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Live Virus Vaccines
- Rubella
- Flu Shots
- Polio/Smallpox
- MMR
- Varicella (Chickenpox)
- Varicella Zoster (Shingles)
- Nursing Implications:
- Live virus vaccines should not be given to immunocompromised/immunosuppressed patients (Prednisone), or Pregnant women
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Hepatitis B Vaccine
- Class: Viral Vaccination
- Action: Produces Active Immunity by inducing antibody production
- Indications: To prevent infection & used simultaneously with Hep-B Immunoglobulin (HBIG) for post exposure prophylaxis
- Adverse Reactions: Mild local tenderness at injection site, local inflammatory reaction (Several Other Side Effects)
- Nursing Implications:
- Pregnancy/Lactation Safety has not been established.
- Use cautiously if patient has a compromised cardiopulmonary status, serious active infection, fever, thrombocytopenia/bleeding disorders
- Administer in the deltoid muscle in adults, vastus lateralis in neonates.
- Careful Aspiration should be used to assure that med avoids blood vessels
- Shake vial well before administering
- Monitor Temperature after administration (Some people develop a low grade fever that may last 1-2 days)
- Epinephrine should be readily available to treat possible anaphylaxis
- Store unopened vials at 36-46oF
- Avoid freezing(Destroys potency)
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Rubella Vaccine
- Live Virus Vaccine
- Injected SubQ in the upper outer aspect of arm
- Causes Active Immunity (Not communicable) through the formation of antibodies by the immune system
- Mothers may lose their immunity during pregnancy (Additional shot may be required to prevent rubella in mother and future babies)
- Adverse Reactions: lymphadenopathy, rash, urticaria, fever, malaise, sore throat, H/A, dizziness, nausea, vomiting, arthralgia, arthritis
- Contraindications: Immunocompromised individuals (Especially current respiratory or febrile infection) or individuals recieving immunosuppressive therapy such as Prednisone)
- Pregnancy
- Neomycin/Egg Allergies
- Nursing Implications:
- Travels through breast milk, but will not negatively effect the newborn (it will actually help them gain antibodies)
- Avoid pregnancy for 3 months after vaccination (Fetus may be affected by the live virus vaccine)
- Ask them if they are allergic to eggs or immunocompromised prior to administering
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Phytonadione (Vitamin K) Neonatal
- Initial dose given within 1 hour of birth to develop clotting factor
- Additional dose may be given if mother took anticonvulsives during pregnancy or if newborn shows bleeding tendencies
- Action: Promotes clotting factors 2(Prothrombin), 7, 9, & 10 by the liver. Provides vitamin K which is not synthesized in newborns intestine until 5-8 days after birth
- Indications: Prevention/Treatment of hemorrhagic disease of the newborn
- Adverse Reactions: Pain/Edema at injection site. Hemolysis or hyperbilirubinemia (especially in preterm infants or when large doses are used)
- Nursing Implications:
- Don't give to infants with severe liver disease
- Protect the drug from light until just before injection (Light makes it less potent)
- Apply gentle pressure after injection
- Assess newborn for vitamin K deficiency (Eccymoses or bleeding from any site)
- Give IM in Vastus Lateralis of the newborn
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Herd Effect
- Radicalization of communicable diseases due to a mass increase in Immunizations (Examples: Epiglottitis & Polio)
- A Negative herd effect can take place if masses of people stop getting vaccinations due to rumors, ect. The disease may come back strong, with an increase in incidents.
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