Examkin

Question

Difficulty: HardPharmacological Therapies

A 4-year-old child is receiving inpatient treatment for a severe asthma exacerbation and is currently prescribed high-dose oral prednisone. The practical nurse (PN) notes that a routine measles, mumps, and rubella (MMR) vaccine is scheduled to be administered prior to discharge. Which action should the PN take?

  1. Withhold the MMR vaccine and report the child's current prednisone therapy to the supervising registered nurse.Answer
  2. B
    Administer the MMR vaccine as scheduled, because corticosteroid therapy is only a contraindication for inactivated vaccines.
  3. C
    Prepare and administer an intravenous push dose of a prescribed antihistamine prior to the vaccine to prevent an allergic response.
  4. D
    Proceed with administering the vaccine after verifying the child's identity using their room number and first name.

Answer

The nurse should withhold the MMR vaccine and report the current prednisone therapy to the supervising registered nurse.
The measles, mumps, and rubella (MMR) vaccine is a live attenuated virus. High-dose systemic corticosteroids, such as prednisone, cause significant immunosuppression. Administering a live vaccine to an immunocompromised client places them at high risk for developing a severe, disseminated infection from the vaccine virus itself. The appropriate and safe action within the practical nurse's scope of practice is to recognize this critical safety hazard, withhold the contraindicated medication, and notify the supervising registered nurse or healthcare provider.

Step-by-Step Solution

1
Identify the classification of the scheduled medication.
The MMR vaccine is a live attenuated virus vaccine.
Understanding the vaccine type is essential to identify potential contraindications.
2
Evaluate the client's current medication regimen for interactions.
The client is receiving high-dose oral prednisone, a systemic corticosteroid that causes immunosuppression.
Immunosuppressants alter the body's ability to handle live vaccines safely.
3
Apply pharmacological safety principles.
Live vaccines are strictly contraindicated in immunocompromised clients due to the risk of severe infection from the vaccine strain.
Preventing medication-induced harm is a primary nursing responsibility.
4
Determine the appropriate nursing action within the PN scope of practice.
The PN must safely withhold the contraindicated medication and immediately communicate the finding to the RN or provider.
The PN is responsible for recognizing safety hazards and reporting them up the chain of command.

Key Concept

Immunization Contraindications and Scope of Practice
Estimated Time:1m 30s
Rate this question

Topics

Pharmacological Therapies

More questions from this topic