Concept Map

Running head: CHILHOOD IMMUNIZATION

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CHILHOOD IMMUNIZATION

Childhood Immunization Raven Jinks Chamberlain University

NR 602: Primary Care of the Childbearing and Childrearing Family

January 24, 2021

Childhood Immunization

 

Case # 1

The vaccine that she should receive is Hepatitis B (HepB) ("Baby Vaccines at Birth", 2020). This dose will be the first since all babies should receive the first Hepatitis B vaccine shot at latest 24 hours after birth. Also, the baby is full term (3.5 kg) hence will respond well to the first dose as opposed to low birthweight infants (those below two kilograms).

If the mother tested positive for Hepatitis B, I would give her an additional HBIG (Hepatitis B Immune Globin) to the vaccine ("Baby Vaccines at Birth", 2020). This additional medicine will boost her and assist her in fighting the virus within the first 12 hours.

If the mother’s Hepatitis B was unknown, I would test the level of the Hepatitis B surface antigen within 9-19 months of the baby.

Case # 2

She should receive the second dose/ shot of Hepatitis B since she was a full-term baby. In addition, she should receive the first doses of RV, DTaP, Hib, PCV13, and IPV ("Easy-to-read Immunization Schedule by Vaccine for Ages Birth-6 Years | CDC", 2020). The vaccines will protect her from Rotavirus, Diphtheria, Tetanus and Whooping Cough, Haemophilus influenza type B, Pneumococcal and Polio respectively.

She should return when 4 months old to receive the second shots/ doses of RV, DTaP, Hib, PCV13, and IPV.

The vaccine combinations that can be used to minimize the number of needle injections include Pediarix, Kinrix, and Pentacel ("Combination Vaccines – Fewer Shots Same Protection | CDC", 2019). Pediarix combination if used will protect her from Diphtheria, tetanus, pertussis, hepatitis B and polio. Kinrix combination if used will protect her from Diphtheria, tetanus, pertussis, and polio. Pentacel if used will protect her from Diphtheria, tetanus, pertussis, polio and Haemophilus influenza (b) (Hib) ("Combination Vaccines – Fewer Shots Same Protection | CDC", 2019).

Case # 3

At this visit I recommend the fifth dose of DTaP, fourth dose of IPV, second dose of MMR, second dose of Varicella (Chicken Pox). I also recommend two doses of the influenza vaccine; the first dose should be given as soon as it is available. However, the CDC advises that the vaccine should be administered before October yearly.

If the child has an allergy to thimerosal, she should be given an influenza vaccine free of thimerosal. In addition, the two doses of influenza vaccine should be four weeks apart. At this age, since two doses are required, the process should be commenced as soon as possible for better protection ("Children & Influenza (Flu)", 2020).

Contraindications to DTaP include previous occurrence of the Guillain-Barre Syndrome around the administration of the dose before or unstable neurological disorders for instance uncontrolled seizures (Meissner, 2017). Presence of medium or severe acute illness, otitis media, upper tract respiratory illness is a contraindication to all vaccinations. A contraindication to administration of MMR vaccine is individuals with ITP history (Meissner, 2017).

Case # 4

At this visit I recommend one dose of Meningococcal disease vaccine, two doses of HPV, one dose of Tdap, and the yearly influenza flu vaccine ("Preteen Vaccines at 11-12 Years Old", 2020).

I think the nurse practitioner should counsel the mother and the patient by explaining to them why vaccinations are important. For instance,

· The vaccines administered during childhood are currently wearing off and the girl will need other additional vaccinations for protection extension purposes ("Preteen Vaccines at 11-12 Years Old", 2020).

· Since the girl is almost entering teenage years she will need additional vaccines to protect her. She needs the vaccination for protection before the exposure increases and her immunity is weakened.

As for today, the only vaccines that should be administered are the four stated above. However, at 13 to 18 years of age she will receive the yearly influenza vaccine and the 2nd dose of the Meningococcal disease vaccine.

 

 

 

 

 

 

 

References

Meissner, H. (2017). Understanding vaccine precautions, contraindications. Retrieved 24 January 2021, from https://www.aappublications.org/news/2017/05/30/IDSnapshot053017#:~:text=Contraindications%20to%20DTaP%20administration%20include,and%20the%20condition%20has%20stabilized.

Preteen Vaccines at 11-12 Years Old. (2020). Retrieved 24 January 2021, from https://www.cdc.gov/vaccines/parents/by-age/years-11-12.html

Children & Influenza (Flu). (2020). Retrieved 24 January 2021, from https://www.cdc.gov/flu/highrisk/children.htm

Combination Vaccines – Fewer Shots Same Protection | CDC. (2019). Retrieved 24 January 2021, from https://www.cdc.gov/vaccines/parents/why-vaccinate/combination-vaccines.html

Baby Vaccines at Birth. (2020). Retrieved 24 January 2021, from https://www.cdc.gov/vaccines/parents/by-age/birth.html

Easy-to-read Immunization Schedule by Vaccine for Ages Birth-6 Years | CDC. (2020). Retrieved 24 January 2021, from https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html