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JMJ

Marist Brothers

Notre Dame of Dadiangas University

College of Nursing

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A Ward Class Lesson Plan

On

Immunization

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Presented to:

Ms. Claire Espiritu, RN

Ms. Eleanor Caballero, RN

CLINICAL INSTRUCTOR

In Partial Fulfillment of the Requirements in

Nursing Care Management 102-B

Presented by:

Jeande Lee Sasam, SN

Joanna Paula Songcayauon, SN

Level III Section B

MEIN BENENNEN 2010

January 19, 2009

2nd Semester S.Y. 2008-2009

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IMMUNIZATION (VACCINATION)

Overview

At birth, infants have protection against certain diseases because

antibodies have passed through the placenta from the mother to the unborn
child. After birth, breastfed babies get the continued benefits of additional
antibodies in breast milk. But in both cases, the protection is temporary.

Immunization (vaccination) is the process by which vaccines are

introduced into the body before infection sets in. Vaccines are administered to
induce immunity thereby causing the recipient’s immune system to react to the
vaccine that produces antibodies to fight infection. Vaccinations promote health
and protect children from disease-causing agents. Infants and newborns need to
be vaccinated at early age since they belong to the vulnerable age group. They
are susceptible to childhood diseases.

TARGET DISEASES
1. tuberculosis
2. diphtheria
3. pertussis
4. tetanus
5. poliomyelitis
6. measles
7. hepatitis

A child is “Fully Immunized Child” when a child receives one dose of BCG, 3
doses of OPV, 3 doses of DPT, 3 doses of Hepa B and one dose of measles
before a child’s birthday.
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TETANUS VACCINE

Description: The tetanus vaccine is an inactivated toxin (poison) called a toxoid.

It is made by growing the bacteria in a liquid medium and purifying and
inactivating the toxin. Because it is not a live vaccine, a person's immunity tends
to decline with time, which is why booster doses are recommended.

Indication: To actively immunize all children from the age of 6 weeks onwards.
• To protect infants against the risks of tetanus neonatorum by immunizing
pregnant mothers.
• To actively immunize civil population particularly those who are exposed
to occupational risks such as road workers, athletes, agricultural workers,
industrial workers etc.
o To actively immunize civil and defense personnel, home guards
and police personnel.

Dosage: The full basic course of immunization against tetanus toxoid consists of
three primary doses of 0.5ml at least four weeks apart, followed by booster doses
at 18 months, 5 years, 10 years and 16 years and then every 10 years.

Protection of the newborn against tetanus:

For prevention of neonatal tetanus, tetanus toxoid is recommended for
immunization of women of childbearing age, and especially pregnant women.
Tetanus toxoid may be safely administered during pregnancy and should be
given to the mother at first contact or as early as possible in pregnancy.

Administration:
The vaccine should be administered by deep intramuscular injection.
Tetanus toxoid should be injected intramuscularly into the deltoid muscle in
women and older children. If there are indications for the use of tetanus toxoid in
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younger children the preferred site for intramuscular injection is the anterolateral
aspect of the upper thigh since it provides the largest muscular area.
Only sterile needles and syringes should be used for each injection. The
vaccine should be well shaken before use.
Each injection of the primary immunization series should be made into a
different site.

Adverse Reactions:
Mild local reactions consisting of pain, erythema, tenderness and
induration at the injection site are common and may be associated with systemic
reactions including mild to moderate transient fever and irritability.

BCG VACCINE

BCG, or bacille Calmette-Guérin, is a vaccine for tuberculosis (TB)

disease. Many foreign-born persons have been BCG-vaccinated. BCG is used in
many countries with a high prevalence of TB to prevent childhood tuberculous
meningitis and miliary disease. However, BCG is not generally recommended for
use in the United States because of the low risk of infection with Mycobacterium
tuberculosis, the variable effectiveness of the vaccine against adult pulmonary
TB, and the vaccine’s potential interference with tuberculin skin test reactivity.
The BCG vaccine should be considered only for very select persons who meet
specific criteria and in consultation with a TB expert.

Contraindications

Immunosuppression
BCG vaccination should not be given to persons who are
immunosuppressed (e.g., persons who are HIV infected) or who are likely to
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become immunocompromised (e.g., persons who are candidates for organ

transplant).

Pregnancy
BCG vaccination should not be given during pregnancy. Even though no
harmful effects of BCG vaccination on the fetus have been observed, further
studies are needed to prove its safety.

Recommendations
Children
 BCG vaccination should only be considered for children who have a
negative tuberculin skin test and who are continually exposed, and cannot
be separated from, adults who
 Are untreated or ineffectively treated for TB disease (if the child cannot be
given longterm treatment for infection); or
 Have TB caused by strains resistant to isoniazid and rifampin.

Health Care Workers

BCG vaccination of health care workers should be considered on an
individual basis in settings in which
 A high percentage of TB patients are infected with M. tuberculosis strains
resistant to both isoniazid and rifampin;
 There is ongoing transmission of such drugresistant M. tuberculosis
strains to health care workers and subsequent infection is likely; or
 Comprehensive TB infection-control precautions have been implemented,
but have not been successful.
 Reference/
Classroom/Clinical
Specific Objectives Contents Time Allotted Instructional Evaluation
Skills Lab
Materials

After 45 minutes of
lecture, the student Fundamentals quiz
nurse will be able to: of Nursing 7th
Edition,
Barbara Kozier
Define Immunization The process by which vaccines 5 mins
et. Al
are introduced into the body
before infection sets in.
RT Building Brunner and
Room 201 Suddarth’s
Enumerate diseases 1.tuberculosis 10 mins textbook of
that commonly 2.diphtheria Medical-
require immunization 3.pertussis Surgical
4.tetanus Nursing
5.poliomyelitis Volume 1, 10th
6.measles Edition,
7.hepatitis

Nursing Care
Discuss the Description, Indication, Dosage, 10 mins Plans
description, indication Protection of the newborn Guidelines for
and nature of the against tetanus, Administration, individualizing
Tetanus Toxoid Adverse Reactions patient care,
Vaccine edition 6,
Marilynn E.
Doenges
Description, Contraindications 10 mins
Discuss the (Immunosuppression,
description, indication Pregnancy), Recommendations LCD
and nature of the (Children, Health Care
BCG Vaccine Workers)
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