The nurse is planning to provide immunizations to a medically ...

[dalyningkenk]

The nurse is planning to provide immunizations to a medically stable preterm infant. Which of the following immunizations would be indicated for this infant?
 
  1. Hepatitis B
   2. Smallpox
   3. Influenza
   4. Diphtheria, tetanus, acellular pertussis

Question 2

A 70-year-old client who is in the terminal phases of a debilitating muscular disease tells his wife that he believes the health care team has failed and given up on him and aren't trying as hard..
 
  The nurse caring for this client plans interventions for this family based on which of the following? 1. This idea of abandonment is unfounded.
   2. This is a common fear in the terminally ill client.
   3. When clients become terminal, physician care is no longer necessary.
   4. Clients who feel this way are in denial of the facts of their care.

[raenoj]

Answer to Question 1

4. Diphtheria, tetanus, acellular pertussis

Rationale:
Medically stable preterm infants should receive full doses of diphtheria, tetanus, and acellular pertussis at a chronologic age consistent with the schedule recommended for full-term infants. The optimal timing to initiate Hepatitis B vaccination in preterm infants has not been determined. The influenza vaccine should be administered at 6 months of age before the beginning of and during the influenza season. There is not enough information to determine whether the influenza vaccine is or is not indicated for the baby at this time. Smallpox vaccinations are provided to older children.

Answer to Question 2

2. This is a common fear in the terminally ill client.

Rationale:
If the client feels that his terminal state is a reflection of failure of the medical system, this fear of abandonment is common. It may not be totally unfounded because failing to cure a client is frustrating and may reflect in the care provided to the client. While nurses do provide much of the care given to terminal clients, physicians continue to be an integral part of care. There is no indication of denial in this client's statements, but powerlessness or hopelessness may be evident.