Author Question: The parents of a 2-month-old infant ask the primary care nurse practitioner (NP) if they can ... (Read 57 times)

Chloeellawright · **on:** Jul 24, 2018

The parents of a 2-month-old infant ask the primary care nurse practitioner (NP) if they can immunize their child by giving one or two immunizations per month instead of following the recommended immunization schedule for vaccines at 2, 4, 6, 12, and

15 months of age. The NP should: a. respect the parents' wishes and agree to the revised schedule for immunizations.
b. explain that prolonging the vaccine regimen will lead to a decrease in final antibody concentrations.
c. tell the parents that protection from diseases may be delayed until all immunizations have been given.
d. inform the parents that a prolonged interval between some vaccines may require restarting the series for those vaccines.

Question 2

A patient who is taking metronidazole calls the primary care NP to report severe nausea and vomiting along with heart palpitations. The NP should:

a. counsel the patient to take the medication with food.
b. ask the patient about any recent alcohol consumption.
c. reassure the patient that these symptoms will subside.
d. instruct the patient to go to an emergency department for intravenous fluids.

ally · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

C
Young infants are the most vulnerable to serious outcomes of vaccine-preventable disease. Vaccination providers should adhere as closely as possible to recommended vaccination schedules. Protection may not occur until all doses have been given. Parents should be counseled about the risks and benefits of vaccines. Longer than recommended intervals between doses do not reduce final antibody concentrations. With the exception of oral typhoid, an interruption in the schedule does not require restarting the entire series.

Answer to Question 2

B
Metronidazole can cause a disulfiram-like reaction if taken with alcohol. Mild gastrointestinal upset may be prevented by taking the medication with food. The patient needs to be told not to drink alcohol with this drug to prevent this severe reaction. If the symptoms persist, it may be recommended that the patient go to the emergency department.