07 Dec discuss other applicable preventative guidelines for one of the patients from the initial scenario. Provide a link to patien
discuss other applicable preventative guidelines for one of the patients from the initial scenario. Provide a link to patient education relating to this additional guideline that your peer would find interesting and helpful.
Focus on Preventative Guidelines for Childhood Immunizations
You are working as an APRN in your local primary care office. The rural town of Maynard has 300 people, a post office, a doctors office, and a gas station. The primary source of income is farming or driving 45 minutes to a somewhat larger town. With the blizzard coming, all your patients except two have canceled for the morning. Jose is scheduled at 0900; he is a nine-year-old Hispanic male born in Mexico. He and his family (Mom, Dad, and six siblings, ages six months to 14 years) moved into the area just a few months ago. Joses mother reported that he had nearly died two months after contracting pertussis.
Your final patient of the morning is Irena, a 15-year-old teenage female who lives with her aunt in Maynard. Irena is Romanian and barely speaks any English. Her aunt has been your patient for the past few years, and she told you that Irena had been abducted in Romania at the age of 10. Irenas parents found her quiet by accident when a sex trafficking ring dumped all their product in a refugee camp in Serbia just a few months ago. Irenas parents are still in Romania, but they sent Irena here to live with her aunt.
- Discuss the guidelines assigned with your scenario.
First, I will need to complete an assessment to find out if the patients are up to date on their childhood immunizations. If they are not, both patients will be offered the meningococcal, TDaP, Hepatitis A, Hepatitis B, inactivated poliovirus, MMR, varicella, annual influenza, and COVID-19 vaccines. Irena will also be offered the HPV vaccine. The catch-up guidelines are listed specifically on the Centers for Disease Control and Prevention (2021) website. It also discusses the minimum interval between doses. For example, for the TDaP vaccine, the minimum age for dose 1 is 7 years old. There is a minimum interval of 4 weeks between doses 1 and 2, and 2 and 3.
- Will both patients be treated in the same manner? Why or why not?
In a way, yes, I will treat them in the same manner. Both patients have undergone traumatic life events at a young age. This may have some psychosocial ties with fear of primary care providers and vaccinations in general. Although they are 9 and 15 years old respectively, I will need to quickly form a trusting relationship with the patients. Secondly, I will need to communicate with the patient and their families via interpreter if it is requested. I will explain to both patients, and their families the importance of vaccinations and common side effects post-vaccination. According to the Mayo Clinic (2021), side effects from childhood immunizations are minor. They may include a low-grade fever, fussiness, and soreness at the injection site. Some vaccines cause a temporary headache, fatigue, or loss of appetite. Rarely, a child might experience a severe allergic reaction or a neurological side effect, such as a seizure. I will provide them with the vaccine- information summary (VIS) as required by law and will answer any questions they have in an age-appropriate manner. Finally, I will discuss with everyone the plan for follow-up appointments for the vaccinations that require series doses and plan for follow-up care overall. With that noted, each child requires different vaccinations at their current age.
- What would your treatment plan be for each of the individuals in your scenario?
Assuming neither child is up to date on their childhood immunizations, both children will be offered the immunizations listed in part 1. Per the National Foundation for Infectious Disease (2021), the Advisory Committee on Immunization Practices (ACIP) discusses that multiple vaccinations can be given on the same day if they are in separate syringes and the injections sites are spaced out by at least one inch. Both patients will have their deltoid muscles as the designated injection site. This procedure will be followed for both patients. If they are caught up in the vaccinations, I will follow the recommended vaccinations for their age.”
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