1 Vaccine - Preventable Diseases Healthy People 2020 goal: Increase immunization rates and reduce preventable infectious diseases. 1

2 Why We immunize Health promotion: prevent a disease if it is preventable.  Morbidity vs Mortality Protect self Protect others Economics 2

3 Immunizations: Contraindications Anaphylactic reaction to previous vaccine IPV: anaphylactic reaction to neomycin or streptomycin MMR & Varicella  Immunocompromised  allergy gelatin, neomycin  Pregnancy  active Tb 3

4 Barriers to Immunization Complexity of the health care system Expense Parental misconceptions Personal beliefs Inaccurate record-keeping Reluctance of health care workers to give > 2 vaccines at a time Lack of public awareness 4

5 Complications of Common Infectious Diseases (viral) 1. Measles 2. Rubella, Fifth disease (parvovirus B19) 3. Roseola Infantum (HHV-6) 4. Mumps 5. Varicella 1. Pneumonia, otitis media, encephalitis 2. transmission to pregnant women 3. febrile seizures 4. aseptic meningitis, orchitis, deafness 5. secondary infection skin lesions; CNS, Reyes syndrome 5

6 Complications of Common Infectious Diseases (bacterial) 1. Pertussis 2. Diptheria 3. Hep B 4. Hib (Haemophilus Influenzae) 1. Pneumonia 2. Airway obstruction, myocarditis, neuritis 3. Liver cirrhosis, CA 4. Meningitis, epiglottitis, pneumonia, septic arthritis, sepsis 6

7 Immunization Schedule 2, 4, 6, (15) months  Hep B, DTaP, Hib, IPV, PCV MMR, Varicella: after 12 mo** NEW! Tdap 7 th -12 th grade If miss one, do not need to start over 7

8 Biological Terrorism 8

9 Infectious Diseases Primary prevention as intervention  Many diseases are vaccine-preventable Secondary Intervention: treat symptoms  Rash  Fever  Itching  Secondary infection-try to prevent Tertiary Intervention 9

10 Nursing Care Risk for [spread of] infection Ineffective Health Maintenance Risk for ineffective thermoregulation Fatigue r/t fever, discomfort Social isolation r/t confinement 10

Impetigo 11

12 Impetigo - Interventions Soak crusts in warm water Gently cleans w/antibacterial soap Do not pick at lesions Child & caregiver: HANDWASHING Fingernails short & clean Topical antibiotic ointment Communicable up to 48 hours after antibiotic treatment begun. 12

13 Cellulitis Inflammation of skin, SQ tissues Local area is red, hot, swollen & painful Regional lymph nodes often involved Systemic effects: fever, chills, confusion, malaise 13

14 Cellulitis: risk for spread of infection Sepsis Septic arthritis Meningitis Brain abscess Blindness 14

15 Interventions: Cellulitis Antibiotics  if hospitalized, IV Entire course Monitor temp Warm compresses Elevate affected limb Bed rest - acute phase 15

16 Skin Disorders: other causes Viral & Fungal Contact insect & animal contact 16

17 Pubic lice with nits 17

18 Common Nursing Diagnoses r/t integumentary alterations Pain, acute r/t Pruritis r/t reaction to irritants secondary to… Impaired skin integrity r/t inflammation & scratching of lesions Risk for secondary infection r/t altered skin integrity; scratching Knowledge deficit regarding cause, treatment, spread of infection r/t lack of information. 18

19 Nursing Diagnoses: cont. Risk for fluid volume deficit or nutritional deficit if lesions on mouth, tongue, etc. Body image disturbance r/t altered appearance Fatigue r/t fever Social isolation 19

20 Hyperthermia vs Fever Fever: results from an insult or disease that resets the body’s “set point”. Hyperthermia: high body temperature 20