NUR 521 Exam3 Module 7, Module 8 Module

NUR 521 Exam3 – Module 7, Module 8 & Module

9: Questions With Appropriate Solutions

NUR 521: Pharm Exam 3 - Module 7

Measles, Mumps, and Rubella (MMR) Vaccine Correct Answer -

• Combo of 3 live virus vaccines

- AE: Fever

- Contraindication: Pregnancy, eggs, severe immunodeficiency,

neomycin Diptheria and Tetanus Toxoids and Acellular Pertussis Vaccine (DTaP) Correct Answer - - Can be administered to children with mild febrile illness

• Tdap is booster

- Precautions: Seizures, fevers, persistent inconsolable crying

- Contraindications: Encephalopathy

Poliovirus Vaccine, inactivated (IPV) Correct Answer - - Inactivated virus

• Local soreness expected

- Precautions: Allergy to streptomycin or bacitracin

Haemophilus influenzae type b (Hib) conjugate vaccine Correct Answer - - PedvaxHIB

• ActHIB
• Protection begins in 1 week after first dose of PedvaxHIB
• Protection begins 1 week after fourth dose of ActHIB

Varicella Vaccine Correct Answer - - Live, attenuated vaccine

- Varivax: just varicella

- ProQuad: Varicella plus MMR 1 / 4

• Avoid ASA for 6 weeks (Reye Syndrome)

- Contraindications: Pregnancy, cancers, immunocompromised pts

Hepatitis A Vaccine Correct Answer - Recommended for children 12-23 mon, traveling to high rate places, communities with freq. outbreaks, chronic liver disease pts, people who receive clotting factor concentrates

• Inactivated Hep A Virus

Hepatitis B Vaccine Correct Answer - - Made from viral components, not live virus, can NOT cause disease

- Contraindications: Baker's Yeast

Pneumococcal vaccine (PCV13) Correct Answer - Conjugated vaccine

• Recommended to children < 2 yo
• Recommended to children between their 2nd and 5th birthday

who have conditions that put them at high risk for serious pneumococcal disease Influenza Vaccine Correct Answer - Recommended annually for ppl 6 months and older

• High risk pts should receive inactivated vaccine
• Small risk of Gullian-Barre Syndrome

- Contraindications: Acute febrile illness

Meningococcal Vaccine Correct Answer - Recommended to children 12 yo, booster at 16 yo, college freshmen in dorms, U.S.military recruits, injured spleen Rotavirus Vaccine Correct Answer - Live, attenuated virus

• Oral
• All infants beginning at 8 weeks

- AE: Intussusception 2 / 4

- Precautions: Currently ill with moderate to severe diarrhea or

vomiting

- Contraindications: Uncorrected congenital malformation of the GI

tract Human Papillomavirus Vaccine (HPV Vaccine) Correct Answer - Recommended to prevent cancers, precancerous lesions, genital warts

- F & M: 9-45 yo

Severe Allergic Reaction Correct Answer - - Histamine plays a minor role

• Leukotrienes are the principal mediator
• Antihistamines are little help
• Epinephrine is the drug of choice

H1 Antagonists Correct Answer - Used for treatment of mild allergic disorders, motion sickness, and insomnia

- AE: Sedation, dizziness, constipation, dry mucous membranes

First generation

• Diphenhydramine (Benadryl)

Second generation

• Cetirizine (Zyrtec)

Antihistamines Across the Lifespan Correct Answer -

Infants/Children: Can be used in small doses in children older than 6

months

Pregnancy: Should be avoided unless absolutely necessary

Older Adults: Should be avoided unless necessary, use smallest dose. 3 / 4

Diphenhydramine (Benadryl) Correct Answer - Antihistamine

• Non-selective antagonizes central and peripheral H1 receptors
• Monitor for dizziness, drowsiness, urinary retention, and

constipation

• Patients > 2 yo

Cetirizine (Zyrtec) Correct Answer - Antihistamine

• Selectively antagonizes peripheral histamine H1 receptors

Use: Seasonal allergies and chronic idiopathic urticaria

Contraindications: Hepatic and renal impairment in children < 6yo

Side Effects: Drowsiness, headache, abd pain, dry mucous

membranes, and dizziness Effects of COX Inhibitors Correct Answer - - Gastric ulceration

• Bleeding tendencies
• Protection against MI
• Vasoconstriction promotes MI
• Renal impairment
• Reduced inflammation
• Analgesia
• Reduced fever

First-Generation NSAIDs: Aspirin Correct Answer - COX-1 and

COX-2 Inhibitor

• Producing analgesic, anti-inflammatory, and antipyretic effects
• Reduces platelet aggregation

Indications:

- Pediatrics: Pain/fever, juvenile idiopathic arthritis, Kawasaki

disease, thrombotic event prevention

- Adults: Arthritis, pain/fever, acute coronary syndrome, MI

prevention, TIA/thromboembolic stroke prevention

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