pediatrics exam 1 - vaccinations

how long can you expect an infant to keep maternal antibodies?

around 4 to 5 months

how can in infant acquire passive immunity?

antibodies cross the placenta and the breastmilk

how can infants develop active immunity?

immunization and natural disease

what does a live-attenuated vaccine contain?

a weakened form of the organism

what does an inactivated vaccine contain?

a killed version of the organism

what does a subunit/recombinant/polysaccharide/conjugate vaccine contain?

a piece of the organism

what does a toxoid vaccine contain?

a toxin made by the organism

why would a physician recommend a six month infant get a flu vaccine?

respiratory issues (asthma)

what vaccine is given at birth?

Hepatitis B

what vaccine(s) would you expect a 2 month old to be receiving?

possibly the second dose of hepatitis B

what vaccines would you expect to be given to a 2 month old?

possibly second dose of Hepatitis B, Rotavirus, DTaP, Haemophillus Influenzae B, Pneumococcal conjugate, Pollovirus

what vaccines would you expect to be given at a 4 month visit?

Rotavirus, DTaP, Infuenzae B, Pneumococcal conjugate, inactivated pollovirus

what vaccines would you expected to be given at a 6 month visit?

possibly hepatitis B, Rotavirus, DTaP, Influenzae B, Pneumococcal conjugate, possibly inactivated Pollovirus, possibly Flu

What vaccines would you expect to be given at a 9 month visit?

possibly Hepatitis B, possibly pollovirus, possibly Flu

What vaccines would you expect at a 12 month visit?

possibly (all of these) Hepatitis B, influenzae B, pneumococcal conjugate, pollovirus, MMR, varicella, Hepatitis A, and flu

what is the expected shots to be given at 15 months?

possibly hepatitis B, DTaP, influenzae type B, pneumococcal conjugate, pollovirus, MMR, Varicella, Hepatitis A

what are the expected vaccines at 18 months?

hepatitis B, DTaP, pollovirus, hepatitis A

what vaccines would you expect to be given between 4-6 years?

DTaP, pollovirus, MMR, Varicella

what vaccines would you expect to be given at 11-12 years old?

TDAP, HPV, Meningococcal

what vaccines would you expect at 16 years old?

Meningococcal

when can you give each dose of the Hepatitis B vaccine?

1st - Birth

2nd - 1-2 months

3rd - 6-18 months

when would you expect each dose of the Rotovirus vaccine to be given?

1st - 2 months

2nd - 4 months

3rd - 6 months

When are the doses of DTaP given?

1st - 2 months

2nd - 4 months

3rd - 6 months

4th - 15-18 months

5th - 4-6 years

when are the doses of Influenzae B given?

1st - 2 months

2nd - 4 months

3rd - 6 months

4th - 12-15 months

when is each dose of the pneumococcal conjugate vaccine given?

1st - 2 months

2nd - 4 months

3rd - 6 months

4th - 12-15 months

when is each dose of the pollovirus vaccine given?

1st - 2 months

2nd - 4 months

3rd - 6-18 months

4th - 4-6 years

when is each dose of the MMR vaccine give?

1st - 12-15 months

2nd - 4-6 years

when is each dose of the varicella vaccine given?

1st: 12-15 months

2nd: 4-6 years

when is each dose of the hepatitis A vaccine given?

both doses are given between 12 and 23 months

when is the TDaP vaccine given?

11-12 years

when his the HPV vaccine given?

11-12 years

when is the meningococcal vaccine given?

1st - 11-12 years

2nd - 16 years

what vaccines are optional?

HPV

what is contradicted in the administration of a live vaccine?

pregnancy or chemotherapy

a mother brings her 2 month old infant to the ER complaining of a mild fever, some redness on the child’s buttocks, and irritability. the child received their regular vaccines earlier that morning - what would you tell this mother?

these reactions are normal following vaccine administration?

what should you tell a parent to expect following the administration of the MMR vaccine?

fever, rash, and drowsiness in the 7-10 days following immunization

what are some things you can tell a parent to do to comfort the side effect of vaccination?

acetaminophen, ibuprofen, warm compress

at what age can you tell parents they can give their child ibuprofen? why can they not get it before this?

six months - the kidneys are not developed enough before this

what is a contradiction for the Hepatitis B vaccine

an allergy to Brewer’s yeast

who is at the highest risk of getting hepatitis?

children - 90% of infected are infants

viral or bacterial: hepatitis B?

viral (liver)

how could a child get hepatitis B?

birth, blood exposures

viral or bacterial: diptheria

bacterial

how could someone get diphtheria?

contact with secretions (from nose, throat, eye, and skin)

upon assessment, the child has thick secretions at the back of the throat - what do you suspect?

Diphtheria

viral or bacterial: tetanus

bacteria

how would someone get tetanus?

wound in skin contact with soil contaminated with feces

a child presents with spasms of masticatory muscle, difficulty opening their mouth, and restlessness - what do you suspect?

tetanus

what treatment would you expect for tetanus?

tetanus immune globulin and penicillin

viral or bacterial: pertussis

bacterial

how would someone get pertussis?

direct contact with respiratory secretions (droplet)

parents presents with a paroxysmal cough - what do you suspect?

pertussis

viral or bacterial: poliomyelitis

virus

how would poliomyelitis be transmitted?

fecal-oral

what is a priority complication associated with poliomyelitis?

paralysis

viral or bacterial: influenzae type B

bacterial

how is influenzae type b transmitted?

respiratory secreations

what is a hallmark symptom of influenzae type B?

epiglottitis

a child presents with excessive drooling and remains in the tripod position - what do you suspect?

acute epiglottitis

what are two important nursing considerations for treating acute epiglottitis?

do not examine the throat; always have a tracheostomy kit near the bedside

viral or bacterial: pneumococcal disease

bacterial

what is a common symptom of pneumococcal disease?

otitis media (ear pain)

how do you treat pneumococcal meningitis?

vancomycin plus cefotaxime or ceftriaxone

how to you treat non-meningitis pneumococcal disease?

penicillin, ampicillin

what are complications associated with pneumococcal disease?

meningitis or sepsis

how is rotavirus transmitted?

fecal-oral

how is rotavirus prevented/treated?

oral live vaccine

viral or bacterial: measles

viral

how is measles transmitted

droplet

patient presents with a maculopapular rash that began on their head and then traveled downward - what disease do you suspect?

rubella; measles

patient presents with a rash characterized by red spots with blue and white centers - what do you suspect? what kind of rash is this?

measles; koplick spots

what location is it common for a child to have a measles rash?

palms and soles

what suggestion could you give a parents to help calm the itchiness associated with measles?

giving their child an colloidal (oatmeal) bath

viral or bacterial: mumps

viral

how is mumps transmitted?

respiratory secretions

what is a hallmark sign of mumps

parotid gland swelling (neck swelling)

viral or bacterial: rubella

virus

who is rubella transmitted?

nasopharyngeal secretions

patient presents with a maculopapular rash - what do you suspect?

rubella

viral or bacterial: varicella

viral

how is varicella transmitted?

respiratory secretions and direct contact

what is Raye’s syndrome?

encephalopathy associated with varicella

when would you tell a parent their child is safe to return to school following a varicella infection?

once the rash is dry and completely healed

viral or bacterial: Hepatitis A

viral

how is hepatitis A transmitted?

fecal-oral (contaminated food and water)

viral or bacterial: meningococcal disease

bacterial

who is most likely to get meningococcal disease?

infants less than 1 year; people ages 16-21

how is meningococcal disease transmitted?

respiratory secretions (droplet)

what is the treatment for meningococcal disease?

cefotaxime and ceftriaxone as quickly as possible

what should you educate a parent about possible complications of a meningococcal infection?

hearing loss, limb loss, neurologic defects

what is it indicated to give the serogroup A, C, W, Y vaccine for meningitis?

1st - 11-12 years

2nd - 16-18 years

when is group B meningitis recommended to be given?

between 10-25 years; recommended before college

what should you educate a parent on when they decide to give their child their first flu vaccine?

children require 2 doses their first year of receiving the flu vaccine

a child comes to the ER with a fever of 101, vomiting/diarrhea, a skin rash, and mucocutaneous lesions. the parents reports that the child hasn’t come in contact with any disease recently, but did test positive for COVID-19 five weeks ago - what are you worried this child could have developed?

multisystem inflammatory syndrome in children (MIS-C)

identify disease that children are not able to be vaccinated against - (remember, exiting home ensures infection)

roseola infantum, enterovirus, hand-foot-mouth disease, erythema infectiosum, infectious mononucleosis

viral or bacterial: roseola infantum

viral

how is roseola infantum transmitted?

respiratory secretions

what age group is most likely to contract roseola infantum?

6-24 months

a child presents to the ER with a maculopapular rash, and their mother reports that they have had a high fever for the last five days - what do you suspect?

roseola infantum

what is an important consideration when teaching a parent about roseola infantum?

it is a risk all year round