Immunizations and Vital Signs Peds Exam 1

16-18 years old

** Meningitis booster ** Influenza annually

Birth, 2-Week-Old to 1-Month-Old Infant

** Thimerosal-free Hepatitis B (Hep B) #1 at birth #2 at 1 to 2 months of age If planning to use a combination vaccine that contains Hepatitis B, wait until age 2 months for Hepatitis B (Hep B) #2

2 month old infant

DR. B. HIP ** Diphtheria, tetanus, & acellular pertussis (DTaP) #1 ** Rotavirus (RV) #1 ** Haemophilus influenzae type b (Hib) #1 ** Inactivated poliovirus (IPV) #1 ** Pneumococcal conjugate (PCV13) #1 #2 HEB B

The 6-Month-Old Infant

DR. B. HIP ** Hepatitis B (Hep B) #3 may be given between 6 and 18 months ** Diphtheria, tetanus, & acellular pertussis (DTaP) #3 ** Rotavirus #3 for RotaTeq (RV5) ** Hepatitis B (Hep B) #3 may be given between 6 and 18 months (if not in combination vaccine) ** Inactivated poliovirus (IPV) #3 ** Pneumococcal conjugate (PCV13) #3 ** Haemophilus influenzae type b (Hib) #3, depending on manufacturer ** Influenza vaccine can be given at 6 months and annually thereafter; give two doses initially, separated by at least 4 weeks

4 month old infant

DR. HIP **Diphtheria, tetanus, & acellular pertussis (DTaP) #2 **Rotavirus (RV) #2 **Haemophilus influenzae type b (Hib) #2 ** Inactivated poliovirus (IPV) #2 ** Pneumococcal conjugate (PCV13) #2

The parents of an infant ask for information about the vaccines their child is scheduled to receive at the upcoming four-month well visit. The nurse provides patient education handouts about which vaccine(s) typically administered at four months of age? Rotavirus (RV1) Inactivated poliovirus (IPV) Measles, mumps, rubella (MMR) Pneumococcal conjugate (PCV13) Haemophilus influenzae type b (Hib)

Rotavirus (RV1) Inactivated poliovirus (IPV) Pneumococcal conjugate (PCV13) Haemophilus influenzae type b (Hib) ALL BUT MMR

1-Year-Old Immunizations

MAD HPV ** Measles, mumps, rubella (MMR) #1 is given at 12 to 15 months. ** Hepatitis A (Hep A) #1 can be given any time after 12 months. Hep A #2 can be given at least 6 months after the first dose, but should be given by 23 months. ** Diptheria, tetanus, & acellular pertussis (DTaP) #4 is given at age 15 to 18 months. DTaP may be given as early as 12 months if at least 6 months have elapsed since the third dose. ** Haemophilus influenzae type b (Hib) may be given at 12 to 15 months of age. This is dose #3 or #4, depending on the vaccine used in prior doses. ** Pneumococcal conjugate (PCV13) #4 is given at 12-15 months. ** Varicella (VAR) #1 is given at 12 to 15 months. Influenza vaccine is given annually.

11- 12 years old

MITH ** Meningococcal conjugate vaccine #1. a booster dose at 16 years of age. ** Influenza vaccine given annually. ** Tetanus and diphtheria toxoids and acellular pertussis (Tdap) is given in one dose to all adolescents at 11 to 12 years of age. ** Human papillomavirus (HPV) #1, #2, and #3.

The 9-Month-Old Infant

Provide information about upcoming: ** measles, mumps, rubella (MMR) ** varicella (VAR) ** and Hepatitis A (Hep A) vaccines

The nurse is reviewing the immunization record for a healthy six-month-old patient at a well visit. The record indicates that the patient received all the recommended vaccines up to this point, including two doses each of RV1, PCV13, and DTaP. Which vaccine(s) should the nurse prepare for this visit? Rotavirus (RV1) Meningococcal Hepatitis B (Hep B) Inactivated poliovirus (IPV) Pneumococcal conjugate (PCV13) Diphtheria, tetanus, & acellular pertussis (DTaP)

Rotavirus (RV1) Hepatitis B (Hep B) Inactivated poliovirus (IPV) Pneumococcal conjugate (PCV13) Diphtheria, tetanus, & acellular pertussis (DTaP)

VITAL SIGNS: RESPIRATION RATE

Sherpath Lesson Infants (less than 1 year) 30-53 Toddler (1-2 years) 22-37 Preschool (3-5 years) 20-28 School-age (6-11 years) 18-25 Adolescent (12-18 years) 12-20

A healthy child is brought to the clinic for a 15-month well visit. The nurse notes that the toddler received haemophilus influenzae type b (Hib) #4; measles, mumps, rubella (MMR)#1; and pneumococcal conjugate (PCV13)#4 at the one-year visit. Which vaccination(s) will the nurse prepare for this visit? Varicella (VAR) Meningococcal B Measles, mumps, rubella (MMR) Pneumococcal conjugate (PCV13) Haemophilus influenzae type b (Hib) Diphtheria, tetanus, & acellular pertussis (DTaP)

Varicella (VAR) Diphtheria, tetanus, & acellular pertussis (DTaP)

4-6 Year Old Immunizations

Very DIM ** Varicella (VAR) #2 is given between ages 4 and 6 years unless previously given. If VAR was given before age 4, it is accepted as valid as long as it was administered at least 4 weeks after the previous dose. ** Diphtheria, tetanus, & acellular pertussis (DTaP) #5 is given between 4-6 years of age. For catch-up vaccinations, dose 5 of DTaP is not necessary if dose 4 is administered at or over 4 years of age. ** Inactivated poliovirus (IPV) #4 is given between 4 and 6 years and at least 6 months after the previous dose. This is the final dose in the series. ** Measles, mumps, rubella (MMR) #2 is given between 4 and 6 years of age unless previously given. ** Influenza vaccine is administered annually.

Active immunity

occurs when the body has been exposed to an antigen, either through illness or through immunization, and the immune system creates antibodies against the particular antigen. Active immunity generally confers long-term, and in some cases lifelong, protection against disease.

Passive immunity

when a serum that contains a disease-specific antibody is transferred to the child via parental administration (e.g., intravenous immune globulin) or, in some cases, through placental transfer from mother to infant. Protection from passive immunity is relatively short.