The nurse is working with an immunosuppressed child. A parent ...

[NguyenJ]

The nurse is working with an immunosuppressed child. A parent points out that the child is due to have oral poliovirus vaccine and a measles-mumps-rubella (MMR) vaccine prior to school starting.
 
  The nurse will advise the parent to do which of the following? a. Have the child get the MMR but not the oral poliovirus.
  b. Take the child to get the oral poliovirus vaccine but not the MMR.
  c. Omit live viral vaccines until the child is no longer immunosuppressed.
  d. Talk with the pediatrician about getting gamma globulin with the vaccines.

Question 2

The nurse is working with a child who is immunosuppressed. The parents call to tell the nurse that the child has been exposed to varicella. Which of the following courses of action will the nurse suggest?
 
  a. Call the pediatrician, and get the child prompt treatment with a varicella immune globulin within 72 hours of exposure.
  b. Isolate the child, and get an order for an immunization for varicella if the child has not received the immunization.
  c. Take the child to the emergency room there the doctor will begin intravenous (IV) antibiotics.
  d. Take the child to the doctor's office to be seen by the nurse practitioner or the pediatrician.

[stano32]

Answer to Question 1

C

Feedback
A Incorrect. The nurse will not advise the parent to have the child get the MMR but not the oral poliovirus. Neither should be given.
B Incorrect. The nurse will not advise the parent to take the child to get the oral poliovirus vaccine but not the MMR. Neither should be given.
C Correct. The nurse will advise the parent to omit live viral vaccines until the child is no longer immunosuppressed. The child is at risk for developing the disease if a live vaccine is given. MMR and oral poliovirus vaccine are live vaccines.
D Incorrect. The nurse will not advise the parent to talk with the pediatrician about getting gamma globulin with the vaccines. Neither vaccine should be given.

Answer to Question 2

A

Feedback
A Correct. If a child who is immunosuppressed is exposed to varicella, the parents need to call the pediatrician, and get the child prompt treatment with a varicella immune globulin within 72 hours of exposure as a preventive measure. Varicella can be an overwhelming infection in this child.
B Incorrect. The parents should not isolate the child, and get an order for an immunization for varicella if the child has not received the immunization. Prompt treatment with varicella immune globulin is needed.
C Incorrect. The parents may take the child to the emergency room if directed so by their pediatrician. However, IV antibiotics will not be given.
D Incorrect. The parents should not take the child to the doctor's office to be seen by the nurse practitioner or the pediatrician.