NR 602 Week 3 Immunization Case Study Assignment 4

NR 602 Week 3 Immunization Case Study Assignment 4

NR 602 Week 3 Immunization Case Study Assignment 4

The purpose of this assignment is to familiarize the student with the most recent guidelines and recommendations for vaccine-preventable illnesses in the United States.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

List and explain the vaccinations for diseases that can be prevented by vaccination that are sold on the US market.

Identify the risks and precautions associated with using the various vaccinations.

Establish target populations for the administration of each vaccination using the advice of the Advisory Committee on Immunization Practice (ACIP).


The Immunization assignment is worth 100 points and will … on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.

Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer when creating your assignment.

Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty.

The length of the paper should be 2-3 pages, excluding title page and reference page(s). The title and reference pages should be in APA format.

Vaccination schedules should … directly from the Centers for Disease Control and Prevention: Resources for Healthcare Providers website and reflect the most current recommendations from the Advisory Committee on Immunization Practices (ACIP). Additional scholarly resources may be used and all sources must be cited appropriately.

Following the directions above, answer each of the following case scenario questions:

Case # 1

You are rotating in the newborn nursery. Your next admission is a term newborn born at 3.5 kg, and all maternal labs are negative. The infant’s exam is normal.

What vaccine(s) should she receive and why?
… would you do if the mother tested positive for Hepatitis B?
What would you do if the mother’s Hepatitis B status was unknown?
Case # 2

Your first patient in primary care clinic is a healthy 2-month-old. She received Hep B #1 in the nursery. She is a term infant and parents have no concerns. Her exam is normal and there are no contraindications to giving her vaccines.

Which vaccines should the child receive at this visit?
When should she return and which ones would you administer at the next visit?
Which vaccination combinations can … to minimize the number of needle injections, if available?
Case # 3

A healthy 5-year-old comes in with her mother for a well-child check in November. Her routine vaccines are up to date through 2 years old, but she has never received a vaccine for influenza. Her exam is normal.

Which vaccines do you recommend at this visit?
What anticipatory guidance should … given for a child receiving a flu vaccine at this age?
Are there any contraindications for the vaccines that you recommended today?
Case # 4

An 11-year-old girl presents for a routine well-child check. Her immunizations are up to date. Her exam is normal and there are no contraindications to giving her vaccines.

Which vaccine(s) do you recommend at this visit?
The mother is states that she only wants her daughter to have “the one … for school this year but not the others”. How should the Nurse Practitioner counsel the mother and the patient?
The mother is agreeable to proceed with vaccine administration today. Are additional doses needed? If yes, state which ones and when.


NR 602 Week 3 Immunization Case Study Assignment 4

NR 602 Week 3 PBL Case Study Discussion Assessment of a Child Recent

Child with Fever and Respiratory or Skin Issues

Riley, who is now 17 months old, is brought in by Kayla with a fever and rash. The fever started “a few days ago,” is mild in the morning, and rises to 103 to 104 degrees in the afternoon. Riley also experienced evident rhinorrhea, and during the past day and a half, he has also acquired a dry cough in addition to a red, widespread rash across his torso and belly that does not itch. He is drinking, but not as much as usual, according to his mother. Despite not eating or playing much, he did have a good wet diaper this morning.

Medications: Mother is giving OTC Robitussin cough and cold at 1 tsp last night and this morning. Liquid Tylenol ½ a tsp last night and this morning.

She is very concerned about the level of the fever and the fact that after 3 days he is not improving.
Discussion Questions Part One

We will begin by focusing on gathering history in an ill child.

What ‘red flags’ did you note in the historical data?

What data is most important to include in this particular case and which historical data that might be gathered on a well-child exam can be left out of this ill visit?

What are your differential diagnoses?

What parts of the physical exam will you focus on today to rule in or out your differentials?

Discussion Part Two (graded)

Physical Examination Riley:
V/S: Height: 81 cm (31.89 in), Weight: 13 kg (28.66 lbs), B/P: 94/60, T: 100.6, HR: 114 BMP/reg., Resp: 28, reg, non-labored, SpO2: 97%
17 months old, Height 51st percentile, Weight 87th percentile (CDC, 2016)

General: somewhat lethargic and cries some throughout exam. SKIN: Diffuse erythemamtous rash in fine popular patches across the torso and very erythematous to the cheeks. HEENT: Head normocephalic atraumiatic. Conjuctiva clear, non-icteric, but mildly injected PERRL. Unable to complete fundoscopic exam. Tympanic membranes intact with scant clear fluid posteriorly bill and mild injection. EAC unremarkable. Pinna/tragus w/o tenderness. Nares patent, mucosa mildly injected with sl. edema to the inferior and medial turbinates bill, moderate clear rhinorrhea. Pharynx with mild slight erythema, tonsils 2/4 bill. Oral exam unremarkable. Neck supple w/mild anterior cervical lymphadenopathy bill. Thyroid small, firm, equal bill. CARDIOPULMONARY: Heart RRR w/o murmur. Lungs with mild expiratory wheeze in posterior bases. Respirations even and unlabored. Abdomen rounded normative bowel sounds throughout, soft, non-tender, no masses or organomegaly.

Lab: WBC 6.9, Lymph 50%, Neutrophils 40%, Monocytes 6%, Eosinophils 3%

Discussion Questions Part Two

After reviewing the physical exam.

What were your ‘red flags’ on physical exam?

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