Module 5 Learning Guide Learning Outcomes • Outline side effects, precautions, contraindications, and injection method for immunizations, as well as required education. • o Mild fever o Redness and swelling at site (apply cold pack) o Influenza- allergy to eggs o MMR- allergy to Neomycin (cause arthritis) o Hep B- allergy to yeast o IPV (polio)- allergy to neomycin Determine recommended vaccinations for child’s age. Birth- Hep B 2months- BDRHIP -HEP B 1 -DTAP -ROTAVIRUS -HIB -INACTIVATED POLIO -PNEUMOCOCCAL 4months- DRHIP 6months-DRHIP + INFLUENZA 12months- MADHPV -MMR -HEP A -DTAP -HIB -PNEUMOCCAL -VARICELLA 4-6 years-VERYDIM -VARICELLA -DTAP -INFLUENZA -MMR 11-12 years- MITH -MMR -INFLUENZA -TDAP -HPV 16-18 years-MEN -MENINGITIS • Differentiate clinical manifestations of common childhood communicable diseases. • Determine nursing management for common childhood communicable diseases. 2 How can nurses make help decrease the number of hospital-acquired infections (HAIs) experienced by children? What are common side effects of immunizations? o Mild fever o Redness and swelling at site (apply cold pack) Explain the difference between a precaution and contraindication in regard to immunization. o Contraindication- increases the risk for serious adverse reaction. Vaccine should not be administered o Precaution- MAY increase the risk of an adverse reaction or that may compromise the ability of the vaccine to produce immunity What is the vaccine information statement (VIS) and how is it used? o Vaccine information Statement- document from CDC that informs vaccine recipients about the benefits and risks of a vaccine o Give before every vaccine and every dose Provide nursing assessment and management for: • Chickenpox (varicella) • • • • Nursing Assessment • Nursing Management Diphtheria • Nursing Assessment • Nursing Management Erythema infectiosum (fifth disease) • Nursing Assessment • Nursing Management Exanthem subitum (roseola infantum) • Nursing Assessment 3 • • • • • • • • • Nursing Management Mumps • Nursing Assessment • Nursing Management Pertussis (whooping cough) • Nursing Assessment • Nursing Management Poliomyelitis • Nursing Assessment • Nursing Management Rubella (German measles) • Nursing Assessment • Nursing Management Scarlet fever • Nursing Assessment • Nursing Management Acute conjunctivitis • Nursing Assessment • Nursing Management Stomatitis • Nursing Assessment • Nursing Management Intestinal parasitic diseases • Nursing Assessment 4 • • Nursing Management Bedbugs • Nursing Assessment • Nursing Management Chapter 6: Childhood Communicable and Infectious Disease - Case Studies (from Evolve) Case #1 1. Kyle, age 5 years, is in kindergarten. Kyle's mother calls the school nurse to report that he "broke out" with chickenpox last night. Kyle was in school yesterday. Kyle's mother says, "I'm glad he broke out at night so he can't give it to the other children." The nurse's response should be based on knowledge that chickenpox a. is not very contagious. b. is only spread by direct contact with lesions. c. probably can be transmitted to others 1 day before eruption of lesions. d. probably can be transmitted to others 5 or 6 days before eruption of lesions. 2. Kyle's mother asks what she can do to minimize itching. The most appropriate recommendation is to a. avoid overheating. b. take frequent warm baths with mild soap. c. expose child to sunlight if weather permits. d. apply thick coat of calamine lotion over open lesions. 5 3. Kyle's mother asks the nurse, "Is it OK for him to scratch the rash?" When teaching Kyle’s mother about home care, the nurse tells her to prevent scratching because scratching: a. increases the risk of contagion and communicability. b. causes increased spread of chickenpox lesions. c. prolongs varicella symptoms such as fever. d. increases secondary infection and scarring. 4. The nurse should tell Kyle's mother that he can return to school a. in 3 days. b. in 14 days. c. when all lesions are crusted. d. when he stops getting new lesions. Case #2 1. Taylor, a 5-year-old boy, comes to the clinic. He has never had any immunizations. According to the recommendations by the American Academy of Pediatrics (AAP) and the Center for Disease Control and Prevention (CDC), what vaccines should be administered today? Hint: https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html 6 2. When should Taylor return for the next immunizations? 3. The mother reports that Taylor once developed a contact dermatitis related to neomycin. The nurse notes that the MMR contains a minute amount of neomycin. What is the correct action when giving vaccines to Taylor? 4. What information regarding vaccine administration must be documented? 5. Before administering the next pertussis vaccine, it is important to ask the parent or guardian about contraindications and precautions to pertussis vaccine. What are the contraindications and precautions? Case #3 1. Sally is a 6-year-old girl who is being seen for her well-child examination. During the assessment, the nurse notices several round scaly patches in her scalp. Sally's mother states they have gotten worse in the past month and that Sally seems to be losing her hair where the patches are located. What is the most likely cause of Sally's scalp lesions? a. Fungal infection b. Bacterial infection c. Mosquito bite d. Viral infection 7 2. Sally's mother is worried about the other two younger children and hopes that they will not get the lesions. Name four things that would be important to instruct Sally's mother at this time. 3. Sally’s pediatrician decides to treat her with griseofulvin. What are important considerations to teach Sally’s mother about this medication? 4. REMEMBER: Health care providers are experts on health care; families are experts on the child and child’s response to illness Don’t forget to review the Key Point Summary at the end of the chapter (available on Evolve). 8