CMN 571 Immunizations Exam Questions with Correct Answers

CMN 571 Immunizations Exam Questions with Correct Answers Immunization given @ birth - Answer-Hep B (B=HepB) Immunizations @ 2 mths - Answer-HepB, DTaP, RV, Hib, IPV, PCV (2 B Dr Hip) Immunizations @ 4 mths - Answer-DTaP, RV, HiB, IPV, PCV (4 Dr Hip) Immunizations @ 6 mths - Answer-HepB, DTaP, RV, Hib, Influenza (yrly) PCV, IPV (B Dr Hip In 6mths) Immunizations @ 1-1.5 yrs - Answer-MMR, HepA, DTaP, Hib, PCV, Varicella (1 MAD HPV) Immunizations @ 4-6 yrs - Answer-Varicella, DTaP, IPV, MMR (Very Dim 4-6pm) What is the required vaccination documentation? - Answer-Vaccine manufctr, lot #, administration date, expiration date, VIS version & date, site, & route. Hay pg 249 What can be done to alleviate pain in the injection site? - Answer-5% topical eumulsion of lidocaine-prilocaine applied to site for 30-60 min prior to injection. Preferred vaccination site for newborns up to 2 yo - Answer-anterolateral thigh Hay 249 Preferred vaccination site for 3 - 18 yo - Answer-Deltoid muscle (although anterolateral is acceptable. Hay 249 Needle size & location - Answer-5/8" in newborns-thigh 1" in infants 1-12 mo-thigh 1 or 1-1/4" in 1-18yo - thigh 5/8"-1" in 1-18yo - deltoid - Hay 249 Which vaccines are live-virus? - Answer-MMR, VAR, Live attenuated influenza, - if not administered on the same day, should be given at least 4 wks apart - Hay 250 How long should live-virus vaccination be delayed if an immunoglobulin (1g) or blood product was given? - Answer-3-11 months Hay pg 250 What is Active Immunity? - Answer-Resistance developed in response to infection with an agent resulting in antibody production. Active immunity is usually permanent. Can be either naturally acquired thru exposure and infection with the disease or artificially acquired thru immunization. Onset is 2-4 wks and duration is years to lifetime. - Dr. Lang's reading assignments What is Passive Immunity? - Answer-A person is given antibodies to a disease rather than producing them through his or her own immune system. This is short-term immunity through introduction of antibodies to a disease Can occur naturally as in the passage of antibodies from the mother to the fetus during pregnancy or artificially acquired through injection of antibodies such as gamma globulin. Onset is within 24 hrs of the dose and duration is about 4-6 mths. Dr. Lang's reading assignments What is a Herd Immunity? - Answer-This occurs when a significant portion of the population is vaccinated and that provides a portion of immunity for those that have not developed immunity. The population (herd) helps prevent disease in the unprotected population. The herd protects those who can not safely get vaccinations. Dr. Lang's Reading assignments What % of the population should be vaccinated to have effective herd immunity? - Answer-90-95% - Dr. Lang's reading assignments What paperwork is required to review with the caregiver/parent before vaccination administration? - Answer-Vaccine Information Sheets (VIS) for each vaccine given. Obtain from CDC website. Dr. Lang's notes. As a rule, vaccinations should not be stored frozen except for which ones? - Answer- Varicella containing vaccines; MMRV, VAR, herpes zoster. Hay pg 250 If a child has a minor acute illness with or without low-grade fever, should vaccination be postponed? - Answer-No. Not a contraindication for vaccination. Hay pg 255 Should a child with a chronic disease be vaccinated? - Answer-Yes. chronic illness is not a contraindication for vaccination. Child may be at greater risk of complications from vaccine preventable diseases. Hay pg 255 Vaccine doses should note be reduced for preterm or low birth-weight infants with one exception. What is that exception? - Answer-Children with progressive central nervous system disorders. Vaccination with DTaP should be deferred until the neuro condition has been clarified and is stable. Hay pg 255 Should congenitally immunodeficient children be immunized with live-virus or live- bacteria vaccines? - Answer-No - Live virus vaccines - oral polio (only in developing countries), rotavirus, MMR, VAR, MMRV, yellow fever or LAIV. Live bacteria vaccines are BCG or live typhoid fever. Hay pg. 255 Should children with cancer receiving high-dose corticosteroids or other immunosuppressive agents be immunized with live-virus or live-bacteria vaccines? - Answer-No - Contraindication does not apply if cancer is in remission & chemo has not been administered for at least 90 days. Hay pg 255 Live-virus vaccines can be administered to children receiving low-mod dose corticosteroids for less than 14 days. What is the dosage? - Answer-Defined as up to 2 mg/kg/day of prednisone or equivalent, with a 20 mg/day max. Hay pg 255 What is the difference between DTap and Tdap? - Answer-. The pediatric formulation will have about 3-5 times the amount of diphtheria component compared to the adult formulation. Therefore, you will see it indicated with an upper-case "D" (DTaP) and lower-case "d" in the adult formulation (Tdap, Td). Think of it like this, DTaP helps young children develop immunity to diphtheria, tetanus, and (whooping cough) pertussis. Tdap served as a "booster" for continued protection. Dr. Townsend Forum How many HepB doses does a child need before 6yo and which months are they recommended? - Answer-3 doses recommended at birth, 1-2mos & 6-18 mos - Hay Table 10.2 How many Rotovirus (RV) doses are recommended before 6 yo and which months? - Answer-2 doses if RV1 (Rotorix) is used. Mos 2 & 4. 3 doses if RV5 (RotoTeq) is used. Mos 2,4, & 6. Hay Table 10.2 How many DTaP doses are recommended <6yo and which months? - Answer-5 doses given at 2,4,6, 15-18 mos & last dose 4-6yo Hay Table 10.2 How many Hib (Haemophilus Influenzae type b are recommended <6yo & which months? - Answer-Hib is a 2-3 dose vaccine with a booster. Dose #1 & #2 are both given at 2 & 4 mos. If a third dose is needed it is given @ 6 mos. Booster is given @ 12- 15 mos. Hay Table 10.2