Chapter 31: Vaccines
The nurse is discussing vaccines with the mother of a 4-year-old child who attends a day care center
that requires the diphtheria, tetanus, acellular pertussis (DTaP) vaccine. The mother, who is pregnant,
tells the nurse that she does not want her child to receive the pertussis vaccine because she has
heard that the disease is "not that serious" in older children. What information will the nurse include
when discussing this with the mother?
a. If she gets the vaccine, both she and her 4-year-old child will be protected.
b. If the 4-year-old child contracts pertussis, it can be passed on to her newborn.
c. The vaccine will not be given to her child while she is pregnant.
d. Vaccinating the 4-year-old will provide passive immunity for her unborn child. - ✔✔ANS: B
Even though pertussis is not as serious in older children, it is important to vaccinate children to
prevent the spread of the disease to infants and others who are not immunized and who are at risk for
significant morbidity and mortality from this disease. Vaccinating the mother will not protect the
4-year-old from getting pertussis. The DTaP vaccine may be given to children whose mothers are
pregnant. Vaccinating the child does not confer passive immunity to the unborn child.
A woman who is pregnant tells the nurse she has not had any vaccines but wants to begin so that
she can protect her unborn child. Which vaccine(s) may be administered to this patient?
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a. Human papillomavirus (HPV) quadrivalent vaccine (Gardasil)
b. Trivalent influenza vaccine
c. Measles-mumps-rubella (MMR) vaccine
d. Varicella vaccine - ✔✔ANS: B
The influenza vaccine is recommended for pregnant women and should be given. Gardasil is given to
young women who are not yet sexually active. The MMR is contraindicated because rubella can
cause serious teratogenic effects. Varicella is contraindicated during pregnancy.
A 4-year-old child is receiving amoxicillin (Amoxil) to treat otitis media and is in the clinic for a
well-child checkup on the last day of antibiotic therapy. The provider orders varicella (Varivax);
measles-mumps-rubella (MMR); inactivated polio (IPV); and diphtheria, tetanus, and acellular
pertussis (DTaP) vaccines to be given. Which action by the nurse is correct?
a. Administer the vaccines as ordered.
b. Discuss giving the MMR vaccine in 4 weeks.
c. Hold all vaccines until 2 weeks after antibiotic therapy.
d. Recommend aspirin for fever and discomfort. - ✔✔ANS: A
Antibiotic therapy is not generally a contraindication to the use of vaccines. Vaccines may be given in
cases of mild acute illness or during the convalescent phase of an illness. All four vaccines may be
stuvia