Immune and Infectious Disorders:
Vaccines:
● Have the same antigen as the disease, but it is either
○ Killed
○ Weakened
● Therefore not strong enough to cause the disease.
● Memory cells are formed to protect from future exposures to that same infection.
● This is called immunity.
○ Tetanus
○ Diphtheria
○ Pertussis (Whooping Cough)
○ Haemophilus influenzae type b (Hib)
○ Polio
○ Hepatitis A
○ Hepatitis B
○ Rotavirus
○ Mumps
○ Measles
○ Rubella (German Measles)
○ Varicella (Chickenpox)
○ Pneumococcus
○ Meningococcus
○ Influenza
○ Human Papillomavirus (HPV)
● Complications:
○ Severe febrile illness: Immunizations contraindicated
○ Moderate/severe illnesses: precautions for immunization
○ Common cold and other minor illnesses: not contraindications to immunizations
○ Severely immunocompromised: Do not administer live virus vaccines, such as
varicella or MMR
○ A severe allergic reaction can occur in response to any vaccine
○ Further doses then contraindicated
● Nursing Administration:
○ Verify informed consent Provide vaccine information sheets (VIS)
○ Give IM immunizations in:
■ Vastus lateralis or ventrogluteal muscle in infants and young children
■ Deltoid muscle for older children and adolescents.
○ Give subcutaneous injections in
■ Outer aspect of the upper arm or anterolateral thigh.
○ Provide distraction
○ Apply topical anesthetic prior to injection
○ Give infants oral sucrose solution
○ Allow pacifiers/cuddling
, ○ After the procedure:
■ Apply cool compresses to injection site,
■ Gently move extremity
■ Provide praise
■ Apply a colorful bandage
○ Document the administration of the vaccine.
■ Date, route, and site of immunization
■ Type, manufacturer, lot number, and expiration date of the vaccine
○ Have emergency medications/equipment on standby in case of allergic response
○ Provide distraction
○ Apply topical anesthetic prior to injection
○ Give infants oral sucrose solution
○ Allow pacifiers/cuddling
○ After the procedure:
■ Apply cool compresses to injection site,
■ Gently move extremity
■ Provide praise
■ Apply a colorful bandage
● Nursing Education
○ Encourage maintenance of up-to-date immunizations for the child.
○ Instruct parents to avoid administering aspirin.
○ Instruct the parents and child to:
■ Observe for complications
■ Notify the provider if adverse effects occur
○ Nurses report any adverse reactions to the Vaccine Adverse Event Reporting
System.
Conjunctivitis
● Spread: Direct contact
● Viral: Clears on its own in 1-2 weeks
● Bacterial: Clears with antibiotics
● Allergic: Clears with allergy medications.
● Manifestations:
○ Pink or red color in the sclera of the eyes
○ Swelling of the conjunctiva
○ Excessive tearing
○ Yellow-green, purulent discharge from the eyes
○ Crusting of the eyelids in the morning
Epstein-Barr virus (EBV)/ mononucleosis
● Spread: Saliva
● Incubation: 30 to 50 days
○ Healthy people can carry EBV in saliva, transmitting the virus for a lifetime.
○ People who have mononucleosis can transmit for weeks.
● Manifestations:
○ Fever
○ Lethargy
Vaccines:
● Have the same antigen as the disease, but it is either
○ Killed
○ Weakened
● Therefore not strong enough to cause the disease.
● Memory cells are formed to protect from future exposures to that same infection.
● This is called immunity.
○ Tetanus
○ Diphtheria
○ Pertussis (Whooping Cough)
○ Haemophilus influenzae type b (Hib)
○ Polio
○ Hepatitis A
○ Hepatitis B
○ Rotavirus
○ Mumps
○ Measles
○ Rubella (German Measles)
○ Varicella (Chickenpox)
○ Pneumococcus
○ Meningococcus
○ Influenza
○ Human Papillomavirus (HPV)
● Complications:
○ Severe febrile illness: Immunizations contraindicated
○ Moderate/severe illnesses: precautions for immunization
○ Common cold and other minor illnesses: not contraindications to immunizations
○ Severely immunocompromised: Do not administer live virus vaccines, such as
varicella or MMR
○ A severe allergic reaction can occur in response to any vaccine
○ Further doses then contraindicated
● Nursing Administration:
○ Verify informed consent Provide vaccine information sheets (VIS)
○ Give IM immunizations in:
■ Vastus lateralis or ventrogluteal muscle in infants and young children
■ Deltoid muscle for older children and adolescents.
○ Give subcutaneous injections in
■ Outer aspect of the upper arm or anterolateral thigh.
○ Provide distraction
○ Apply topical anesthetic prior to injection
○ Give infants oral sucrose solution
○ Allow pacifiers/cuddling
, ○ After the procedure:
■ Apply cool compresses to injection site,
■ Gently move extremity
■ Provide praise
■ Apply a colorful bandage
○ Document the administration of the vaccine.
■ Date, route, and site of immunization
■ Type, manufacturer, lot number, and expiration date of the vaccine
○ Have emergency medications/equipment on standby in case of allergic response
○ Provide distraction
○ Apply topical anesthetic prior to injection
○ Give infants oral sucrose solution
○ Allow pacifiers/cuddling
○ After the procedure:
■ Apply cool compresses to injection site,
■ Gently move extremity
■ Provide praise
■ Apply a colorful bandage
● Nursing Education
○ Encourage maintenance of up-to-date immunizations for the child.
○ Instruct parents to avoid administering aspirin.
○ Instruct the parents and child to:
■ Observe for complications
■ Notify the provider if adverse effects occur
○ Nurses report any adverse reactions to the Vaccine Adverse Event Reporting
System.
Conjunctivitis
● Spread: Direct contact
● Viral: Clears on its own in 1-2 weeks
● Bacterial: Clears with antibiotics
● Allergic: Clears with allergy medications.
● Manifestations:
○ Pink or red color in the sclera of the eyes
○ Swelling of the conjunctiva
○ Excessive tearing
○ Yellow-green, purulent discharge from the eyes
○ Crusting of the eyelids in the morning
Epstein-Barr virus (EBV)/ mononucleosis
● Spread: Saliva
● Incubation: 30 to 50 days
○ Healthy people can carry EBV in saliva, transmitting the virus for a lifetime.
○ People who have mononucleosis can transmit for weeks.
● Manifestations:
○ Fever
○ Lethargy
