immunization

Question 1

what is immunity?

Answer 1

• body’s ability to resist disease
• can be:
  innate
  acquire
  - active (natural contact w antigen or artificial
  immunization w antigen)
  - passive (natural transplacental and colostrum
  mediated or artificial inj of serum from
  immune human)

Question 2

what are vaccines? what are vaccines suspensions of?

Answer 2

• primary prevention measure
• increases resistance to infections
• inactive component added to enhance effectiveness and safety

1) live microorganism
2) attenuated (weakened) microorganism
3) killed (inactivated) microorganism

Question 3

what is the effectiveness of vaccines?

Answer 3

• protects against 14 serious disease
• 90% protection against disease
• community immunity (herd immunity)
• higher rate of vaccination = low disease outbreak

Question 4

what is the safety related to vaccines?

Answer 4

• no reaction in most cases
• severe reaction = rare
• no live vaccine to immunocompromised pt
• vials have synthetic tubber that prevent latex allergy
• anergy screening after full cancer treatment (diagnostic procedure used to obtain information regarding the competence of the cellular immune system: TB)

Question 5

myths r/t vaccines?

Answer 5

• causes autism
• disease doesnt exist anymore, so i don’t have to vaccinate

Question 6

guiding principle to vaccination scheduling?

Answer 6

• give at age when risk of contracting disease is highest
• must be effective at age its given
• nmbr of doses must result in ST protection
• must be given at age when it causes the least symptoms
• need and timing for a booster needs to be evaluated to ensure LT protection
• all children including premature infants should start being vaccinated by chronological age of 2

Question 7

QIP

Answer 7

CHECK CHART

Question 8

what is RN accountable for regarding vaccination?

Answer 8

• strong knowledge and awareness of ressource
• understanding of risk and contraindications
• support of prevention programs
• incidental teaching in hospitalized cl
• participate in vaccination program
• answer FAQ abt communicable diasease and immunization
• avoid judgemental attitudes

Question 9

what is RN accountable for regarding vaccination?

Answer 9

• strong knowledge and awareness of ressource
• understanding of risk and contraindications
• support of prevention programs
• incidental teaching in hospitalized cl
• participate in vaccination program
• answer FAQ abt communicable diasease and immunization
• avoid judgemental attitudes

Question 10

how did bill 90 increase scope of practice?

Answer 10

• independent decision making re vaccination in accordance w QIP
• assessment + remain on site and be accessible
• document: date, vaccine, route, dose, site used, lot #, exp date
• report adverse effets to canadian adverse effects following immunization surveillance system (CAEFISS)

Question 11

what is your role?

Answer 11

• ask if vaccines up to date
• check if pt exposed to chicken pox or measles at daycare, school or home. if yes= place pt under additional precautions during incubation period (8-21 days)
• refer to vaccination calendar
• suggest seasonal synagis and yearly influenza immunization for at risk pt

Question 12

what can the LPN do?

Answer 12

• participate in collection of pre-vaccination information
• prep and inject
  monitor post vaccination and apply emergency measures

Question 13

what are the principles for vaccine administration?

Answer 13

• proper storage
• expiry date
• im injections = vastus lateralis or ventrogluteal (deltoid if child over 18 mo and less than 1ml)
• dont use dorsogluteal
• dont withdraw plunger
• needle length based on age
• topical anastehtic agent (EMLA)
• sucrose 24% solution on pacifier for infant
• give deep into msk (better blood supply and less pain receptors

Question 14

contraindication for vaccine?

Answer 14

• severe anaphylactic type allergy to component of vaccine or to prior dose
• severe acute illness, unidentified diease (to not mask symp or progress of diease)
• fever
• pt who developed encephalopathy to other vaccines
• seizures, T more than 40c
• no MMR, for pregnant women (measles mumps rubella)
• allergies (eggs)
• withhold active immunologic products in prescence of URTI or other infection
• immunosupressed pt or cl in close household contact w immunosup pt -> no MMR , no oral polio no live
• dont give live attenuated vaccines and passive immunization at same time

Question 15

side effects of vaccines?

Answer 15

• pain/tenderness at inj site
• erythema/heat at inj site
• swelling at inj site
• low grade fever
• headache
• syncope
• anaphylactic shock (epinephrine readily available)
• behavioural changes
• observe client 15 min post vaccine

Question 16

what are some post vaccinationdiscomfort relief techniques?

Answer 16

• analgesic for pain: acetaminophen and ibuprofen (not for less than 6mo)
• dont give ASA to kids d/t risk of reyes syndrome
• cool cloth to injection site
• rest and fluids
• f/u w md of fever persists more 48h