Author Question: The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the ... (Read 89 times)

krzymel · **on:** Jul 24, 2018

The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99 F to 100 F and two to three loose stools per day.

Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should: a. administer the 6-month immunizations at this visit today.
b. schedule an appointment in 2 weeks for 6-month immunizations.
c. administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.
d. withhold all immunizations until the infant's temperature returns to normal and the cough is gone.

Question 2

The primary care NP sees a 5-year-old child for a prekindergarten physical examination.

The child's parents do not have immunization records, and a local record search does not provide proof of vaccinations, although the parent thinks the child may have had some vaccines several years ago. The NP's initial action will be to: a. perform serologic tests for measles, rubella, and tetanus antigens.
b. administer TdaP, MMR, Varivax, PCV13, hepatitis A, hepatitis B, and IPV vaccines.
c. administer DTaP, Hib, hepatitis A, hepatitis B, MMR, Varivax, IPV, RV, and PCV13 vaccines.
d. ask the parent to look for immunization records and schedule an appointment for vaccines when those are found.

flannelavenger · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
Minor upper respiratory infection or gastroenteritis, with or without fever, is not an indication for withholding a scheduled vaccine dose.

Answer to Question 2

B
Persons without documentation of vaccine receipt should be considered nonimmunized if a reasonable effort to locate records is unsuccessful and should be started on age-appropriate vaccines. The Hib and rotavirus vaccines are not given after age 5, or 60 months of age. Serologic testing for immunity may be done for certain antigens, but this does not include tetanus.