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. Mild illnesses like nasopharyngitis (a common cold) do not typically contraindicate vaccination, so there is no need to delay immunization.
B. It is essential to evaluate for allergies to vaccine components, such as gelatin or neomycin, which could contraindicate the administration of the varicella vaccine.
C. The first dose of the varicella vaccine is recommended at 12-15 months of age, not at 4 years of age, so it is appropriate to administer it during this well-check.
D. The varicella vaccine is administered subcutaneously, not intramuscularly, so this is not the correct route for administration.
Correct Answer is D
Explanation
Rationale:
A. Prone positioning is not recommended post-operatively for abdominal surgery and could exacerbate respiratory issues.
B. While monitoring white blood cell count is important, encouraging lung expansion and preventing complications such as atelectasis is a more immediate priority.
C. The client's pain rating is low and does not necessitate immediate administration of acetaminophen.
D. Encouraging the use of an incentive spirometer helps improve lung expansion, which is crucial to prevent atelectasis and promote proper oxygenation, particularly when breath sounds are diminished.