NURS 6565 FNP review address.
By:Evatee
FNP REVIEW - AANP
Document created using Leik, Hollier and Fitzgerald – I do not own the copy rights to images, etc.
,NURS 6565 FNP review address.
By:Evatee
JULY 27, 2018
, PREVENTION/HEALTH PROMOTION/IMMUNIZATION
LEVEL OF PREVENTION IMMUNIZATION PEARLS SMOKING - PACK YEAR HX
PRIMARY HX of Anaphylactic Immunization to avoid Number of packs-per-day (PPD)
Goal: preventing the health problem, the reaction Multiplied by # of years smoked
most cost-effective form of healthcare Neomycin IPV, MMR, varicella
Example: immunizations, counseling about Streptomycin, IPV, smallpox
safety, injury and disease prevention polymyxin B, neomycin 5 A’S OF SMOKING CESSATION
SECONDARY Baker’s yeast Hepatitis B 1. Ask about tobacco use
Goal: detecting disease in early, Gelatin, neomycin Varicella zoster
2. Advise to quit
asymptomatic, or preclinical state to minimize Gelatin MMR
3. Assess willingness to make a quit
its impact
Example: screening tests, such as BP check, Previously unvaccinated adults age 19-59 with attempt
mammography, colonoscopy, ASA in hx MI diabetes should be vaccinated against Hepatitis B 4. Assist in quit attempt
TERTIARY LIVE VACCINES 5. Arrange follow-up
Goal: minimizing negative disease induced o MMR
outcomes ▪ Patients born before 1957 have
Example: in established disease, adjusting likelihood of immunity due to PNEUMOCOCCAL IMMUNIZATION
therapy to avoid further target organ damage. natural infection
➢ PCV13 associated with greater
Potentially viewed as a failure of primary ▪ Two doses 1 month apart for
prevention, support groups those never immunized immunogenicity
o Varicella ➢ PPSV23 not licensed for children
o Zostavax under 2
IMMUNIZATION PRINCIPLES o Intranasal Flu Mist ➢ Indications: chronic lung disease,
Community (herd immunity) ➢ Avoid these with Pregnancy, immune suppression chronic cardiovascular disease,
Immunize those who can be to protect those and with HIV (CD4 count < 200) – case by case diabetes, chronic liver disease,
who cannot be immunized situation
chronic alcohol abuse, smokers,
Active immunity ➢ Rotavirus
o Avoid with SCID (severe combined malignancy, chronic renal failure,
Resistance developed in response to an
immunodeficiency) asplenia, sickle cell,
antigen (either infection or vaccine)
immunocompromised, HIV.
Passive immunity
Immunity conferred by an antibody produced HEPATITIS B ➢ PCV13 followed by PPSV23 one year
in another host (infant of mother or immune ➢ Chronic Hep B can lead to hepatocellular later and then again at 65
globulin carcinoma, cirrhosis and continued infectivity o Exception: HIV (8 weeks
later)
➢ Childhood Hep B vaccines began in 1982
Immunize unless sending to the hospital in an ambulance
➢ 3 dose series 0, 1, 6 months ➢ If PPSV23 before age 65, repeat in 5
➢ If not vaccinated and exposed – HBIG and series years
➢ If vaccinated and exposed – single dose vaccine
, PREVENTION/HEALTH PROMOTION/IMMUNIZATION
TETANUS
VARICELLA ➢ Infection caused by Clostridium
SMALLPOX
➢ Live virus; 2 dose series starting > 1 year of age tetani – found in soil lead to lockjaw
➢ Caused by variola virus
➢ Although highly protective, mild cases of chicken ➢ If no previous immunity - give Tdap
➢ Infective droplets – contagious during fever, but
pox have been associated with the disease followed by Td in 1 and 6 months
most contagious during rash
➢ Varicella antibody titers should be ordered on a ➢ Need vaccine every 10 years with a
o Contagious until last scab falls off
healthcare worker who had chicken pox as a child single dose of Tdap in adulthood
➢ Stopped vaccinating in 1972
➢ Varicella Zoster Immune Globulin (VZIG) is made ➢ If dirty wound – BOOST if not TD in
➢ Incubation period 7-17 days
of pooled blood product with excellent safety 5 years (Tdap and Immunoglobin if
➢ Prodromal stage – fever, malaise, headaches,
rating (given if contraindications for vaccine) no previous vaccine)
body aches
➢ Pregnant women without immunity should be
➢ Rash starts on face > arms/legs > hands/feet
vaccinated with two doses after giving birth
o All lesions within same phase and spreads HEPATITIS A
➢ Varicella is transmitted via droplet
within 24 hours ➢ Peak infectivity occurs the 2-week
➢ Vaccination within 3-5 days of exposure has
➢ Vaccination within 3 days of exposure reduces period before the onset of jaundice
shown benefits to reduce disease
severity or elevated liver enzymes
➢ Vaccinia – unique immunization method ➢ Approximately 50% of cases have
o 2-pronged needle dipped into vaccine and no specific risk factors identified
then pricks skin STAGES OF CHANGE MODEL
➢ PRECONTEMPLATION ➢ When traveling to developing
o Not interested or minimalizes nations, avoid foods that are eaten
➢ CONTEMPLATION raw
POLIOVIRUS
o Considering change, looks at positive and ➢ Administer 4-6 weeks prior to
➢ Transmission is fecal-oral
negative, feels “stuck” traveling to an area where disease is
➢ PREPARATION endemic
SENSITIVITY AND SPECIFICITY o Exhibits some change behaviors, but does ➢ Treatment is supportive
➢ Sensitivity – ability of a test to detect a person not have tools to proceed
who has disease (SEN rule in) ➢ ACTION SHINGLES VACCINE
➢ Specificity – ability of a test to detect a person o Ready to go forward, takes concrete ➢ Recommended for everyone except
who is healthy (SPOUT – rule out) steps, but no consistency those contraindicated
➢ MAINTENANCE/RELAPSE ➢ Infectious until lesions dry/crusted
o Learns to continue the change and ➢ Zostavax
embraced the healthy habit o Live; One-time dose age 60
➢ Shingrix
o Non-live; 2 doses age 50
o Preferred vaccine
By:Evatee
FNP REVIEW - AANP
Document created using Leik, Hollier and Fitzgerald – I do not own the copy rights to images, etc.
,NURS 6565 FNP review address.
By:Evatee
JULY 27, 2018
, PREVENTION/HEALTH PROMOTION/IMMUNIZATION
LEVEL OF PREVENTION IMMUNIZATION PEARLS SMOKING - PACK YEAR HX
PRIMARY HX of Anaphylactic Immunization to avoid Number of packs-per-day (PPD)
Goal: preventing the health problem, the reaction Multiplied by # of years smoked
most cost-effective form of healthcare Neomycin IPV, MMR, varicella
Example: immunizations, counseling about Streptomycin, IPV, smallpox
safety, injury and disease prevention polymyxin B, neomycin 5 A’S OF SMOKING CESSATION
SECONDARY Baker’s yeast Hepatitis B 1. Ask about tobacco use
Goal: detecting disease in early, Gelatin, neomycin Varicella zoster
2. Advise to quit
asymptomatic, or preclinical state to minimize Gelatin MMR
3. Assess willingness to make a quit
its impact
Example: screening tests, such as BP check, Previously unvaccinated adults age 19-59 with attempt
mammography, colonoscopy, ASA in hx MI diabetes should be vaccinated against Hepatitis B 4. Assist in quit attempt
TERTIARY LIVE VACCINES 5. Arrange follow-up
Goal: minimizing negative disease induced o MMR
outcomes ▪ Patients born before 1957 have
Example: in established disease, adjusting likelihood of immunity due to PNEUMOCOCCAL IMMUNIZATION
therapy to avoid further target organ damage. natural infection
➢ PCV13 associated with greater
Potentially viewed as a failure of primary ▪ Two doses 1 month apart for
prevention, support groups those never immunized immunogenicity
o Varicella ➢ PPSV23 not licensed for children
o Zostavax under 2
IMMUNIZATION PRINCIPLES o Intranasal Flu Mist ➢ Indications: chronic lung disease,
Community (herd immunity) ➢ Avoid these with Pregnancy, immune suppression chronic cardiovascular disease,
Immunize those who can be to protect those and with HIV (CD4 count < 200) – case by case diabetes, chronic liver disease,
who cannot be immunized situation
chronic alcohol abuse, smokers,
Active immunity ➢ Rotavirus
o Avoid with SCID (severe combined malignancy, chronic renal failure,
Resistance developed in response to an
immunodeficiency) asplenia, sickle cell,
antigen (either infection or vaccine)
immunocompromised, HIV.
Passive immunity
Immunity conferred by an antibody produced HEPATITIS B ➢ PCV13 followed by PPSV23 one year
in another host (infant of mother or immune ➢ Chronic Hep B can lead to hepatocellular later and then again at 65
globulin carcinoma, cirrhosis and continued infectivity o Exception: HIV (8 weeks
later)
➢ Childhood Hep B vaccines began in 1982
Immunize unless sending to the hospital in an ambulance
➢ 3 dose series 0, 1, 6 months ➢ If PPSV23 before age 65, repeat in 5
➢ If not vaccinated and exposed – HBIG and series years
➢ If vaccinated and exposed – single dose vaccine
, PREVENTION/HEALTH PROMOTION/IMMUNIZATION
TETANUS
VARICELLA ➢ Infection caused by Clostridium
SMALLPOX
➢ Live virus; 2 dose series starting > 1 year of age tetani – found in soil lead to lockjaw
➢ Caused by variola virus
➢ Although highly protective, mild cases of chicken ➢ If no previous immunity - give Tdap
➢ Infective droplets – contagious during fever, but
pox have been associated with the disease followed by Td in 1 and 6 months
most contagious during rash
➢ Varicella antibody titers should be ordered on a ➢ Need vaccine every 10 years with a
o Contagious until last scab falls off
healthcare worker who had chicken pox as a child single dose of Tdap in adulthood
➢ Stopped vaccinating in 1972
➢ Varicella Zoster Immune Globulin (VZIG) is made ➢ If dirty wound – BOOST if not TD in
➢ Incubation period 7-17 days
of pooled blood product with excellent safety 5 years (Tdap and Immunoglobin if
➢ Prodromal stage – fever, malaise, headaches,
rating (given if contraindications for vaccine) no previous vaccine)
body aches
➢ Pregnant women without immunity should be
➢ Rash starts on face > arms/legs > hands/feet
vaccinated with two doses after giving birth
o All lesions within same phase and spreads HEPATITIS A
➢ Varicella is transmitted via droplet
within 24 hours ➢ Peak infectivity occurs the 2-week
➢ Vaccination within 3-5 days of exposure has
➢ Vaccination within 3 days of exposure reduces period before the onset of jaundice
shown benefits to reduce disease
severity or elevated liver enzymes
➢ Vaccinia – unique immunization method ➢ Approximately 50% of cases have
o 2-pronged needle dipped into vaccine and no specific risk factors identified
then pricks skin STAGES OF CHANGE MODEL
➢ PRECONTEMPLATION ➢ When traveling to developing
o Not interested or minimalizes nations, avoid foods that are eaten
➢ CONTEMPLATION raw
POLIOVIRUS
o Considering change, looks at positive and ➢ Administer 4-6 weeks prior to
➢ Transmission is fecal-oral
negative, feels “stuck” traveling to an area where disease is
➢ PREPARATION endemic
SENSITIVITY AND SPECIFICITY o Exhibits some change behaviors, but does ➢ Treatment is supportive
➢ Sensitivity – ability of a test to detect a person not have tools to proceed
who has disease (SEN rule in) ➢ ACTION SHINGLES VACCINE
➢ Specificity – ability of a test to detect a person o Ready to go forward, takes concrete ➢ Recommended for everyone except
who is healthy (SPOUT – rule out) steps, but no consistency those contraindicated
➢ MAINTENANCE/RELAPSE ➢ Infectious until lesions dry/crusted
o Learns to continue the change and ➢ Zostavax
embraced the healthy habit o Live; One-time dose age 60
➢ Shingrix
o Non-live; 2 doses age 50
o Preferred vaccine
