BROWARD COLLEGE NUR 1310 EXAM 2 OUTLINE 2 PEDS QUESTIONS
AND ANSWERS | COMPLETE PEDIATRIC NURSING STUDY GUIDE
2026/2027
EXAM 2
UNIT 4: HEALTH PROMOTION OF PEDIATRIC PATIENT=↓ communicable disease & epidemics
IMMUNIZATIONS (p.350)=↑quality of life for children. inject w/vaccine/toxoid » develop antibodies (1)
against specific (2nd expose to dis) organism » active immunity
Parents may not maintain a sked due to lack of knowledge
Schedule reviewed annual by CDC & American Academy of pediatrics=recommendations not rules.
Health promo during infancy includes discussion of all childhood immunizations
TYPES OF VACCINES
Live Vaccine=live when they go into body
Dead Vaccine=capable of producing antibodies
Toxoid=txted w/ chemicals & heat
Recumbent=genetically altered
Conjugated=combined w/ another substance to produce desired effects
TYPES OF IMUNIZATIONS
HEPATITIS B (HBV) birth, 1-2 mos, 6-18 mos
Side effects - ↑ liver enzymes, photophobia
Look for local rxn: pain, heat, redness at site
(Birth, 1-2 mths, 6-18 mths)=Only 2 sites recommended Birth – Lateralis & toddler. Children Adolescent
are given– deltoid
At Birth
1st is given to all infants at birth before baby leaves the hospital (monovalent Hep B)
mom=hep B surface antigen (HSaAG+) baby also given Hep B immune globulin (HBIG) w/in 12 hrs
birth. (IgG provides more immediate affects)
mom’s status unknown monovalent HepB is given w/in 12hrs, moms Hep B status is checked & if
HSaAG + HBIG is given as soon as possible (NO LATER THAN AGE 1
WK) Aft the Birth dose
Hep B series should be complete w/either monovalent Hep B or a combination vaccine containing Hep B.
2nd dose should be admin age 1-2mths. The final dose should be admin no earlier than age 24 wks
(recommend 6-18 mths). Infants born to mothers w/ Hep B should be tested for HBsAg & antibody to
HBsAG aft completion of at least 3 doses of Hep B series, at age 9-18 mths (next well baby check- up)
4 mth dose (some-times 4 doses)
It is permissible to admin 4 doses of Hep B when combination vaccines are admin aft the birth dose. If
monvalent Hep B is used for doses aft birth a doses at age 4 mths is not needed.
7-18yrs Hep B schedule (catch –up)
Admin the 3-dose series to those who were not previously vaccinated.
A 2-dose series of Recombivax HB* is licensed for children aged 11-15 yrs.
Pathophysiology
Disease: lead to fatal consequences from cirrhosis or liver cancer as adult.
Late 90’s HepB had thimerosal thought to cause mercury poison. Now preservative free HepB
(Recombivax) is avail.
,DIPTHERIA, TETANUS, PERTUSSIS (DTaP) [Lg. letter = full dose; sm. Letter = sm. Dose]
2, 4, 6 & 15-18mths then 4-6yrs,(booster) 11-12 (Tdap) minimum age: 6 w k sg ne o1 t indicated for > 7
Pa
yrs
Given IM, side effects – local pain, edema, febrile, few hours to a few days
DIPTHERIA also given DT, Td. (complete immunity not achieve, only protect antitoxin be repeat 10 yrs)
o Pathophysiology
, Respiratory manifestations=obstructive laryngotracheitis Cutaneous=vaginal,
otic, conjunctival skin lesions (seen in tropics) Incubation 2-5 days
Txt w/ abx (penicillin/erythromycin), complete BR, tra ch
Resemble common cold, serosanguineous mucopurulent nasal dscharge, malaise, anorexia, sore
throat, ↓ grade fever, ↑pulse, lymphadenitis, toxemia if severe, hoarse, cough
TETANUS = tetanus toxoid (toxoid usually given), tetanus antitoxin (horse not used in US), tetanus
immune globulin (immediate effects) Given 1st series then 10 yrs later
Clean Wounds
< 3 dose →Td given 3
dose » nothing
Dirty Wound (lg dose tetanus small dose diphtheria)
< 3 dose →Td & Tig given 3
dose→Tig given
Pathophysiology
For wound mgt passive immunity is available w/ TIG
>7 who req wound prophylaxis may admin Td (adult diphtheria & tetanus toxiods)
PERTUSSIS may cause local rxn: tenderness, fever; or generalized: convulsion, shock, stroke, coma
Pathophysiology
Whole cell pertusis (from inactive cells of Bordetella pertusis & contains multi antigens)
▪ Acellula= highly purified accellurlar vaccine is assoc w/fewer local & systematic rxns.
Catarrhal stage: Symptoms of URI, sneezing, ↓ grade symptom, hacking cough
Paroxysmal stage, cough at night, short rapid cough follow by sudden inspiration w/ hi
pitch crowning sound like whoop, cheek flush or cyanotic, eyes bulge, tongue protrudes
Infants <6 mos may not whoop.
Incubation 6-20 days Abx,
↑ oxygenation
May cause OM, seizures, hemorrhage, wt loss, hernias, prolapsed rectum
4th dose DTaP may be admin as early as age 12 mths provided 6 mths has elapsed since the 3rd dose.
Admin the final dose in the series at age 4-6 yrs.
• Tdap (7-18yr) min age: 10yrs for BOOSTRIX & 11yrs for ADACEL
• Admin age 11-12yrs for those who complete recommend DTP/DTaP vaccine series & have not receive
tetanus & diphtheria toxoids (Td) booster dose.
• 13-18 (catch-up) miss 11-12yr Tdap or rec Td only=encourage to receive 1 dose Tdap 5 yrs aft last dose
HAEMOPHILUS INFLUENZA TYPE B (HIB) 2, 4, 6 mos 12-15 mos minimum age 6 wks
IM, protects against meningitis epiglottitis, bacterial pneumonia, septic arthritis & sepsis,
pain at site & redness, ↓ grade fever
Made of an Egg base, don’t give if allergic to egg, or neomycin
If PRP-OMP (PedvaxHIB or ComVax (MERECK) admin 2 & 4 mths, dose at 6 mths is not req.
TriHIBit (DTaP/Hib) comb product not used for prime immunizations, can give as booster follow any
Hib vaccine age 12 mth or older.
Page2
INFLUENZA minimum age 6 mos-5 yrs and yearly
2 doses, 2 wks apart beginning 6 mos.
Yearly ages 6mths to 5yrs--- aft than to high risk groups
egg base don’t give to pts allergic to eggs or neomycin
AND ANSWERS | COMPLETE PEDIATRIC NURSING STUDY GUIDE
2026/2027
EXAM 2
UNIT 4: HEALTH PROMOTION OF PEDIATRIC PATIENT=↓ communicable disease & epidemics
IMMUNIZATIONS (p.350)=↑quality of life for children. inject w/vaccine/toxoid » develop antibodies (1)
against specific (2nd expose to dis) organism » active immunity
Parents may not maintain a sked due to lack of knowledge
Schedule reviewed annual by CDC & American Academy of pediatrics=recommendations not rules.
Health promo during infancy includes discussion of all childhood immunizations
TYPES OF VACCINES
Live Vaccine=live when they go into body
Dead Vaccine=capable of producing antibodies
Toxoid=txted w/ chemicals & heat
Recumbent=genetically altered
Conjugated=combined w/ another substance to produce desired effects
TYPES OF IMUNIZATIONS
HEPATITIS B (HBV) birth, 1-2 mos, 6-18 mos
Side effects - ↑ liver enzymes, photophobia
Look for local rxn: pain, heat, redness at site
(Birth, 1-2 mths, 6-18 mths)=Only 2 sites recommended Birth – Lateralis & toddler. Children Adolescent
are given– deltoid
At Birth
1st is given to all infants at birth before baby leaves the hospital (monovalent Hep B)
mom=hep B surface antigen (HSaAG+) baby also given Hep B immune globulin (HBIG) w/in 12 hrs
birth. (IgG provides more immediate affects)
mom’s status unknown monovalent HepB is given w/in 12hrs, moms Hep B status is checked & if
HSaAG + HBIG is given as soon as possible (NO LATER THAN AGE 1
WK) Aft the Birth dose
Hep B series should be complete w/either monovalent Hep B or a combination vaccine containing Hep B.
2nd dose should be admin age 1-2mths. The final dose should be admin no earlier than age 24 wks
(recommend 6-18 mths). Infants born to mothers w/ Hep B should be tested for HBsAg & antibody to
HBsAG aft completion of at least 3 doses of Hep B series, at age 9-18 mths (next well baby check- up)
4 mth dose (some-times 4 doses)
It is permissible to admin 4 doses of Hep B when combination vaccines are admin aft the birth dose. If
monvalent Hep B is used for doses aft birth a doses at age 4 mths is not needed.
7-18yrs Hep B schedule (catch –up)
Admin the 3-dose series to those who were not previously vaccinated.
A 2-dose series of Recombivax HB* is licensed for children aged 11-15 yrs.
Pathophysiology
Disease: lead to fatal consequences from cirrhosis or liver cancer as adult.
Late 90’s HepB had thimerosal thought to cause mercury poison. Now preservative free HepB
(Recombivax) is avail.
,DIPTHERIA, TETANUS, PERTUSSIS (DTaP) [Lg. letter = full dose; sm. Letter = sm. Dose]
2, 4, 6 & 15-18mths then 4-6yrs,(booster) 11-12 (Tdap) minimum age: 6 w k sg ne o1 t indicated for > 7
Pa
yrs
Given IM, side effects – local pain, edema, febrile, few hours to a few days
DIPTHERIA also given DT, Td. (complete immunity not achieve, only protect antitoxin be repeat 10 yrs)
o Pathophysiology
, Respiratory manifestations=obstructive laryngotracheitis Cutaneous=vaginal,
otic, conjunctival skin lesions (seen in tropics) Incubation 2-5 days
Txt w/ abx (penicillin/erythromycin), complete BR, tra ch
Resemble common cold, serosanguineous mucopurulent nasal dscharge, malaise, anorexia, sore
throat, ↓ grade fever, ↑pulse, lymphadenitis, toxemia if severe, hoarse, cough
TETANUS = tetanus toxoid (toxoid usually given), tetanus antitoxin (horse not used in US), tetanus
immune globulin (immediate effects) Given 1st series then 10 yrs later
Clean Wounds
< 3 dose →Td given 3
dose » nothing
Dirty Wound (lg dose tetanus small dose diphtheria)
< 3 dose →Td & Tig given 3
dose→Tig given
Pathophysiology
For wound mgt passive immunity is available w/ TIG
>7 who req wound prophylaxis may admin Td (adult diphtheria & tetanus toxiods)
PERTUSSIS may cause local rxn: tenderness, fever; or generalized: convulsion, shock, stroke, coma
Pathophysiology
Whole cell pertusis (from inactive cells of Bordetella pertusis & contains multi antigens)
▪ Acellula= highly purified accellurlar vaccine is assoc w/fewer local & systematic rxns.
Catarrhal stage: Symptoms of URI, sneezing, ↓ grade symptom, hacking cough
Paroxysmal stage, cough at night, short rapid cough follow by sudden inspiration w/ hi
pitch crowning sound like whoop, cheek flush or cyanotic, eyes bulge, tongue protrudes
Infants <6 mos may not whoop.
Incubation 6-20 days Abx,
↑ oxygenation
May cause OM, seizures, hemorrhage, wt loss, hernias, prolapsed rectum
4th dose DTaP may be admin as early as age 12 mths provided 6 mths has elapsed since the 3rd dose.
Admin the final dose in the series at age 4-6 yrs.
• Tdap (7-18yr) min age: 10yrs for BOOSTRIX & 11yrs for ADACEL
• Admin age 11-12yrs for those who complete recommend DTP/DTaP vaccine series & have not receive
tetanus & diphtheria toxoids (Td) booster dose.
• 13-18 (catch-up) miss 11-12yr Tdap or rec Td only=encourage to receive 1 dose Tdap 5 yrs aft last dose
HAEMOPHILUS INFLUENZA TYPE B (HIB) 2, 4, 6 mos 12-15 mos minimum age 6 wks
IM, protects against meningitis epiglottitis, bacterial pneumonia, septic arthritis & sepsis,
pain at site & redness, ↓ grade fever
Made of an Egg base, don’t give if allergic to egg, or neomycin
If PRP-OMP (PedvaxHIB or ComVax (MERECK) admin 2 & 4 mths, dose at 6 mths is not req.
TriHIBit (DTaP/Hib) comb product not used for prime immunizations, can give as booster follow any
Hib vaccine age 12 mth or older.
Page2
INFLUENZA minimum age 6 mos-5 yrs and yearly
2 doses, 2 wks apart beginning 6 mos.
Yearly ages 6mths to 5yrs--- aft than to high risk groups
egg base don’t give to pts allergic to eggs or neomycin
