A nurse is caring for a 6-month-old child. The child's provider has ordered a diphtheria, tetanus, and pertussis (DTaP) vaccine to be administered. Which of the following should cause the nurse to question the administration of this vaccine?
New onset of seizure disorder in the child's sibling
Evidence of sensitivity to egg antigens
Afebrile otitis media
Temperature of 40.5° C (104.9° F) after last DTaP
The Correct Answer is D
A. New onset of seizure disorder in the child's sibling: This does not contraindicate DTaP vaccination unless the child itself has a history of seizures or neurological disorders.
B. Evidence of sensitivity to egg antigens: DTaP vaccine is not contraindicated by egg allergy; this is more relevant to influenza vaccines.
C. Afebrile otitis media: This is not a contraindication for DTaP vaccination.
D. Temperature of 40.5° C (104.9° F) after last DTaP: A high fever following a previous dose of DTaP may indicate a severe reaction, necessitating caution or further evaluation before administering another dose.
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Related Questions
Correct Answer is C
Explanation
A. "Your newborn will receive the first DTaP vaccine during the initial well-baby visit.": The first dose of DTaP is typically given at 2 months, not at the newborn stage.
B. "Your newborn should receive an immunization for MMR at 6 months.": The MMR vaccine is usually administered at 12-15 months, not at 6 months.
C. "Your newborn is scheduled to have a hepatitis B vaccine prior to discharge.": Hepatitis B vaccine is recommended to be given within 24 hours of birth as the first dose of a series.
D. "Your newborn should receive the PCV vaccine two times prior to his first birthday.": The pneumococcal conjugate vaccine (PCV) schedule starts at 2 months with multiple doses, but not specifically "two times" before the first birthday.
Correct Answer is B
Explanation
A. "I'll give him acetaminophen for the pain.": Acetaminophen is used for pain relief and fever reduction but does not address disease transmission. It does not prevent the spread of the streptococcal infection.
B. "I'll discard his toothbrush and buy another.": This is crucial because the streptococcal bacteria can remain on the toothbrush, leading to potential reinfection or spreading the bacteria to others. Replacing the toothbrush after starting antibiotics helps to reduce the risk of reinfection.
C. "I'll continue to encourage him to drink lots of fluids.": Staying hydrated is important for recovery, but it does not prevent the transmission of the infection.
D. "I'll take his temperature every 4 hours.": Monitoring temperature helps track the child’s condition but does not prevent the spread of the infection.
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