Immunisation Program Registered Nurse Module 2 Assessment 2019

This document presents a completed assessment for the Immunisation Program, specifically designed for Registered Nurses, focusing on the Health (Drugs and Poisons) Regulation 1996. The assignment covers a range of topics including the management of patients presenting with potential tetanus exposure, the implications of blood transfusions on MMR vaccination, parental concerns regarding vaccine adjuvants, and the management of a family exposed to pertussis. The assessment requires detailed responses, including discussions on immune responses, public health considerations, and recommendations for vaccination schedules. The solution demonstrates an understanding of vaccine-preventable diseases, the National Immunisation Program Schedule, and relevant public health protocols. It also includes appropriate referencing in APA style.

Module 2 Assessment | 2019
Immunisation Program Registered Nurse Health
(Drugs and Poisons) Regulation 1996 course

Name of publication Module 2 Assessment | 2018
Immunisation Program Registered Nurse Health (Drugs and Poisons)
Regulation 1996 course
Version 3.2
Approved April 2019
First Published April 2017
Published by Cunningham Centre
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Toowoomba Queensland 4350
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Assessment activities Module 2
Workbook
 Pass mark 50%
 Due date: please see your course calendar
It is recommended you work through the study guide in chronological order to
successfully complete the workbook.
Please ensure you keep a copy of your completed workbook for your own records.
 Please phone or email the course coordinator for assistance if required.
Phone or email the course coordinator for assistance if required.
Note, approximate word counts in each question are provided as a guide only (i.e. to
give you an idea of how much is expected for each answer). You will not be
penalised if you do not adhere to these word limits.
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Submission of your assessment
 Please submit in Word format only.
 Suggested word counts for your written responses are provided.
 APA referencing style is required (both in text and a reference list. The
reference list can be after each question, or one list at the end of your
workbook. If a question is asking you to discuss a particular document, then
you do not need to include references).
 Complete cover page prior to submission
o File name your assessment as follows:
Given name Surname WB1 e.g. Mary Brown WB1
 Submit the workbook either on or before the due date – you have until midnight
on the due date.
 Ensure you keep a copy of your assessment for your own records
 Submit via Turnitin (you will receive a confirmation email)
 Allow 2-3 weeks for your assessment to be returned

Cover PageModule 2 Assessment
Student to complete
Name: Cohort:
Due Date: Date Submitted:
Date extension granted until:
By the action of submitting this workbook, I declare that I am the original author of this
assessment, and to my knowledge there is no material which has been previously
published or written by another person except where reference is made. I have read
and understand the section on academic dishonesty in the Cunningham Centre Client
Handbook, and understand that should this declaration be false then I will be subject
to disciplinary action as per Cunningham Centre policy.
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Office use only
Question Marks
available
Marks
achieved
1. Immune
system
1 8
2. Vaccinology 2 2
3 2
3. Vaccine
preventable
diseases
4 8
5 3
6 4
4. National
Immunisation
Program
Schedule
(NIPS)
7 2
8 2
9 2
10 3
11 1
12 4
13 3
14 2
15 3
16 2
5. SIP 17 3
6. Myths &
realities
18 3
19 3
Referencing Ungraded
Mandatory
Reflective
activity
Ungraded
Mandatory
TOTAL 60
Date received:
Marker:
Marks:
Comments:
Date returned: Resubmission date:
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The immune system
Question 1 8 marks
George is a 62-year-old non-Indigenous male who has injured himself with an old piece
of wire whilst gardening. He has a minor laceration to his left forearm which is no longer
bleeding. George is otherwise well. George says he does not think he has ever had a
tetanus vaccination in the past.
How will you manage this presentation? (Approximately 300-400 words)
In your answer include:
 Your immediate assessment and management
 In regard to tetanus vaccination, include:
o Your assessment of any requirements for vaccination
According to Collins et al. (2015), timely administraton of the post-exposure prophylaxis
after the injury or cut can help to prevent the development of the clinical tetanus or
reduce the severity of the tetanus. Thus the wound of George must be assessed and
thoroughly cleaned. The type of tetanus prophylaxis recommended mainly depends in
the overall nature of the wound and vaccination history of the patients. Collins et al.
(2015) stated that fully immunized patients who are immunospuuressed must be
managed as if they are immunized incompletely.
o Recommendations for vaccination (including vaccine type), and
o Rationale for your recommendations.
Since George has stated that as per his memory he does not think that he has been
immunised with the tetanus vaccine before, he will require one dose of the tetanus
vaccine to be given immediately. Then further arrangement of the vaccination will be
done in order to complete the rest five dose of the course. This is because tetanus is
potentially fatal disease caused by the neurotoxin produced by Clostridium tetani.
However, the tetanus is preventable under the action of the tetanus vaccination.
Moroever, the signs of the clinical signs of the tetanus vaccination like muscle rigidity,
spasms are presented between 4 to 21 days after the inoculation of the bacteria
(Collins et al., 2015). So since George is unware about his current status of the tetanus
vaccination and tetanus symptoms appear after 4 days. It will is strictly recommened to
immunize George with tetanus vaccines.
 A discussion of the relationship of vaccination requirements in this specific case
to the body’s immune response.
The administration of the vaccination tetanus vaccine or tetanus toxoid (TT) is formed
by inactivated tetanus vaccine. The administration of TT leads to the formation of the
antibodies against TT and thus helping in the development of immunity (Collins et al.,
2015).
 Public health considerations in this case (as an unimmunised individual)
An immunised individuals main develops prophylaxis vaccination after 4 to 21 days of
the inoculation of the bacteria. The tetanus toxins bind to the peripheral and central
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nervous system leading to the development of the symptoms of the muscle rigiidyt,
spasms and spastcity fllowed my death arising from the multi-organ failure (Collins et
al., 2015).
Reference
Collins, S., White, J., Ramsay, M., & Amirthalingam, G. (2015). The importance of tetanus risk
assessment during wound management. IDCases, 2(1), 3-5.
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Vaccinology
Question 2 2 marks
Prue has presented for a MMR vaccine ten weeks postnatal. During the antenatal
period Prue was advised to have an MMR vaccine after her baby was born. She had
forgotten all about the vaccine up until now. Whilst completing your pre-vaccination
check, you find out that Prue had was given a blood transfusion of packed red blood
cells after birth as she had a post-partum haemorrhage.
How will you manage this presentation?(Approximately 100-150 words)
 What is the significance of having received a blood transfusion and needing an
MMR vaccine?
Owatanapanich et al. (2014) stated that MMR (measles - mumps - rubella) vaccination
is given shortly before, simultaneously with or after an antibody-containing blood
product like immune globulin or a complete blood transfusion. This is because after
blood transfusion, the vaccination effect or secondary immune-response to MMR
antigens is diminished. Vaccine is given either 2-wekks before the receipt of the blood
product or 3 to 11 months after the receipt of the blood product.
 What advice/recommendations will you provide to Prue?
Prue is presented with MMR vaccine 10 weeks post-natal and during antenatal care
she was advised to have MMR vaccine after her baby was born. Since only packed red
blood cells were given to Prue, MMR vaccination might not be necessary as it is packed
red blood cells are devoid of immunoglobulin.
Reference
Owatanapanich, S., Wanlapakorn, N., Tangsiri, R., & Poovorawan, Y. (2014). Measles-
mumps-rubella vaccination induced thrombocytopenia: a case report and review
of the literature. Southeast Asian Journal of Tropical Medicine and Public
Health, 45(5), 1053.
Question 3 2 marks
Joe has brought his two-month-old baby in to be vaccinated. Joe says he has heard
there is aluminium in some vaccines and he is concerned.
How will you manage this presentation?(Approximately 75-100 words)
 What advice/explanationwill you give to Joe?
I will educate Joe that aluminium used in vaccines in the form of adjuvant. Adjuvant
helps to increase the immune response against the inactivated, killer and subunit
antigens. The presence of adjuvant in the vaccine enables lesser quantity of vaccine
administration along with less dosage. Thus presence of aluminium in vaccines is safe
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to use and is not harmful for his child. While not immunizing his child might invite in fatal
diseases like measles, mumps, rubella and hepatitis (Ghimire, 2015).
Reference
Ghimire, T. R. (2015). The mechanisms of action of vaccines containing aluminum
adjuvants: an in vitro vs in vivo paradigm. Springerplus, 4(1), 181.
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Vaccine preventable diseases
Question 4 8 marks
Ruth presents to see you at the clinic, as she is very concerned about everyone
catching pertussis.
Ruth says her neighbour’s child has just been diagnosed with pertussis. Ruth and her
family meet regularly with the neighbours and the children sometimes play together.
Ruth has two children:
 Rochelle (just had her 4th birthday)
 Thomas (six weeks of age). He has only received birth dose of H-B-Vax II
(paediatric).
Ruth is also concerned as her sister, who is 30 weeks pregnant, is staying with her.
How will you manage this presentation?(Approximately 500 words)
Include in your answer:
 Epidemiological and public health considerations that will influence your clinical
decision making
Pertussis is a respiratory illness commonly known as whooping cough. It is a
contagious disease caused by bacteria Bordetella pertussis. Recovery from pertussis
occurs slowly and might take months. The children who are below 18 years of age are
vulnerable towards getting affected with pertussis and best way to prevent this disease
is effective immunisation. Pertussis vaccine is given in combination with Diptheria and
Tetanus. The vaccine is commonly known as Diphtheria Tetanus and Pertussis (DTaP)
vaccination. Thus contagiousness of the disease and curing through effective
vaccination will influense my decision-making process (Centers of Disease Control and
Prevention [CDC], 2019).
 Advice/education you will give to Ruth about pertussis and strategies
(asrequired) to reduce the risk of pertussis to herself, the children and Ruth’s
pregnant sister
The advice will be based on the vaccination states of Ruth and his family members. If
Rochelle, who is four years old is vaccinated with Diptheria - Tetannus and Pertussis
Vaccine during 2, 4 and 6 months of age and during 15 and 18 months and is currently
on the vaccination cycle of (4 to 6-years) then threat of getting infected with pertussis is
minimal. However, threat still persists as she is still not fully vaccinated (CDC, 2019).
In case of Thomas who is six weeks of age, he is still not ready for pertussis vaccination
must be forbidden from going to the neighbour’s house. Moreover, the primary care
givers of Thomas like Ruth or other members of the families with who Thomas spend
majority of the time in a day must forbid themselves from meeting the neighbours child
until recovery as the disease is highly contagious. It mainly spreads from one person to
another through coughing, sneezing or coming in contact with breathing from the
infected person. Since new born child are immuno-compromised, Thomas are more
vulnerable in getting affected with the disease. Moreover, CDC also reveal that majority
of the new borns are infected from their older siblings, parents and caregivers who
might not even aware that they have the disease. New borns are also immuno-
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compromised and thus are more prone towards getting affected with pertussis (CDC,
2019).
For Ruthi's sister who is 30 weeks pregnant, Ruth and the family members must
prevent from visiting the neighbour's house in order to restrict the spread of the disease
from direct contact. Pregnant women infected with pertusis are known to spread to
infection to the newborn. Moreover, pregnant lady is recommended to get vaccinated
with Tetanus Diphtheria and Pertusis (Tdap) vaccine. During pregnancy Tdap
vaccination is given during 27 weeks through 36 weeks of gestation. Vaccination in
pregnant lady leads to the transmission of the maternal pertussis antibodies to the new-
born and thus providing protection against pertussis in the early stages of life before the
baby is physiologically eligible for DTaP vaccine (CDC, 2019).
 Would you recommend any vaccines? What/why?
DTaP vaccination will be recommended. It helps to prevent occurrence of pertussis
along with the prevention of Diphtheria and Tetanus (CDC, 2019).
Reference
Centers of Disease Control and Prevention [CDC] (2019). Pertussis. Access date: 23rd
April 2019. Retrieved from:
https://www.cdc.gov/pertussis/about/prevention/index.html
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Question 5 3marks
You are providing education to a group of parents about immunisation. One parent says
“My mother says when she was a child everyone had measles, and in fact kids were
deliberately exposed to a known case of measles. Aren’t vaccines overrated for such a
mild childhood illness?”
Discuss how you will respond to the parent. (Approximately 100-150 words).
In your answer consider:
 Clinical features, epidemiological and public health considerations in relation to
measles.
Clinical features of measles include high fever, cough, runny nose along with red and
watery eyes (conjunctivitis). After two to three days there tiny white spots appear inside
the mouth known as Koplik spots this is followed by development of rash over the entire
body (CDC, 2018).
Epidemiological and public health considerations
The children below the age group of 8 to 10 years are vulnerable towards the
development of the disease. Risk of death arising from measles is only 0.2%. However,
the risk of death increases among the children who are malnourished. The majority of
the children who have encountered death from measles are below 5-year of age (CDC,
2018).
 Recommendations for vaccination (for measles) for children and adults.
Measles, the viral disease is highly contagious. The air-borne virus spreads rapidly from
one person to another through sneezing and coughing. Measles can be prevented
through MMR (Measles Mumps and Rubella) vaccination. CDC recommends children
who are aged between 12 through 15 months of age are eligible for MMR vaccination
and second dose must be given at 4 through 6 years of age. Teens and adults should
be up to date about their MMR vaccination (CDC, 2018).
Reference
Centers of Disease Control and Prevention [CDC] (2018). Measles. Access date: 23rd
April 2019. Retrieved from: https://www.cdc.gov/measles/about/signs-
symptoms.html
Question 6 3 marks
Sandy asks why she needs to have an influenza needle every year. She had one last
year, and says she caught the flu from the vaccine. She is reluctant to have another
influenza vaccine.
Discuss how you will respond to Sandy(Approximately 100-150 words).
In your answer consider:
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