302 - Vaccines, Gerontological, EDOF

Hepatitis B (HepB) Vaccine

Protects against Hepatitis B virus; given at birth, 1-2 months, and 6-18 months.

Rotavirus (RV) Vaccine

Protects against rotavirus gastroenteritis; administered orally in early infancy.

Hib Vaccine

Protects against Haemophilus influenzae type b bacteria causing meningitis and pneumonia.

DTaP Vaccine

Protects against Diphtheria, Tetanus, and acellular Pertussis (whooping cough).

Pneumococcal Conjugate Vaccine (PCV)

Protects against Streptococcus pneumoniae infections like pneumonia and meningitis.

MMR Vaccine

Protects against Measles, Mumps, and Rubella; first dose given at 12-15 months.

Influenza Vaccine

Annual vaccine protecting against seasonal flu strains; recommended from 6 months of age.

Varicella Vaccine

Protects against chickenpox virus; given at 12-15 months and 4-6 years.

Hepatitis A (HepA) Vaccine

Protects against Hepatitis A virus; 2-dose series starting at 12 months.

Meningococcal Vaccine (MenACWY)

Protects against Neisseria meningitidis types A, C, W, and Y; routine at 11-12 years.

HPV Vaccine

Protects against Human Papillomavirus strains causing cervical, anal, and throat cancers.

what vaccine is given at birth

Hep B

what vaccine can you not give till 6 months

influenza

what vaccine do you get yearly

flu

what vaccine do you get as an adolescent

meningcoccal and HPV

what vaccine does the older population receive

HIP

what vaccine do you get as a child

rotavirus, DTAP, HIB, PCV13, IPV, MMR, varricella, Hep A

What is Tdap?

tetanus-diphtheria-five component acellular pertussis

how often do you need Tdap

every 10 years

DTaP vs. Tdap (Target Population)

DTaP is given to infants/young children (

DTaP vs. Tdap (Antigen Dosage)

Uppercase letters (DTaP) indicate full-strength doses; lowercase (Tdap) indicate reduced diphtheria and pertussis doses.

Vaccine Information Statement (VIS)

CDC document given to patients detailing benefits and risks before vaccination.

When to Provide a VIS

Must be given prior to administering each dose of a vaccine.

Live Attenuated Vaccine Consideration

Generally contraindicated in pregnant women and severely immunocompromised individuals.

Absolute Vaccine Contraindication

Severe allergic reaction (anaphylaxis) after a previous dose or vaccine component.

Herd Immunity

Indirect protection from infectious disease when a high percentage of population is immune.

Pro-Vaccination Public Health Impact

Dramatically reduces morbidity, mortality, and healthcare costs from preventable diseases.

Vaccine Hesitancy Factor

Concerns over safety, rapid development, side effects, or mistrust of institutions.

Vaccine Adverse Event Reporting System (VAERS)

Post-marketing surveillance system to monitor safety and flag potential adverse events.

Gerontological Nursing

Specialty nursing focused on caring for older adults and meeting their physical and psychosocial needs.

Ageism

Prejudice or discrimination against individuals based solely on their advanced age.

Myth About Aging: Cognitive Decline

False belief that severe memory loss and dementia are inevitable parts of normal aging.

Alzheimer's Disease

Progressive neurodegenerative disorder causing memory loss, cognitive decline, and behavioral changes in older adults.

Cancer in Older Adults

Leading cause of death where risk increases with age due to cellular changes and prolonged carcinogen exposure.

Osteoporosis

Condition marked by decreased bone mass and density, significantly increasing fracture risk in elderly patients.

Arthritis

Joint inflammation causing chronic pain and stiffness; a primary cause of disability in older adults.

Cardiovascular Disease in Aging

Major cause of morbidity in older adults, including hypertension, coronary artery disease, and heart failure.

Health Status Assessment in Geriatrics

Evaluates physical function, cognitive ability, social support, and independence rather than disease presence alone.

Medicaid

Joint federal and state program providing health coverage for low-income individuals.

Medicare Part A

Hospital insurance covering inpatient hospital stays, skilled nursing facility care, and hospice.

Medicare Part B

Medical insurance covering outpatient doctor visits, preventive services, and medical supplies.

Medicare Part C (Medicare Advantage)

Private insurance option combining Part A, Part B, and usually Part D coverage.

Medicare Part D

Prescription drug coverage plan offered by Medicare-approved private insurance companies.

Medicare Eligibility Criteria

Adults aged 65 or older, individuals under 65 with qualifying disabilities, or persons with End-Stage Renal Disease (ESRD).

Medicare Part A Premium

Usually premium-free for individuals who worked and paid Medicare taxes for at least 40 quarters (10 years).

Activities of Daily Living (ADLs)

Basic self-care tasks required for daily living, including bathing, dressing, eating, transferring, toileting, and continence.

Instrumental Activities of Daily Living (IADLs)

Complex tasks needed for independent community living, including meal preparation, shopping, managing finances, using transportation, and medication management.

ADL vs. IADL Primary Difference

ADLs involve basic personal care and hygiene, while IADLs require higher cognitive and organizational skills for independent living.

Elder Abuse Categories

Includes physical abuse, emotional/psychological abuse, sexual abuse, financial exploitation, neglect, and self-neglect.

Signs of Elder Neglect

Poor personal hygiene, untreated medical conditions, dehydration, malnutrition, and unsafe or dirty living conditions.

Adult Protective Services (APS)

Social service agency designated to investigate allegations of elder abuse, neglect, or financial exploitation and offer protective interventions.

Community Services for Healthy Older Adults

Programs such as senior centers, exercise classes, congregate meal sites, volunteer opportunities, and wellness screenings promoting healthy aging.

Preventive Care for Healthy Older Adults

Includes routine vaccinations, cancer screenings, vision/hearing checks, fall prevention assessments, and bone density monitoring.

Palliative Care

Specialized care focused on symptom relief and quality of life at any illness stage.

Hospice Care

Compassionate care for terminally ill patients with a life expectancy of 6 months or less.

Palliative vs. Hospice Care

Palliative allows curative treatment; hospice focuses strictly on comfort when curative treatment stops.

End-of-Life Advocacy

Ensuring patient autonomy, respecting advance directives, and upholding individual care preferences.

Physical Signs of Impending Death

Cheyne-Stokes breathing, death rattle, mottling of extremities, decreased urine output, and weak pulse.

Post-Mortem Care Interventions

Clean the body, elevate head, allow family viewing, apply ID tags, and document carefully.

End-of-Life Communication Strategies

Use open-ended questions, offer empathetic presence, listen actively, and avoid false reassurance.

5 Stages of Grief (Kübler-Ross Model)

Denial, Anger, Bargaining, Depression, and Acceptance.

Stage 1: Denial

Refusal to accept the reality of loss as a defense mechanism to dull shock.

Stage 2: Anger

Frustration and helplessness directed outward toward self, caregivers, or loved ones.

Stage 3: Bargaining

Attempting to negotiate or make promises to a higher power to delay loss.

Stage 4: Depression

Deep sadness, despair, and withdrawal as the full reality of loss sets in.

Stage 5: Acceptance

Reaching a state of emotional calm and coming to terms with the reality of loss.

1-3 months left s&s

withdraw, increased sleep, decreased food intake, increased pain

1 -2 weeks left s&s

disorientation, respiration changes, decreased BP, changes in skin

Allow Natural Death (AND)

Medical order specifying that only comfort measures be provided, permitting natural death without artificial intervention.

Do Not Resuscitate (DNR)

Legal medical order instructing healthcare providers not to attempt CPR if cardiac or respiratory arrest occurs.

Living Will

Advance directive detailing specific medical treatments a person wants or refuses if incapacitated or terminally ill.

Durable Power of Attorney for Healthcare

Legal document designating a trusted surrogate decision-maker to make medical choices if a patient cannot.

mRNA COVID-19 Vaccine Mechanism

Delivers genetic material instructing cells to produce harmless viral spike proteins, triggering an immune response (e.g., Pfizer-BioNTech, Moderna).

Viral Vector COVID-19 Vaccine Mechanism

Uses a modified harmless virus as a delivery vehicle to introduce genetic code for spike proteins into cells.

Protein Subunit COVID-19 Vaccine Mechanism

Includes harmless fragments (proteins) of the virus directly, alongside an adjuvant to enhance immune response (e.g., Novavax).

Special Consideration: Immunizations in Pregnancy

Administer Tdap between 27-36 weeks and seasonal flu/COVID vaccines; avoid live attenuated vaccines.

Special Consideration: Immunocompromised Patients

Avoid live attenuated vaccines (e.g., MMR, Varicella); inactivated vaccines are safe but may elicit reduced immune response.

Barriers to Vaccination: Structural & Access

Includes poverty, lack of insurance, transportation issues, complex scheduling, and limited clinic hours.

Barriers to Vaccination: Educational & Social

Includes health literacy deficits, misinformation, medical mistrust, and cultural or religious beliefs.

Benefits of Vaccination: Individual Protection

Prevents targeted infections, reduces disease severity, and minimizes hospitalization and mortality risk.

Benefits of Vaccination: Community & Economic

Establishes herd immunity, protects unvaccinable populations, and lowers healthcare system financial costs.

Global Health Status of Older Adults

Rapidly growing global population with increased life expectancy and rising chronic disease burden.

National Health Status of Older Adults (US)

Majority manage at least one chronic condition, with heart disease and cancer leading deaths.

Misconception: Aging Equals Dementia

False; significant cognitive impairment is caused by disease, not normal physiological aging.

Misconception: Older Adults Cannot Learn

False; neuroplasticity persists, allowing older adults to learn new skills and adapt.

Misconception: Frailty is Inevitable

False; regular physical exercise and proper nutrition preserve strength and function.

Characteristics of Healthy Older Adults

High functional independence, psychological resilience, active lifestyle, and strong social connections.

Primary Prevention in Older Adults

Administering annual influenza and shingles vaccines to prevent infectious illness.

Secondary Prevention in Older Adults

Routine DEXA scans and mammograms for early disease detection.

Tertiary Prevention in Older Adults

Physical therapy post-stroke or cardiac rehabilitation to restore function and prevent disability.

4 Common Chronic Conditions in Older Adults

Hypertension, osteoarthritis, heart disease, and diabetes mellitus.

4 Primary Types of Elder Abuse

Physical abuse, psychological abuse, financial exploitation, and caregiver neglect.

Effective Older Adult Programs: Criteria 1 (Accessibility)

Must offer affordable, convenient transportation and physical access for individuals with disabilities.

Effective Older Adult Programs: Criteria 2 (Person-Centered Care)

Tailors services to individual preferences, culture, and specific health needs.

Effective Older Adult Programs: Criteria 3 (Interprofessional Collaboration)

Integrates medical, social, and psychological services seamlessly across care teams.

Effective Older Adult Programs: Criteria 4 (Evidence-Based Outcomes)

Utilizes proven interventions and routinely evaluates measurable health and safety outcomes.

Aging in Place Living Option

Remaining in one's own home safely using home health and community supports.

Assisted Living Facility Option

Housing providing support for IADLs and basic personal care while preserving independence.

Continuing Care Retirement Community (CCRC)

Offers a continuum of care from independent living to skilled nursing on one campus.

Skilled Nursing Facility (SNF) Option

24-hour medical and custodial care for individuals with complex chronic health needs.