Module c4; Immunizations and Health Promotion

Healthy people 2030 goals

*a new 10 year goal and objectives to promote health and disease prevention, improve quality of health for the public and develop a road map and compass for better American health focusing on -tobacco -immunizations and infectious diseases -maternal-infant and children -environmental health -injury and violence prevention -public health information

Impact of illness on the patient and family

- Illness is never an isolated event - Behavioral and emotional changes - Impact on body image - Impact on self-concept - Impact on family roles (Stress and coping) - Impact on family dynamics (Role conflict)

Impact of illness on the patient and family

-behavioral and emotional changes -impact on body images -impact on self-concept -impact on family roles -impact on family dynamics

The nurses primary role in health promotion. Is to motivate and support changes

-immunization programs -routine exercise, good nutrition -physical awareness, stress, management, and self responsibility

Common positive health behaviors include

-immunizations -proper sleep patterns -Adequate exercise -stress management -nutrition

Common negative health behaviors

-smoking -drug or alcohol abuse -poor diet -refusing to take necessary medications

IM needle

1 to 1 1/2 inch 18 to 27 gauge Give at 90 degrees These are used for hepatitis A and B, TDaP, DTaP, Ted, PCV, HiB, Influenza

Risk factors

-variables that increase the vulnerability or an individual or a group to an illness or accident **these include Genetic and physiology factors Age Environment Lifestyle

SQ needle

3/8 to 5/8 inch 25-27 gauge Give at 45 to 90 degrees Used for MMR and varicella

Colonoscopy

50-75 years, every 5-10 years

Adjuvnet

A Vaccine component distinct from the antigen that enhances the immune response to the antigen.

Immunobiologic

Antigenic substances (e.g., vaccines and toxoids) or antibody-containing preparations (e.g., globulins and antitoxins) from human or animal donors. These products are used for active or passive immunization or therapy. Examples include antitoxins, immune globulin and hyperimmune globulin, monoclonal antibodies, toxoids, and vaccines.

Stress

A lifestyle risk factor and if it is severe enough or prolonged or in the person is unable to cope with life events adequately; it threatens both mental health and physical well being

Toxoid

A modified bacterial toxin that has been made nontoxic, but retains the ability to stimulate the formation of antibodies to the toxin

Intravenous immune globulin

A product derived from blood plasma from a donor pool similar to the immune globulin pool, but not prepared so that out is suitable for intravenous use; Intravenous immune globulin is used primarily for replacement therapy in primary anti-body-deficiency disorders, for treatment of Kawasaki disease, immune thrombocytopenia purpura, hypogammaglobulinemia in chronic lymphocytic leukemia , and certain cases of HIV virus infection

Antitoxin

A solution of antibodies against a toxin. Antitoxin can be derived from either humans (ex tetanus immune globulin) or animal (usually equine) sources (ex diphtheria and botulism antitoxin). Antitoxins are used to confer passive immunity and for the treatment

illness

A state in which a persons physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired

Vaccine

A suspension of the live (usually attenuated or inactivated microorganisms )(ex bacteria or virus) or fractions thereof administered to induce immunity and prevent infectious disease or its sequelae. Some vaccines contain highly defined antigens (ex the polysaccharides of Heamophilus influenzae type B or the surface antigen of hepatitis B); others have antigens that are complex or incompletely defined (ex Bordetrella pertussis antigens or life, attenuated viruses)

Varicella (chicken pox vaccine

A-antibodies are produced that provide immunity. Allergies to Neomycin or gelatin-clients should not get vaccine. V-vaccine should not be given if adult or child has chicken pox. If they have not have chicken pox, they should receive the vaccine. O-omit if pregnant, or if child will be around a pregnant woman. Omit salicylates for 6 weeks following vaccines. D-dose #1 given at 12-15 months, and #2 at 4-6 years, 2 doses should be administered 4 weeks apart if given after age 13

Illness prevention

Activities such as immunizations programs and blood pressure screenings protect people from actual or potential threats to health; they also help people avoid declines in their health or ability to function

Health belief model

Addresses the relationship between a person's beliefs and behaviors

Monoclonal antibody

An antibody product prepared from a single lymphocyte clone, which contains only antibody against a single antigen

Adverse reaction

An undesirable medical condition that has been demonstrated to be caused by a vaccine, Evidence for the casual relation is usually obtained through randomized clinical trial, controlled epidemiological studies, isolation os the vaccine strain from the pathogenic site, or recurrence of the condition with repeated vaccination; synonyms include side effect and adverse effect.

Adverse event

An undesirable medical condition that occurs following vaccination which might be truly caused by a vaccine, or it might be pure coincidence

Healthy people 2020

Approved in December 2010; if promotes a society in which all people live long health lives; identifies leading health indicators (ex access to health services, injury and violence prevention, maternal, infant, and child health), which are high priority health issues in the United States

Hepatitis A and B

Avoid if pregnant or allergic reaction to baker's yeast Hep A is taken twice; 1 year and 1 and half years Hep B is taken 3 times; 12 hours old, 1-2 months. And 6-to 18 months (all before age 12)

Breast cancer

Clinical breast exams Ages 20-39 every 1 to 3 years Mammogram annually after 40 years of age

Physical exam

Every 1-3 years (age 20-40) every 5 years

Human Papillomavirus (HPV) vaccine

F-fainting shortly after receiving the vaccine; fatigue; temp-37.7 C or 99.9 F or higher A- administer the second dose 1 to 2 months after the first dose, the third dose administer is 16 weeks after the second I-increase in muscle pain (myalgia) N- nausea, vomiting, abdominal pain T- tenderness and redness at injection site HPV 2 , HPV4, or HPV 9 3 doses over a 6 months period for males and females 11-12 years old

Modifiable risk factors

Factors such as lifestyles practices and behaviors can be modified. These include poor nutrition, overeating and insufficient rest and sleep; lifestyle behavioral choices Examples that contribute to chronic illnesses include unhealthy diet, physical activity, tobacco use, alcohol abuse, poor control of hypertension, and elevated lipid and glucose levels

Components of health belief model

First component-individuals perception of susceptibility to an illness Second component-individuals perception of the seriousness of the illness Third component-the likelihood that a person will take preventative action

Public health

Focuses on health promotion, wellness, and illness prevention. Health education, legislation, and policy help communities improve their health, decrease the incidence of disease and disability, and improve quantity of life. Health policies and laws affect all people in the community, state, or country even if the people affected by the policies are not aware of them.

Secondary prevention

Focuses on preventing the spread of disease, illness, or infection once it occurs; activities are directed at diagnosis and prompt intervention, thereby reducing severity and enabling the patient to return to a normal level of health as early as possible;

Anaphylactic reaction to a vaccine

IS A CONTRAINDICATION for further doses of that vaccine

Simultaneous

In the context of vaccine timing and spacing, occurring on the same clinic day, at different anatomic sites, and not combined in the same syringe

Influenza (IIV)

Inactivated influenza; DEAD vrisu

Should live vaccines be administered to a pregnant woman or a client who is severely immunocompromised? Yes or no

No

External variables

Influencing a patient's illness behaviors include the visibility of symptoms, social group, cultural background, economic variables, accessibility of the health care system and social support

Variables Influencing Health and Health Beliefs and Practices

Internal variables •Developmental stage •Intellectual background •Perception of functioning •Emotional factors •Spiritual factors External variables •Family role and practices •Socioeconomic factors .cultural background

Influenza immunization

L-live virus given within 1 month; don't give E- egg hypersensitivity, don't give unless HCP has experience and emergency equipment is close by G- Gillian bare syndrome, don't give! S- Salicyates taken recently, don't give!

Live vaccines

MMR Varicella Influenza LAIV (nasal) **(never give to pregnant women)

Positive health behaviors

Maintain, attain, or regain health and prevent illness

PSA-digital recap exam

Men should have annually at ages 50-75

Mallows hierarchy of needs

Nurses use this model to understand the interrelationships of basic human needs; basic Hyman needs are necessary fore human survival and health (examples food, water, safety and love). Although each person has unique needs, all people share basic human needs and the extent to which people meet their basic needs is a major factor in determining their level of health -According do this models, certain human needs are more basic than others, and some needs must be met before other need. Self actualization is the highest expression of ones individual potential and allows for continual self discovery. Mallows model considers individuals experiences, which are always unique to the individual **it is important not to assume the patients needs just because other patients reacted in a certain way. Apply maslow's hierarchy to each patient individually

Tertiary prevention

Occurs when a defect or disability is permanent or irreversible; in involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration.

Health promotions

Often classifies as either passive or active. Passive strategies of health promotion, individuals gain from the activities of others without acting themselves. An example would be fluoridation of municipal drinking water and the fortification of homogenized milk with Vitamin D. Active health strategies-individuals become personally involved; for example weight reduction and smoking cessation programs require patients to be actively involved in measures to improve their present and future levels of wellness while decreasing the risk for disease

Testicular exam

Over 20 at every routine health visit

Blood cholesterol

Over 20 years of age every 5 years

Risk factor modification

Patient teaching for lifestyle changes Objective: patient will reduce health risks related to poor lifestyle habits through behavior changes Teaching strategies: provide active listening, ask about perceived barriers, assist the patient in establishing goals, and reinforce the process of change. Evaluation: have the patient track adherence, and provide positive reinforcement

Illness behavior

People who are ill generally act in a way that medical sociologists call illness behavior; people who are ill adopt cognitive affective and behavioral reactions that are influenced by sociocultural and psycho behavioral factors. Illnesses behavior affect how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use health care resources

Stages of health behavior changes

Precontemplation- no intent to make changes within the next 6 months Contemplation-considering a change within the next 6 months Preparation-making small changes in preparation for a change in the next month Action-actively engaged in strategies to change behavior; lasts up to 6 months Maintenance stage-sustained change over time; begins 6 months after action has started and continues indefinitely.

Primary, secondary, and tertiary

Primary-prevents Secondary-screens Tertiary-treats

The 5 Rs of safe immunization administration

R- ready for an allergic response such as an anaphylaxis by having emergency meds and equipment on standby R- reconstitution of immunizations-follow directions! use within 30 mins of being reconstituted R- review and. Provide written vaccine information sheets for parents, children, and adults. If client is an infant or child, review and obtain informed consent from legal guardian prior to administration R-review undesirable effects with clients/family members and when to notify provider regarding these R-route, date, and site; type, manufacturer, lot number and expiration of vaccine; evidence or informed consent from legal guardian, and name, address and signature and title of administering nurse must be DOCUMENTED.

Precautions and contraindications with Immunizations: Risk

R- risks that come with the immunizations (weight risks/data that come with canonization or not!) I-illnesses (with out without fever); immunocompromised individuals S-substance in any immunization that caused reactions in the past should not be used in any vaccine K-know of a previous anaphylactic reaction to a vaccine is contraindicated for further doses of vaccine.

Diphtheria

Vaccine-DTaT vaccine protects against diphtheria Disease spread by-Air; direct contact Disease symptoms-sore throat, mild fever, weakness, swollen glands in the back of neck Disease complications- swelling of the heart muscle, heart failure, coma, paralysis, death

Hyperimmune globulin (specific)

Special preparations obtained from blood plasma from donor pools preselected for a high antibody content against a specific antigen (ex hepatitis B immune globulin, varicella-zoster immune globulin, rabies immune globulin, tetanus immune globulin, vaccinia immune globulin, cytomegalovirus immune globulin, botulism immune globulin).

Hepatitis A

Vaccine-HEPA vaccine protects against Hepatitis A Disease spread by-direct contact, contaminated food or water Disease symptoms- may be no symptoms, fever, stomach pain, loss of appetite, fatigue, vomiting, jaundice (yellowing of skin and eyes), dark urine Disease complications-liver failure, arthralgia (joint pain), kidney, pancreatic and blood disorders

Healthy People

The healthy people initiative provides evidence based, 10 year national objectives for promoting health and preventing disease. It provides a framework to help the United States increase its focus on health promotion and disease prevention (instead of illness care) and encourages cooperation. Among individuals, communities,and other public, private, and nonprofit organizations to improve health.

Health

The world health organization decides HEALTH as state of complete physical, mental, and social well being, not merely the absence of disease or infirmity; a state of being that people define in relation to their own values, personalities, and life style; each person has a personal concept of health; Health is the actualization of inherent and acquired human potential through foal directed behavior, competent self care, and satisfying relationship with others.

Healthy people 2030

The secretary's advisory committee on National health promotion and disease prevention objectives for 2030 is guiding the development and implementation of Healthy people 2030. The framework proposed by the healthy people 2030 will build on the previous editions of health people, promote a holistic approach to health promotion and disease prevention and help to engage community leaders to act and design policies to improve the health and well being of all Americans.

Vaccination and immunization

The terms vaccine and vaccinations are derived from vacca, the lAtin term for cow. Vaccine was the term used by Edward Jenner to describe material used (ex cowpox virus) protein produce immunity to smallpox. The team vaccination was used by Louis Pasteur in the 19th century to include physical act of administering any vaccine or toxoid. Immunization is more inclusive terms denoting the process of including or providing immunity by administering an immunobiologic. Immunization can be active or passive. Active immunization is the production of antibody or other immune responses through the administration of a vaccine or toxoid. Passive immunization means the provision of temporary Immunity by the administration of performed antibodies. Although persons often use the terms vaccinations and immunization interchangeably in reference to active immunization, the terms are not synonymous because the administration of an immunobiologic cannot be equated automatically with development of active immunity

Personal strategies focus on health promoting behaviors and healthy lifestyle choices

These include Nutritious diet 'Adequate and regular sleep Regular exercise Wear safety gear Relaxation Good work family balance Engage in regular non work activities Coping skills Practice safe sex Allowing personal time for grieving the loss of patients Focusing on spiritual health Mentor or experienced nurse to help your coping strategies See medical care when necessary, get routine screenings, and perform recommended self examinations (breast, testicular)

Rotavirus

To prevent diarrhea RV-1 vaccine-administer as a two-dose series at 2 and 4 months RV-5 vaccine-administer as a three-dose series at ages 2, 4, and 6 months Undesirable effects: Gastric upset Irritability

Family history and genetics are risk factors for some illnesses. True or false

True

Sometimes gender affects a person's risk factors. True or false

True

Primary prevention

True prevention; its goal is to reduce the incidence of disease; many of these programs are supported by the government (ex federally funded immunization programs). These programs include health education programs, nutritional programs, and physical fitness activities. It includes all health promotion effort and wellness education activities that focus on maintaining or improving the general health of individuals, families and communities. examples include promoting hearing protection in occupational settings and providing education to reduce cardiac disease risk factors.

Acute illness

Usually reversible and has a short duration; the symptoms appear abruptly, are. Intense, and subside after a relatively short period; **severe

VAERS

Vaccine Adverse Event Reporting System

Human Papillomavirus (HPV)

Vaccine- HPV vaccine protects against virus Virus spread by-direct skin contact Disease symptoms-may be no symptoms or genital warts Disease complications-cervical, vaginal, vulvar, penile, anal, oropharyngeal cancers

Pneumococcal

Vaccine- PCV13 3vaccine protects against pneumococcus Disease spread by-air and direct contact Disease symptoms-may be no symptoms, pneumonia Disease complications- bacteremia (bacteria in the blood, meningitis (infection around covering of brain and spinal cord). Deathj

Pertussis

Vaccine-DTaP* vaccine protects against pertussis (whooping cough) Disease spread by-air; direct contact Disease symptoms-severe cough, runny nose, apnea (a pause in breathing in infants) Disease complications- pneumonia and death

Tetanus

Vaccine-DTaP* vaccine protects against tetanus Disease spread by-exposure through cuts in the skin Disease symptoms-stiffness in the neck and abdominal muscles, difficulty swelling, muscle spasms, fever Disease complications-broken bones, difficulty breathing, death

Hepatitis B

Vaccine-HepB protects against hepatitis B Disease spread by-contact with blood or bodily fluids Disease symptoms-may. be no symptoms, fever, headache, weakness, vomiting, jaundice (yellowing of skin and eyes), joint pain Disease complications-chronic liver infection, liver failure, liver cancer

HiB

Vaccine-HiB vaccine protects against Haemophilus influenzae type b Disease spread by-Air; direc contact Disease symptoms-may be no symptoms unless bacteria enters the blood Disease complications-meningitis (infection of the covering of the brain and spinal cord, intellectual disability) epiglottis; (life threatening infection that can block the windpipe and lead to serious breathing problems), pneumonia, and death

Polio

Vaccine-IPV vaccine protects against polio Disease spread by- air; direct contact; through the mouth Disease symptoms-may be no symptoms, sore throat, fever, nausea, headache Disease complications-paralysis and death

Measles

Vaccine-MMR** vaccine protects against measles Disease spread by: air; direct contact Disease symptoms-rash, fever, cough, runny nose, pink eye Disease complication-encephalitis (brain swelling), pneumonia,death

Mumps

Vaccine-MMR** vaccine protects against mumps Disease spread by-air, direct contact Disease symptoms-swollen salivary glands (under the jaw), fever headache, tiredness, muscle pain Disease complications-meningitis (infection of the covering of the brain and the spinal cord, encephalitis (brain swelling), inflammation skin of testicles or ovaries, deafness

Rubella

Vaccine-MMR** vaccine protects against rotavirus Disease spread by-air and direct contact Disease symptoms-sometimes rash, fever, sore throat, fever, swollen lymph nodes Disease complications-very serious in pregnant women; can lead to miscarriage, stillbirth, premature delivery, and birth defects

Meningococcal disease

Vaccine-MenACWY and MenB protects against disease Disease spread. by-air and direct contact Disease symptoms-sudden onset or fever, headache, and stiff neck, dark purple rash Disease complications-loss of limb, deafness, nervous system disorders, developmental disabilities, seizures, stroke death

Rotavirus

Vaccine-RV vaccine protects against rotavirus Disease spread by-through the mouth Disease symptoms-diarrhea, fever, vomiting Disease complications-severe diarrhea and dehydration

Chickenpox

Vaccine-Varicella vaccine protects against chickenpox Disease spread by -AIR; direct contact Disease symptoms-rash, tiredness, headache, fever Disease complications-infected blisters, bleeding disorders, encephalitis (brain swelling), pneumonia, (infections in the lungs)

Influenza

Vaccine-flu vaccine protects against infliuenza Disease spread by-air; direct contact Disease symptoms-fever, muscle pain, sore throat, cough, extreme fatigue Disease complications- pneumonia

Modifiable risk factor; environment

Where we live and the condition of that area determine how we live, what we eat, the disease agents to which we are exposed, our state of health, and our ability to adapt

Risk factor indentification and changing health bevahiors

You identify your patients modifiable and unmodifiable risk factors to help them understand what they can modify, control, or even eliminate to promote wellness and prevent illness

Nonmodifiable risk factors

age, gender, genetics, family history; these cannot be changed! *age risk factors are often closely associated with other risk factors such as family history and personal habits.

Internal variables

a patient's perceptions of symptoms and the nature of an illness

Health beliefs

a person's ideas, convictions, and attitudes about health and illness

Immune globulin

a sterile solution containing antibodies from human blood. It is obtained by cold ethanol fractionation or large pools of blood plasma and contains 15-18% protein. Intended for intramuscular administration, immune globulin is primarily in dictated for routine maintenance of immunity amongst certain immunodeficiency persons and for passive protection against measles and hepatitis A.

Cultural health beliefs

affect how people think and feel about their health and health problems, when and from whom they seek health care, and how they respond to recommendations for lifestyle change, health-care interventions, and treatment

Risk factor

any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident. An example is risk factors for falls, such as impaired gait, reduced vision and lower extremity weakness. Nurses in all areas of practice have opportunities to reduce patients risk factors to promote health and decrease risks of illness or injury

Dental exam

every 6 months

Health promotion

helps individuals maintain or enhance their present health; it motivates people to engage in healthy activities such as routine exercise and good nutrition to reach more stable levels of health.

Health education

includes topics such as physical awareness, stress management, and self-responsibility. Helps people develop a greater understanding of their health and how to better manage their health risks.

Holistic health model

promotes a patient's optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual's wellness

Chronic illness

usually lasts more than 6 months, is irreversible, and affects functioning in one or more systems

VIS sheets

vaccine information sheets made by CDC, must be accompanied with every vaccine adminstration, new ones get printed every year

Models of health and illness

•Models help explain complex concepts or ideas, such as health and illness; models helps you understand the relationship between these concepts and a patients attitudes toward health and health behaviors