Following the directions, 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.

  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?
  2. When should she return and which ones would you administer at the next visit?
  3. Which 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.

  1. Which vaccines do you recommend at this visit?
  2. What anticipatory guidance should be given for a child receiving a flu vaccine at this age?
  3. 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.

  1. Which vaccine(s) do you recommend at this visit?
  2. The 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?
  3. The mother is agreeable to proceed with vaccine administration today. Are additional doses needed? If yes, state which ones and when.

Solution

Case#1

As specified by CDC (Centers for Disease Control) and Prevention, the first of three shots given to newborns is the hepatitis B vaccine. A dose of this medication should be prescribed within twenty-four (24) hours of birth in infants who are more than or 2,000 grams and are presumed stable.  Hepatitis B infection is a chronic disease that can produce symptoms such as fever, fatigue, and jaundice (Oliver & Moore, 2020). In order to curb this transmission, it is fundamental receive the Hepatitis B vaccination.

 Following the birth of a child, the mother should be tested for the presence of hepatitis B. To ensure that the child is protected against this disease, a series of vaccinations and immune globulins (HBIG) should be administered within 12 hours after birth.  In the case of a mother who tests positive for hepatitis B, the first dose of Hepatitis B vaccine and Hepatitis B immune globulin should be administered to her baby within 12 hours after delivery.  The Centers for Disease Control and Prevention recommends that hepatitis B immunizations be given to children at birth, regardless of their birth weight. However, if the child weighs less than 2 000 grams at birth, three doses of vaccine are given on the first day of life. The provider should test the child for hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (anti-HBs) between 9 and 12 months. It is important to note that if the mother is positive for Hepatitis B, then the child should receive Hepatitis B immune globulin (HBIG) with the deadline for this application being set at seven days (CDC, 2021)….Kindly click the purchase icon to access the full solution at $10