What vaccine(s) should she receive and why?

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. 1.What vaccine(s) should she receive and why? 2.What would you do if the mother tested positive for Hepatitis B? 3.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. 1.Which vaccines should the child receive at this visit? should she return and which ones would you administer at the next visit? vaccination combinations can be used 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. vaccines do you recommend at this visit? anticipatory guidance should be given for a child receiving a flu vaccine at this age? 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. vaccine(s) do you recommend at this visit? mother is states that she only wants her daughter to have “the one required for school this year but not the others”. How should the Nurse Practitioner counsel the mother and the patient? mother is agreeable to proceed with vaccine administration today. Are additional doses needed? If yes, state which ones and when.

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