Pediatrics Exam 2 2023 Updates

PEDIATRICS EXAM 2 2023 UPDATES Exam 2: Pediatrics  Chapter 6: Childhood Communicable/Infections Diseases/Immunization Schedule Good way to remember the first 6 months B (Hep B) D (Dtap) R(rotavirus) H (Hib) I(IPV)P (PCV) Birth: B 2 Months: B DR ROTA HIP 4 Months: DR ROTA HIP 6 Months: B (to 18 months) D (then at 15 months) R ROTA (teq) HIP (then at 12 To 15 months) Recommended Schedule (pg 171) • Hepatitis B o Birth, 1 to 2 months, then at 6 to 18 months (3 Doses) o If mother is positive or status is unknown give both hep b and HBIG (immunoglobin) within 12 hours o Do NOT give to infants less than 2000 grams (4.4 lbs) until one month of age o Review: This is spread via sex and blood products, symptoms will be liver dysfunction • Hepatitis A o Give at 1 year of age and then 6 months after [around 19 to 23 months)) (2 Doses) • TdaP (older kids) o Give combination of tetanus and pertussis vaccines) (younger than 11 years of age o This is a booster shot for those who have already completed the DdaP • DdaP (younger kids) o Give at 2, 4, 6 and 15 months (4 Doses) o Combination of tetanus and pertussis vaccines for less than 7 years of age • Pneumococcal (PVC13) o Give at 2, 4, 6 and 12 to 15 months (4 Doses) • Rotavirus o Give at 2, 4, 6 months (3 doses) for RotaTeq ▪ Do not give after 32 weeks o Give at 2 and 4 months (2 Doses) for Rotarix o Both medications are given orally o If infection occurs, still complete series • Polio o Give at 2, 4, 6 to 18 months, and 4 to 6 years of age (4 Doses) • MMR (Measles, Mumps, Rubella) (all well have droplet/contact precautions) o Given at 12 to 15 months of age and at 4 to 6 years of age (2 Doses) o Woman should be taught to avoid pregnancy for 28 days after vaccine o DO NOT administer if pregnant o The MMR vaccine may cause thrombocytopenia in some cases o Measles Vaccine is contraindicated for pt with allergies to neomycin or eggs • Varicella o Give at 12 to 16 months and 4 to 6 years (2 Doses) o Keep the vaccine frozen in the lyophilic form o Use within 30 minutes of being reconstituted to ensure viral potency o Administer with MMR (separate syringes and sites) o Must wait at least one month if MMR and Varicella are administered separately o SubQ injection • Influenza o Give at 6 months then 2 weeks' apart for first time receipts that are younger than 9 years of age o The vaccine is administered in early fall before the flu season begins and is repeated yearly for ongoing protection o Given via IM o The dose is 0.25 ml for children 6 to 35 months old and 0.5 ml for children 3 years old and older. An intradermal form of IIV has been licensed for persons 18 to 64 years of age o Can be given with other vaccines but in a separate syringe and at a separate site • Menactra (Meningococcal Disease) o Give at 11 to 12 years of age then booster at 16 to 18 years • HPV (Gardasil 9) o Administer via IM in deltoid muscles o Give at 11 to 12 years of age, second dose 1 to 2 months after, and third dose give 6 months after the first dose (3 Doses) o Contraindicated for those who have yeast sensitivity, neomycin allergy, (confirm) Live Vaccines (Varicella, MMR, Rotavirus) Documentation (Lot number, route, time/date, Site Administered, Vaccine information statement with side effects and when to contact MD (VI statement),