NR602 Week 3: Homework- Website Exploration Assignment

The aim of primary care for children is to promote health, growth, and development. One mechanism for addressing safety issues and parental concerns ahead of problems is to institute standard anticipatory guidance. Standard anticipatory guidance should be a routine part of well-childcare, and many resources exist for current anticipatory guidance information, such as the Bright Futures program. The website is noted below. Anticipatory guidance should be age appropriate and deal with common concerns that can be anticipated at upcoming ages. Anticipatory guidance can be organized into areas of injury and violence prevention, nutrition, sleep, and developmental or behavioral issues and categorized by visit date. The American Academy of Pediatrics recommends well-child visits at 2 weeks and then at 2, 4, 6, 9, 12, 15, 18, and 24 months, annually up to age 6, and every 2 years from age 6 through adolescence.

Topics and needs of anticipatory guidance can vary according to family needs. For example, limiting media time and pediatric obesity education may be needed for one family, while another may need more education on discipline. Careful history taking is key. Clinicians must take the time to address all standard areas and additional parent concerns, keeping in mind that handouts often go unread by families. Standard anticipatory guidance forms per visit can be found at the Bright Futures website.

Routine immunizations during childhood are some of the strongest clinical recommendations and guidelines encouraged by numerous federal agencies and expert children’s health organizations. One goal of Healthy People 2020 was to achieve 80% vaccination rates across all age groups, generally because achievement of Herd immunity for vaccine preventable diseases requires that 80% or more of the population be vaccinated.

Recommendations for increasing vaccine rates are as followed:

Test Your Knowledge

Make sure to review all vaccine recommendations and guidelines.

In 1994, the VFC program was started to provide vaccines for free to uninsured, Medicaid, and Native American patients. Today, 43% or more of all U.S. vaccinations are provided through this program. Enrollment and maintenance in the program require time, documentation, personnel to be head and follow the program, and documentation.

The current immunization schedule can be found at the Centers for Disease Control and Prevention (CDC) website, under Vaccines & Immunizations. The catch-up vaccine schedule is also posted on the CDC website.

An immunization is a suspension of microorganism that can be inactivated, partially inactivated, or attenuated. The purpose of introducing these microorganisms to the body is to create an antigen-antibody response within the body for recognition in future exposure and either reduced disease or no disease symptoms.

Vaccines work by boosting antibody production right after vaccination. Subsequent injections help to boost memory in the immune system. Most vaccines are given intramuscularly, but live or attenuated vaccines, such as MMR and Varicella, are usually given subcutaneously.

All NPs who work with children and adolescents should know vaccine schedules, side effects, and risk factors.

Common side effects of vaccinations are as follows.

• Localized erythema, swelling, and pain, particularly with DTaP and Varicella vaccines
• Pain with injection
• Low grade fever

Vaccine contraindications in childhood:

• Any secondary dose of a vaccine after severe allergic reaction to a prior vaccination.
• If the patient has severe combined immunodeficiency (SCID), they should not have rotavirus, Varicella, measles mumps rubella (MMR), varicella, or live influenza virus vaccines.
• Live influenza virus should also not be used in children with asthma, diabetes, or cardiac or renal disease. Influenza inactivated injectable vaccine (IIV) can be used.

For more information on contraindication to vaccines and vaccine side effects, visit CDC website.

It is also critical to note the vaccine administration guidelines at the bottom of the vaccine schedule.

Immunizations are not just for infants. Adolescents have several recommended vaccines, including Tdap at age 11, HPV in both boys and girls, Hepatitis A if not previously given, and Meningococcal vaccine.

Yearly influenza vaccinations are recommended for children of all age groups, particularly children with chronic conditions, such as diabetes and asthma. Flumist vaccine is a live intranasal vaccination and should not be given to pregnant women, asthmatics, or children with chronic disease that may affect immunity. All these populations can receive influenza vaccination through intramuscular routes.