signs of illness and when to call doctor
    • Coordinate rehab for child
  33. Pertussis is most common in
    under 6 months
  34. Epidemic cycles occurs every 3-4 years in
  35. Pertussis
    • infection or immunity is long lasting
    • Disease may occur as immunity wanes
    • Nasal congestion, runny nose, cough
    • With coughing: gagging, apnea, gasping, cyanosis, vomiting and profuse mucous production 
    • Direct contact with droplets
    • INcubation 7-10 days
    • COmplications: pneumonia, atelectasis, encephalopathy, death
  36. Pertussis treatment
    • NP culture or PCR
    • Supportive care
    • Macrolide antibiotics
  37. Pertussis Nursing interventions
    • Droplet precautions until 5 days after antibiotics
    • Continuous assessment of resp status
    • Monitor with pulse oximeter
    • Remain with chil during coughing spells to monitor for cyanosis
    • Give oxygen if ordered
    • Have emergency equipment prepared
    • Provide humidification
    • Ecourage rest periods
    • Small frequent feedings of desired foods
  38. HepB vacine
    • Birth
    • 1-2 months
    • 6-18 months

    • Min of 4 wk between doses 1 and 2
    • Min of 8 wk between doses 2-3
    • Final dose no earlier than 24 wk and at least 16 wk after first dose
  39. Rotovirus (RV)
    • 2 months
    • 4months

    • Max age for first dose is 14 wk, 6 days
    • Max age for last dose is8 months
    • Cant start after 15 weeks
  40. DTaP
    • 2 months
    • 4 months
    • 6 months
    • 15-18 months
    • 4-6 yr
    • 11-12 yr
    • ten year booster shots 

    • Min of 6 months between dose 3-4 
    • Boster can be either Tdap or Td
  41. Hib
    • 2 months
    • 4 months
    • 12-15 months
  42. Pneumococcal (PCV)
    • 2 months
    • 4 months
    • 6 months
    • 12-15 months
  43. Inactivated poliovirus (IPV)
    • 2 months
    • 4 months
    • 6-18 months
    • 4-6 years 

    Final dose should be after 4 years and at least 6 months from previous dose
  44. nfluenza (TIV)
    must be 2 years or older to recieve live vaccine
  45. MMR
    • 12-15 months
    • 4-6 years

    given 6-11 months if traveling internationally
  46. Vericalla
    • 12-15 months
    • 4-6 years
  47. HepA
    • 12 months to 2 years
    • 6-18 months following
  48. Meningococcal
    11-12 years

    • Can be given earlier to high risk groops
    • If given before 16 years, booster recommended
  49. HPV
    11-12 years

    second dose 1-2 months after first

    third 6 months after first dose
Card Set:
Immunizations/Communicable diseases
2015-02-11 05:50:04
exam 1
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