Question

Critical Thinking Case Study RR, a 22-year-old college student, is in the wellness clinic with her 3-month-old daughter and her 13-year-old sister. They live with RR’s grandmother, who is 68 years old. RR requests immunizations for her daughter and asks if there are any immunizations she and her sister need.

1. RR says her daughter needs her “regular shots.” The infant received her first hepatitis B vaccine while in the newborn nursery but has not had any shots since coming home. Against what vaccinepreventable illnesses should the nurse plan to vaccinate this infant today?

2. RR is worried that she will need to start her immunizations over because “she’s so far behind.” How should the nurse respond to her concern? When would her infant be due for another series of immunizations?

3. Which vaccines is RR’s daughter due for today?

4. RR reports she is afraid the baby will have a reaction. Compare the mild side effects with the more severe allergic reactions. What is the best way of allaying RR’s fears?

5. The nurse asks RR about her vaccine history. RR says she had her “baby shots” a long time ago but did not keep her personal vaccine record; however, she remembers receiving a flu shot 2 years ago. What immunizations will she need at this point? How can she best keep track of her immunizations?

6. RR informs the nurse that she is a college freshman and just received an email informing her that there is a campus-wide meningitis outbreak. She doesn’t live on campus and asks the nurse if she needs a meningitis shot anyway. Identify the manifestations of this vaccine-preventable disease.

7. After administering RR’s meningitis vaccine, RR’s 13-year-old sister mentions that she heard that high school students should get a vaccination for human papillomavirus (HPV). She wants to know if she should get one or if it is too late. Who is eligible to receive the HPV vaccine, and what assessment questions would the nurse ask? What type and dosage of vaccine would the nurse administer?

8. RR appears relaxed and comfortable during the visit. However, she states that she is worried about her grandmother’s health because her grandmother has diabetes and high blood pressure. RR wants to know if her grandmother should get any immunizations or if those would just make her sick. Identify which vaccine-preventable diseases and vaccines should be given.

9. After the visit, how does the nurse ensure that the vaccines were safely administered?

This is a clear question I need the answer for all of these questions

Answer 1

SL No	Critical Thinking Case Study RR, a 22-year-old college student, is in the wellness clinic with her 3-month-old daughter and her 13-year-old sister. They live with RR’s grandmother, who is 68 years old. RR requests immunizations for her daughter and asks if there are any immunizations she and her sister need.	Answer to the questions
1.	RR says her daughter needs her “regular shots.” The infant received her first hepatitis B vaccine while in the new born nursery but has not had any shots since coming home. Against what vaccine preventable illnesses should the nurse plan to vaccinate this infant today?	According to data available it is noted that the child is 3 month old and hence the nurse plans all those shots between child’s birth and 3rd month it is also noted that the child has not taken any immunisation after the necessary at birth immunisation.
2.	RR is worried that she will need to start her immunizations over because “she’s so far behind.” How should the nurse respond to her concern? When would her infant be due for another series of immunizations?	Yes definitely it is necessary to get the child immunised at every cost and there is a need to develop a plan that she would not forget or skip in future days. The nurse plans to educate her and provide her an immunisation plan card which should have mentioning of all the necessary immunisations names along with months and dates to be taken. The nurse enters the details of the immunisation already taken and to be taken in future along with mentioned dates so that it makes the mother easily follow and accept the strategy.
3.	Which vaccines is RR’s daughter due for today?	Now, the current scenario, the baby is 3 month old and was given immunisation at birth Hence, · BCG (the only dose) – at birth – given – intra dermal · Hepatitis B (first dose) – at birth – given – intra muscular · OPV (first dose) – at birth – given – orally 1. OPV (second dose) – 6 weeks after birth – not given hence plan to be given now – orally 2. Rotavirus (first dose) – 6 weeks after birth – not given hence plan to be given now – orally 3. DPT (diphtheria, pertussis, tetanus) first dose – 6 weeks after birth – not given hence plan to be given now – intra muscular 4. Hepatitis B vaccine (second dose) – 6 weeks after birth – not given hence plan to be given now – intra muscular 5. HIB vaccine (haemophilus influenza type B) (first dose) – 6 weeks after birth – not given hence plan to be given now – intra muscular 6. IPV (Inactivated polio vaccine) (first dose) – 6 weeks after birth – not given hence plan to be given now – intra muscular 7. Pneumococcal immunisation (PCV13) (first dose) – 6 weeks after birth – not given hence plan to be given now – intra muscular
4.	RR reports she is afraid the baby will have a reaction. Compare the mild side effects with the more severe allergic reactions. What is the best way of allaying RR’s fears?	Definitely there is concern for the reaction of the immunisation being given, there might be slight raise in body temperature of the child and child might seems to become sick but these are very common and normal processes. Mild analgesics and antipyretics shall be given to the child and the disorders might be resolved. There are no major reaction into the immunisations as such there is no concern regarding that. Hydration of child good feeding should be followed
5.	The nurse asks RR about her vaccine history. RR says she had her “baby shots” a long time ago but did not keep her personal vaccine record; however, she remembers receiving a flu shot 2 years ago. What immunizations will she need at this point? How can she best keep track of her immunizations?	RR the mother of the child had a flu shot 2 years ago. The immunisation of mother after child birth is Tdap, which has a reduced dose of the Tetanus Toxoid, diphtheria and pertussis vaccines immunisation to given IM and influenza vaccination should be given IM. Rountine immunisation every year of Flu and pre immunisation during pregnancy are important for mothers
6.	RR informs the nurse that she is a college freshman and just received an email informing her that there is a campus-wide meningitis outbreak. She doesn’t live on campus and asks the nurse if she needs a meningitis shot anyway. Identify the manifestations of this vaccine-preventable disease.	Yes definitely the mother who is 22 year old should get MenB Vaccine (Serogroup B meningococcal (MenB) vaccines). It is noted that (only one shot is necessary no booster dose after the age of 18) here the RR is 22 year old hence only shot is given RR’s sister who is 13 year old should get Meningococcal conjugate (MenACWY) vaccines. For meningitis as there is out break of mengitis along with first booster dose at the age of 15 and second booster dose at age of 18
7.	After administering RR’s meningitis vaccine, RR’s 13-year-old sister mentions that she heard that high school students should get a vaccination for human papillomavirus (HPV). She wants to know if she should get one or if it is too late. Who is eligible to receive the HPV vaccine, and what assessment questions would the nurse ask? What type and dosage of vaccine would the nurse administer?	RR’s sister who is 13 year old should get Human papillomavirus (HPV), a sexually transmitted infection prevents cervical cancer. This has to be given for young girls of age 9 to 12 years of age and goes till 26 years of age any time this immunisation should be given 2 doses with 6 months apart. The details of the vaccine are it is given 500μg amorphous aluminium hydroxyl-phosphate sulphate.
8.	RR appears relaxed and comfortable during the visit. However, she states that she is worried about her grandmother’s health because her grandmother has diabetes and high blood pressure. RR wants to know if her grandmother should get any immunizations or if those would just make her sick. Identify which vaccine-preventable diseases and vaccines should be given.	Yes elderly need Yearly immunisation of Tetanus toxoid Influenza Shingles After the age of 65 years given IM
9.	After the visit, how does the nurse ensure that the vaccines were safely administered?	All the Rights of the mother, baby and her sister were considered and immunisation was given using appropriate aseptic technique and education was provided as well as it was made sure that all data’s were entered without fail and information to the mother that her next scheduled visit is planned