NURS 307. Immunization &
Communicable Diseases & Cardiac
Anomalies & Dysfunction (Week 3)
Immunizations - answer Always refer to the *CDC* for updated information and to
provide education to patients and their families
*Vaccines have same antigen as disease, but it's weaker or killed*
Memory cells help to protect from future exposure
Complications, Contraindications/Precautions - answer If *anaphylactic reaction* -> no
more doses of the specific vaccine and any vaccine containing the causing agent
-can occur w/ all vaccines
*Contraindicated* if causing severe allergies
Hold vaccines if patient is febrile, or has an acute illness *until symptoms resolve*
-shows S/S
Other causes determined by HCP and risk vs benefit in case to case circumstances
Ex.
Hep B contraindication for kids w/ allergy from baker's yeast
Immunzation (*Common Side Effects & Contraindications*) - answerSwelling &
Tenderness at injection site
Fever
Immunization (*Contraindications*) - answer*Contraindications*
-Severe febrile illness
-Previous severe allergic reaction
Minor illness and common cold are not contraindications
*Severe febrile illness is contraindication for all immunizations*
Don't administer live-lev vaccine such as varicella and MMR for immunocompromise
kids.
Immunization (*Nursing Administration Considerations*) - answerObtain *consent*
,*Document date, route, site of immunization, lot number, expiration date*
Provide *atraumatic care*, and age appropriate play/distractions, topical anesthetic
Be prepared for emergencies
Provide documentation/record for parents
*Education* on what to watch for after administration
Avoid aspirin use to treat fever
after a live vaccine (VAR & MMR) due to risk of developing *Raye syndrome*
-swelling of the liver & brain
Report adverse reactions to *Vaccine Adverse Event Reporting System* (VAERS)
combine top slide and below comments
Communicable Diseases - answerCan be transmitted via:
-contact
-droplet (3 ft)
-airborne (N95)
Can be prevented with immunizations
-And Personal protective equipment in in-patient settings!
Communicable Diseases (*Risk Factors*) - answerImmunocompromised, poor nutrition,
circulation
Environmental
Chronic illness
Recent exposure
Not immunized or Up-to-date
Communicable Diseases (*Nursing Care & Management*) - answerIsolate
Antipyretics, analgesics
Skin care if applicable
Play, rest, ambient environment
, *Medications* (ensure compliance!)
-*Antihistamines*
-*Antibiotics, antivirals*
-*NSAIDs or acetaminophen*
*Education* on preventing spread of infection, red flags, and documentation on when to
return to normal activity/school
Sepsis & Septic Shock - answer*Sepsis or systemic inflammatory response syndrome*
(SIRS)
Infection in the blood stream
-Group B strep
-E. coli
-Staph
-H. influenzae
Sepsis & Septic Shock (*At Risk*) - answerBurns
Multiple surgeries
Invasive catheters
Compromised immune system
Long-term antibiotics
Sepsis & Septic Shock (*So what happens?*) - answerInflammation and coagulation
inhibit fibrinolysis (breakdown)-> *disseminated intravascular coagulation* (DIC)
*Fibrinolysis:* is a process that prevents blood clots from growing
*DIC:* abnormal coagulation involve formulation of multiple small clots that consume
clotting factors and fibrinogen faster than the body produced leading to bleeding
Vasodilation, or constriction leads to hypoxia and ultimately multi system dysfunction
-hypoxemia 1st
-hypoxia after (tissue)
Signs of Sepsis (*Early*) - answerFever or hypothermia
Tachycardia
Tachypnea
Communicable Diseases & Cardiac
Anomalies & Dysfunction (Week 3)
Immunizations - answer Always refer to the *CDC* for updated information and to
provide education to patients and their families
*Vaccines have same antigen as disease, but it's weaker or killed*
Memory cells help to protect from future exposure
Complications, Contraindications/Precautions - answer If *anaphylactic reaction* -> no
more doses of the specific vaccine and any vaccine containing the causing agent
-can occur w/ all vaccines
*Contraindicated* if causing severe allergies
Hold vaccines if patient is febrile, or has an acute illness *until symptoms resolve*
-shows S/S
Other causes determined by HCP and risk vs benefit in case to case circumstances
Ex.
Hep B contraindication for kids w/ allergy from baker's yeast
Immunzation (*Common Side Effects & Contraindications*) - answerSwelling &
Tenderness at injection site
Fever
Immunization (*Contraindications*) - answer*Contraindications*
-Severe febrile illness
-Previous severe allergic reaction
Minor illness and common cold are not contraindications
*Severe febrile illness is contraindication for all immunizations*
Don't administer live-lev vaccine such as varicella and MMR for immunocompromise
kids.
Immunization (*Nursing Administration Considerations*) - answerObtain *consent*
,*Document date, route, site of immunization, lot number, expiration date*
Provide *atraumatic care*, and age appropriate play/distractions, topical anesthetic
Be prepared for emergencies
Provide documentation/record for parents
*Education* on what to watch for after administration
Avoid aspirin use to treat fever
after a live vaccine (VAR & MMR) due to risk of developing *Raye syndrome*
-swelling of the liver & brain
Report adverse reactions to *Vaccine Adverse Event Reporting System* (VAERS)
combine top slide and below comments
Communicable Diseases - answerCan be transmitted via:
-contact
-droplet (3 ft)
-airborne (N95)
Can be prevented with immunizations
-And Personal protective equipment in in-patient settings!
Communicable Diseases (*Risk Factors*) - answerImmunocompromised, poor nutrition,
circulation
Environmental
Chronic illness
Recent exposure
Not immunized or Up-to-date
Communicable Diseases (*Nursing Care & Management*) - answerIsolate
Antipyretics, analgesics
Skin care if applicable
Play, rest, ambient environment
, *Medications* (ensure compliance!)
-*Antihistamines*
-*Antibiotics, antivirals*
-*NSAIDs or acetaminophen*
*Education* on preventing spread of infection, red flags, and documentation on when to
return to normal activity/school
Sepsis & Septic Shock - answer*Sepsis or systemic inflammatory response syndrome*
(SIRS)
Infection in the blood stream
-Group B strep
-E. coli
-Staph
-H. influenzae
Sepsis & Septic Shock (*At Risk*) - answerBurns
Multiple surgeries
Invasive catheters
Compromised immune system
Long-term antibiotics
Sepsis & Septic Shock (*So what happens?*) - answerInflammation and coagulation
inhibit fibrinolysis (breakdown)-> *disseminated intravascular coagulation* (DIC)
*Fibrinolysis:* is a process that prevents blood clots from growing
*DIC:* abnormal coagulation involve formulation of multiple small clots that consume
clotting factors and fibrinogen faster than the body produced leading to bleeding
Vasodilation, or constriction leads to hypoxia and ultimately multi system dysfunction
-hypoxemia 1st
-hypoxia after (tissue)
Signs of Sepsis (*Early*) - answerFever or hypothermia
Tachycardia
Tachypnea
