NUR 113 immunity, otitis media, conjunctivitis

Active immunity

Person’s own immune system creates immune response, lasts for years/lifetime, memory cells produce antibodies when reintroduced to antigen

Passive immunity

Immunoglobulins transferred from one person to another, lasts weeks to months, administered by injection, transferred mother to baby

Live vaccines

Weakened, modified living organisms (MMR, varicella, RV)

Inactivated vaccines

Dead organisms, capable of immune response (Hep A, IPV)

Toxoid vaccine

Toxins weakened, produces immune response (Dtap, Tdap)

Conjugate vaccines

Chemically linking bacterial cell wall to proteins (pneumococcal, Hib)

Recombinant vaccines

Genetically engineered/altered (hep B)

PED IM needle size

23-25

Birth needle length

5/8

1-2 year needle length

1-1.25

Live vaccines contraindications

Immunocompromised, pregnancy, allergies, delay for patients receiving IVIG or blood products, history of febrile seizures

Hep B vaccine schedule

Birth, 1-2 mo, 6-18 mo

RV vaccine schedule

2 mo, 4mo, 6mo

DTap vaccine schedule

2 mo, 4mo, 6 mo, 15-18 mo, 4-6 year

Flu vaccine schedule

6 mo-18+ years

MMR vaccine schedule

12-15 mo, 4-6 years

Pneumococcal vaccine schedule

2, 4, ,6 12-15 mo

RSV vaccine schedule

Birth-6 mo

Varicella vaccine schedule

12-15 mo, 4-6 years

Hep A vaccine schedule

12-23 mo

HPV vaccine schedule

11-12 years

Tdap vaccine schedule

11-12 years

Hep A is spread by

Close contact, eating or drinking contaminated food or water

Meningococcal vaccine schedule

11-12, 16 yo

Hep B is spread by

Contact w blood and body fluids and can be spread from an infected gestational parent to newborn, it affects the liver

Tdap booster schedule

Q10years

General conjunctivitis symptoms

Redness, edema, eye pain, discharge, itching

Conjunctivitis risk factors

Daycare, schools, can be concurrent with upper respiratory infection, concurrent with otitis media, can occur during birth from mother sti

Bacterial conjunctivitis

Begins in one eye, pain, burning, tearing, purulent/ mucoid drainage, antibiotic eyedrops or ointment

Viral conjunctivitis

Copious tears, watery/mucoid discharge, photophobia, typically associated w upper respiratory infection, symptom relief only (warm compress), return to school 3-7 days (until resolved symptoms)

Allergic conjunctivitis

Most common in kids, itching, redness, watery/stringy discharge, treat w antihistamine eyedrops

Conjunctivitis education

Wash hands, don’t share towels, bathe regularly, wash face, don’t rub eyes, return to school at least 24-48 hours after antibiotics and when mucopurulent drainage is gone

Otitis media

Infection of fluid in middle ear, Eustachian tube dysfunction, common in kids during winter

Otitis media diagnosis

Signs of fluid, bulging of tympanic membrane, inflammation, ear pain, hearing loss, scarring of tympanic membrane, intracranial infections

Otitis media education

Avoid exposure to ppl w upper respiratory infections, avoid second hand smoke, proper antibiotic use, wash hands, follow up

Otitis media w effusion

Presence of fluid working middle ear without infection, can be independent or longer after acute otitis media,

Otitis media w effusion symptoms

Asymptomatic, fullness in ear, popping sensation, monitor for hearing loss

Pressure equalizing tubes

Equalize pressure behind eardrum, allows for adequate hearing, tubes in place for months and fall out on their own, contact PCP if ear infection w tubes in place

Adult ear drop position

Up and out

Child ear drop position

Up and back