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177 Cards in this Set

  • Front
  • Back
All organs and systems in the body are subject to anaphylaxis.
True
What is the appropriate dosage when administering 1:2000 aqueous Intramuscular via EpiPen Junior?
0.15mL
Stimulation of which division of the autonomic nervous system causes the release of epinephrine?
Sympathetic division
Epinephrine is referred to as adrenaline and causes ______?
vasoconstriction/bronchodilation
What effect does epinephrine have on cardiac activity?
Epinephrine stimulates the receptor cells of the smooth cardiac muscle causing the heart rate and blood pressure to increase.
What is the most dangerous aspect of a vasovagal episode?
Injuries obtained from the fall
There are two types of syringe tips - plan and locking.
True
What is the most common type of syringe used for administration of parenteral injections?
plastic
Syringe selection is based on _____?
purpose of the injection, the volume of vaccine to be injected and the need for accuracy in dosage
The most accurate size syringe is the _____?
1 mL
Prepackaged units_________
guarantee accuracy, are convenient for normal use, are especially convenient for emergency situations
The gauge of a needle is an inverse measurement of the diameter. As the diameter increases, the gauge decreases.
True
Which of the following should be considered when selecting a needle for administering injections?
size of the muscle, thickness of adipose tissue at injection site, volume of material to be administered
Because vaccine administered parenterally is almost totally absorbed rather than being partially destroyed by the digestive system, a smaller dosage will achieve the same therapeutic effect.
True
Only the purpose and characteristics of the vaccine determine the route of administration.
False
Of the different sites available for an intramuscular injection for an adult, which site has the best blood supply and the most rapid response?
Deltoid Muscle
What steps can you take to prevent nosocomial infections and associated complications?
hand washing, maintain sterility of equipment, cleaning of the injection site
When preparing a syringe for vaccine administration you notice the package is partially open. What should you do?
get a new syringe
The proper procedure for drawing vaccine from a vial is?
Remove the protective cap on the vial and clean off the diaphragm with an alcohol swab. Pull back the plunger to aspirate the needed amount of air and insert the needle in the center of the rubber diaphragm. Inject the air and aspirate the vaccine.
When reconstituting a multi-dose vaccine you should_________?
Label the vial with the date and time mixed
What steps should you take before administering a vaccine?
Follow the 6 rights of medication administration
What is the mot commonly used area for the administration of Intradermal injections?
ventral surface of forearms
The most common site for subcutaneous injections is the
triceps
Which intramuscular injection site presents the most risk because of proximity to the large sciatic nerve?
Gluteal sites
Choose the correct intramuscular injection needle angle when administering an injection into the deltoid muscle
90 degrees
Vaccines can be given in the gluteal area to pediatric patients
False
Active immunity ________?
is a reaction that stimulates antibody production, appears following exposure to an antigen, is a direct result of an immune response
Artificially acquired passive immunity results from the administration of a specific _____?
antibody
The prescribed dosage and route for anthrax vaccine is ____ with a possible mild ____ reaction.
0.5mL IM; local, systemic
The recommended booster dose for the Anthrax vaccine is _____
Annually if continued immunity is needed
What is the routine schedule for Hepatitis-B vaccination?
Day-30, day-60, day-180
A patient with a history of an anaphylactic reaction after ingestion of eggs should not receive a(n) ______ vaccination before they are skin tested.
Influenza
The Td booster dose is administered _________
every 10 years throughout lifetime
What is the dosage requirement for a child for Recombivax (Hepatitis-B) vaccine?
0.50mL IM Deltoid muscle (<20 years of age)
A 6-month-old healthy child presents for routine immunizations. Child is up to date through 4 months of age. What vaccines are required?
DTap, HiB, Prevnar, IPV
An 8-week healthy child presents for routine immunization. The child has no immunizations to date. What vaccines are required?
Comvax, Prevnar, IPV, DTap
Primary immunization series for the Pediarix vaccine is?
2, 4, and 6 months
Smallpox vaccine (ACAM2000) is administered ____ route.
Percutaneous
How many jabs does an individual receive if receiving the Smallpox vaccine for the first time?
15
TB test are administered intradermally on the volor aspect of either forearm. About how far below the bend in the elbow should it be placed?
4 inches
International health threat assessments are conducted by which governing agency?
Defense Intelligence Agency Armed Forces Medical Intelligence Center (AFMIC)
AFJI 44-102 outlines immunization guidelines for active duty personnel on alert status
True
Can waivers for religious reasons be revoked if the mission is compromised?
Yes
Who has the responsibility for ensuring that military and nonmilitary personnel who are subject to rapid deployment, receive all required immunizations?
Do you have allergies to any medications, foods or vaccines?
Are you or a family member immunocompromised/deficient due to medication, treatment, or disease?
Are ou pregnant or have the intention of becoming pregnant in the next three months?
When annotating immunization records =, using a signature stamp is authorized.
False
When transcribing an adult's immunization record, only transcribe immunizations that are _______
once in a lifetime, current and in a series
IAW WHO Article 80, what document is considered adequate proof of vaccination for armed forces personnel?
DD Form 2766C, Vaccine Administration Record
At the time of initial immunization of Air Force non-military personnel, a DD form 2766C is established. Which other form can you use to document the immunization?
International Certificate of Vaccination or Prophylaxis (ICVP)
Anthrax
indicated ages
individuals between 18-65
Anthrax
Primary Series
Booster
consists of 5 intramuscular doses at 0 and 4 weeks and 6, 12 and 18 months
Yearly booster 0.5mL still risk
Anthrax
contraindications
Severe allergic reaction (e.g. anaphylaxis) after a previous dose of BioThrax
Anthrax
Storage/Management
2 to 8 degrees C
(36 to 46 degrees F)
Do not use BioThrax after expiration date printed on the label
Hepatitis A
Indications
19 year and older
All active duty
arrears of high endemicity
persons in high-risk sexual activity
Hepatitis A
dosage
1.0mL in deltoid
Hepatitis A
primary series
single dose given followed with a booster dose 6-12 for Havrix
6-18 months later for Vaqta
Hepatitis B Vaccine
Indications
Infants including those born to HBsAg positive mothers
Those born after 21NOV1991
Adolescents
Health Care Professionals
Morticians/Embalmers
Blood Bank/Plasma workers
Prisoners
Hepatitis B Vaccine
Dosage
1.0mL IM deltoid muscle (>19 years)
Hepatitis B Vaccine
Primary Series
Three (3) doses regimen.
First dose at elected date, second dose one (1) month later, third dose six (6) months after the first
Hepatitis B Vaccine
Contraindications
Hypersensitivity to yeast
Any component of the vaccine
Human Papillomavirus (GARDASIL)
indications
females 9-26 years of age
prevention of HPV types 6,11,16 &18
Human Papillomavirus
(GARDASIL)
dosage
0.5mL IM
Human Papillomavirus
(GARDASIL)
primary series
First dose: at elected date
Second dose: 2 months after the first
Third dose: 6 months after the first
Human Papillomavirus
(GARDASIL)
contraindication
Hypersensitivity to the active substances or to any of the excipients of the vaccine
Influenza (Flu) injectable
indications
All active duty
Healthcare workers
persons age less than or equal to 65
Women in the second and third trimester of pregnancy
Influenza (Flu) Injectable
dosage
0.5mL IM
Influenza (Flu) injectable
Primary Series
Annually
Influenza (Flu) Injectable
contraindications
hypersensitivity (allergy) anaphylactic reactions to eggs or egg products
Sensitive to Thimerosal
Influenza (Flu) Intranasal
indications
All active duty
Healthcare workers
persons 2-49 years
healthy children and adults
Influenza (Flu) Intranasal
dosage
0.20mL
Influenza (Flu) Intranasal
primary series
Annually
Influenza (Flu) Intranasal
contraindications
No administration parenterally
Hypersensitivity to eggs or egg products
children/adolescents 2-17 years
history of Guillain-Barre syndrome
Japanese Encephalitis Vaccine
indications
month or longer in endemic areas during transmission season
lab workers exposed to virus
specific guidance for AD by MAJCOM
Japanese Encephalitis Vaccine
dosage
1.0mL patient 3 yrs and older SQ
0.50mL 35 months to 1 yr SQ
Japanese Encephalitis Vaccine
primary series
three (3) doses given 0, 7 and 30 days
third dose at least 10 days before travel
Japanese Encephalitis Vaccine
contraindication
allergic reaction to prior dose or vaccine components
persons with multiple allergies; hx of urticria or angiodema
pregnancy
Measles, Mumps, Rubella (M-M-RII)
indications
12 months or older
adults born in 1957 or later
college students
healthcare personnel
women of childbearing age
international travel
Measles, Mumps, Rubella (M-M-RII)
dosage
0.5mL SQ
Measles, Mumps, Rubella (M-M-RII)
primary series
one (1) dose for adults
Measles, Mumps, Rubella (M-M-RII)
second dose
If recommended, minimum of 4 weeks between the 1st and 2nd shot
Measles, Mumps, Rubella (m-M-RII)
contraindications
Hypersensitivity to any component; include gelatin
Pregnancy
Febrile infection
Anaphylactic/anaphylacoid to neomycin
Pt receiving immunosuppressive therapy
pt w/ HIV, disease affecting the bone marrow or lymphatic system
Meningococcal Polysaccharide Vaccine Group A,C,Y and W-135 Combined (Menomune-A/C/Y/W-135)
dosage
0.5mL SQ
Meningococcal Polysaccharide Vaccine Group A,C,Y and W-135 Combined (Menomune-A/C/Y/W-135)
Primary Series
Single dose
Meningococcal Polysaccharide Vaccine Group A,C,Y and W-135 Combined (Menomune-A/C/Y/W-135)
indications
deficiencies in late Complement components
functional/actual asplenia
lab
travelers/residents hyperendemic areas
Meningococcal Polysaccharide Vaccine Group A,C,Y and W-135 Combined (Menomune-A/C/Y/W-135)
contraindications
hx or adverse reaction to Thimerosal
defer immunization during the course of any acute illness
Meningococcal (Group A,C,Y and W-135) Polysaccharide Diptheria Toxoid Conjugate Vaccine Menactra
indications
licensed for ages 2-55 years
travelers to hyperendmic areas
Meningococcal (Group A,C,Y and W-135) Polysaccharide Diptheria Toxoid Conjugate Vaccine Menactra
dosage
0.5mL IM
Meningococcal (Group A,C,Y and W-135) Polysaccharide Diptheria Toxoid Conjugate Vaccine Menactra
primary series
single dose
Meningococcal (Group A,C,Y and W-135) Polysaccharide Diptheria Toxoid Conjugate Vaccine Menactra
contraindications
hx of adverse reaction to Thimerosal
Defer immunization during course of any acute illness
Inactivated Polio Vaccine
(IPV, e-IPV, ep-IPV)
indications
travelers to endemic regions
Healthcare workers exposed
Lab workers exposed
All active duty required to have one (1) dose
Inactivated Polio Vaccine
(IPV, e-IPV, ep-IPV)
dosage
0.5mL SQ/IM (IPV)
Inactivated Polio Vaccine
(IPV, e-IPV, ep-IPV)
primary dose
unvaccinated adults:
two doses 4-8 weeks apart
followed by third 6-12 months after 2nd dose
day-0, day-30, 6-12 months
Inactivated Polio Vaccine
(IPV, e-IPV, ep-IPV)
contraindications
hx of hypersensitivity to vaccine; 2-phenoxyethanol, formaldehyde, neomycin, streptomycin and polymyxin
Person w/ acute febrile illiness
Pneumococcal Vaccine (PPV 23)
pts 2 yr and older; routine vaccination for persons 50 years or older
Pneumococcal Vaccine (PPV 23) dosage
0.50 mL SQ/IM
one dose
Rabies Vaccine
primary series - pre-exposure
three (3) doses
day -0, day - 7 and day-21 to 28
Rabies Vaccine
primary series - post exposure
give rabies immune globulin asap, followed by five (5) doses day-0, day-3, day-7, day-14 and day-28
Rabies Vaccine
dosage
1.mL IM deltoid
Shingles {Zostavax}, Live
primary series
single dose, 0.65mL SQ
Shingles {Zostavax}, Live
contraindications
hx of allergic reaction to gelatin, neomycin, or compnent of vaccine
hx of immunodeficiency
Immunosuppressive therapy
Active untreated TB
Pregnant
Smallpox (AMSAM2000), Live
primary
administred percutaneous route (scarification) using 15 jabs
Smallpox (AMSA2000), Live
storage
freezer temperature of -15 to -25 degrees C
Tetanus/Diphtheria (Td)
indications
Pt 7 years and older
New recruites
Tetanus/Diphtheria (Td)
dosage
0.5mL IM
Tetanus/Diphtheria (Td)
primary Series
Two (2) doses given at an interval of 4 to 8 weeks, following a third reinforcing dose 6 to 12 months after the second dose
Booster at 10-year intervals
Tdap (ADACEL)
active booster immunization of tetanus, diphtheria and pertussis, 11-64 years
Tdap (ADACEL)
dosage
single dose 0.5mL IM
Tdap - Boostrix
dosage
05.50 mL, IM
Tdap - Boostrix
10-64 yr as a booster to the promary series
Twinrix (Hepatitis A inactivated & Hepatitis B (Rocombiant) Vaccine
indications
chronic liver disease
risk through work
Healthcare workers
daycare or correctional employees
men having sex with men
military recruits
Twinrix (hepatitis A inactivated & Hepatitis B (Recombiant)
dosage
1.0mL IM, primary for adults three (3) doses, day-0, 1 month and 6-month mark
Typhoid Vaccine (Oral, Ty21a), Live
indications
All active duty on mobiility status
Typhoid Vaccine (Oral, Ty21a), Live
dosage
4 capsules orally, one (1) taken every other day
Typhoid Vaccin (Typhim Vi), parenteral
dosage
0.5mL IM
Varicella Virus Vaccine (Chickenpox) (Varivax), Live
indications
> or equal to 12 months of age
high-risk occupational groups
Varicella Virus Vaccine (Chickenpox) (Varivax), Live
dosage
0.5mL SQ
two (2) doses four to eight weeks apart
Yellow Fever, Live
indications
persons >or equal to 9 months of age traveling/living in areas of South America and Africa
Lab personnel who may be exposed
Yellow Fever, Live
single dose, 0.5ml SQ, booster every 10 yrs
Yellow Fever, Live
contraindications
Allergic to eggs
Mercury sensitivity
antibiotic indused allegic reaction
hypersensitvity to vaccine components
Adult Immunization Schedule
Td/Tdap - 1 time dose, then booster every 10 yr (19-65)
HPV - 3 doses, females 19-26
Varicella - 2 doses 19 and up
Zoster - 1 dose, 60 yr and up
MMR - 1 or 2 doses, 19-49; 1 dose 50 and up
Influenza - 1 dose annually 19 and up
Pneumococcal - 1 or 2 dose, 19-64; 1 dose 65 and older
Hepatitis A - 2 doses, 19 and older
Hepititis B - 3 doses 19 and older
Meningococcal - 1 or more doses, 19 and older
Comvax
(Hib and Hep B combination)
schedule
administer at 2, 4 and 12-15 months of age
Comvax
(Hib and Hep B combination)
dosage
0.50mL; IM
Comvax
(Hib and Hep B combination)
contraindications
Hypersensitvity to yeast
any components
DT
schedule
2 months
4 months
6 months
15-18 months
4 - 6 yrs of age
DT
dosage
0.50mL; IM
DT
contraindications
hypersensitivity to component
hypersensitivity to Thimerosal
DTap/DTP
schedule
2, 4, 6, 15-18 months
4-6 years of age
Doses 2&3 can be given 4 weeks after previous dose while dose 4 should be given at least 6 months after dose3. If dose 4 is givven before child's 4th birthday give dose 5 at lease 6 months later. If given after the 4th birthday dose 5 is not necessary
DTap/DTP
dosage
05.50mL; IM
DTap/DTP
contraindications
hypersensitivityto components
hypersensitivity to Thimerosal
Gelatin
DTap-IPV (Kinrix)
schedule
5th dose in DTap series
4th dose in IPV series in children 4-6 years of age
DTap-IPV (Kinrix)
dosage
0.5mL, IM
preferred deltoid upper arm
DTap-IPV (Kinrix)
contraindications
hypersensitivity
encephalopathy
progressive neurologic disorder
DTap-IPV/Hib (Pentacel)
schedule
2, 4, 6, 15 - 18 months
DTap-IPV/Hib (pentacel)
dosage
0.5mL, IM
DTap-IPV/Hib (Pentacel)
contraindications
hypersensitivity
encephalopathy
progressive neurologic disorder
Haemophilus Influenza type B (HIB)
HibTITER (Wyeth)
PedvaxHIB (merck)
ActHIB (Sanofi-Pasteur)
contraindications
prior reaction
hx of hypersensitivitiy to components, Thimersol
Hepatitis A
schedule
1- 18 yrs old
two doses 6 - 12 months apart
Hepatitis A
dosage
0.50mL; IM
Hepatitis A
contraindications
anaphylaxis to components
Hepatitis B (HBV)
schedule
"A" - birth, 2 months, 1-4 months oldand 6-18 months old
"B" - day 0, day 30 and day 180 (for older children)
Hepatitis B (HBV)
dosage
0.50mL; IM
Hepatitis B (HBV)
contrainidications
anaphylaxis to previous dose, vaccine component, yeast and Thimerosal
Inactivated Polio (IPV)
schedule
2, 4, 6-18 months and 4-6 years of age
Inactivated Polio (IPV)
dosage
0.50mL; SQ or IM
Inactivated Polio (IPV)
contraindications
anaphylaxis to components or previous dose
Comvax
(Hib and Hep B combination)
schedule
administer at 2, 4 and 12-15 months of age
Comvax
(Hib and Hep B combination)
dosage
0.50mL; IM
Comvax
(Hib and Hep B combination)
contraindications
Hypersensitvity to yeast
any components
DT
schedule
2 months
4 months
6 months
15-18 months
4 - 6 yrs of age
DT
dosage
0.50mL; IM
Influenza (Flu) injectable
schedule
age 9 and older: one dose annually
age 8 or younger previously unvaccinated: two doses 1 month apart
Influenza (Flu) injectable
dosage
3 and older 0.50mL IM
6 - 35 months 0.25mL IM
Influenza (Flu) injectable
contraindications
eggs and Thimersol or reaction to previous dose
Influenza (Flu) intranasal
2-49 years
0.20mL
Measles, Mumps, Rubella
(M-M-RII), Live
schedule
two doses 12-15 months and 4-6 years old
Measles, Mumps, Rubella
(M-M-RII), Live
dosage
0.50mL; SC
Measles, Mumps, Rubella
(M-M-RII), Live
contraindications
anaphy;axis to components, eggs or neomycin
Measles, Mumps, Rubella
and Varicella (MMRV-ProQuad), Live
schedule
routine - 12-18 months
individuals 12 months - 12 years should recieve a single 0.5mL dose of ProQuad SQ
Measles, Mumps, Rubella
and Varicella (MMRV-ProQuad), Live
contraindications
reaction to neomycin
hypersensitivity to gelatin
immunosuppresive therapy
untreated TB
PEDIARIX (diphtheria, tetanus toxoid and pertusis absorbed, Hepatitis B (Recombiant) and Inactivated Poliovirus Vaccine Combined)
schedule
3 doses - 2 months, 4 months and 6 months of age
PEDIARIX (diphtheria, tetanus toxoid and pertusis absorbed, Hepatitis B (Recombiant) and Inactivated Poliovirus Vaccine Combined)
contraindications
sensitivity to components
yeast
neomycin
polymyxin
previous dose
PEDIARIX (diphtheria, tetanus toxoid and pertusis absorbed, Hepatitis B (Recombiant) and Inactivated Poliovirus Vaccine Combined)
dosage
0.50mL; IM
Pneumococcal Conjugate Prevnar (PCV7)
schedule
2, 4, 6, & 12- 15 months of age
older children at risk: 7-11 months old two doses two months apart, another dose 15-18 months. 12-23 months two doses two months apart and 24months - 9 years one dose
Pneumococcal Conjugate Prevnar (PCV7)
dosage
0.50mL; IM
Pneumococcal Conjugate Prevnar (PCV7)
contraindications
anaphylaxisis to components, diphtheria toxioid
ROTARIX, Live
schedule
administer first dose to infants beginning 6 weeks of age
second dose after at leaset 4 weeks and prior to 24 weeks of age
ROTARIX, Live
dosage
1-mL orally
ROTARIX, Live
contraindication
Hx of uncorrected congential malformation of the GI tract
RotaTeq [Rotavirus Vaccine, Live, Oral, Pentavalent]
schedule
3 ready to use, start at 6 to 14 weeks of age, with subsequent doses administered at 4- to 10- week intervals
RotaTeq [Rotavirus Vaccine, Live, Oral, Pentavalent]
dosage
2 mL Orally
RotaTeq [Rotavirus Vaccine, Live, Oral, Pentavalent]
contraindications
Hx of hypersensitivity to components
sensitivity to first dose
TriHIBit (DTap and HIB)
schedule
12-18 months old ONLY
TriHIBit (DTap and HIB)
dosage
0.50ml; IM
TriHIBit (DTap and HIB)
contraindications
Hx of pertussus or components containing pertussis in vaccine
Thimerosal
Encephalopathy
Varicella, Live
schedule
Children: routine 12-18 months and 4-6 yrs of age, if second dose administered a minimum of 3 months later.
Adolescents: 13 yrs and older at elected date and a second 4-6 weeks later
Varicella, Live
dosage
0.5mL; SQ
Varicella, Live
contrindications
anaphylaxsis to components
neomycin
gelatin
MSG
Purified Protein Derivative (PPD) 5TU Strength; delayed skin test
read 48 to 72 hours after injection
0.1mL of 5TU strength intradermal