The nurse is reviewing the immunization schedule with the parent of a child who is positive for human immunodeficiency virus (HIV). What statement by the parents indicates that teaching has been effective?
"The varicella vaccine should be withheld if my child is symptomatic of their illness."
"The vaccination schedule does not apply to my child."
"The pneumococcal (PCV) vaccine should be delayed until my child's first birthday."
"The human papillomavirus (HPV) vaccine is contraindicated for my child."
The Correct Answer is A
Rationale:
A. The varicella vaccine, which is a live attenuated vaccine, may be withheld if the child is symptomatic of their illness or has a significantly compromised immune system. This is due to the increased risk of severe reactions or complications in immunocompromised individuals.
B. The vaccination schedule is still applicable to children with HIV, but there may be adjustments based on the child’s immunocompetence and specific health status.
C. The pneumococcal vaccine is recommended for children with HIV and is typically administered according to the standard schedule, not delayed until the first birthday.
D. The HPV vaccine is generally recommended for children with HIV, as they are at increased risk for HPV-related complications. It is not contraindicated.
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Correct Answer is B
Explanation
Rationale:
A. While newborns need to feed frequently, particularly breastfed infants, parents do not need to wake their baby for every feeding unless advised by their healthcare provider due to specific concerns like low birth weight.
B. After birth, the newborn receives initial vaccinations, such as the hepatitis B vaccine. The next set of vaccinations is typically administered at the 1 or 2-month check-up, so no additional immunizations are needed immediately after discharge.
C. Full head control is generally achieved by around 4 months of age, not 1 month.
D. Babies typically triple their birth weight by around 12 months of age, not by 4-6 months.
Correct Answer is A
Explanation
Rationale:
A. Keeping a dedicated thermometer in the toddler's room is an appropriate infection control measure to prevent cross-contamination with other patients.
B. RSV is primarily transmitted through droplet and contact, not airborne, so contact and droplet precautions are more appropriate than airborne precautions.
C. Nebulized racemic epinephrine is not typically used for RSV; it is more commonly used for croup. Treatment for RSV may include supportive care such as hydration and oxygen therapy.
D. While monitoring pulse oximetry is important, assessing it every 3 hours might be insufficient. Continuous monitoring may be more appropriate depending on the severity of the illness.