Page 557 - Saunders Comprehensive Review For NCLEX-RN

cervical cancer, and genital warts.
2. The vaccine is most effective for boys and girls if
administered before exposure to human
papillomavirus through sexual contact.
3. The vaccine is administered as 3 injections over 6
months—first dose to girls at age 11 to 12 years, the
second dose 2 months after the first dose, and the
third dose 6 months after the first dose.
4. A 3-dose series may be administered to boys 9 to 18
years old to reduce their likelihood of acquiring
genital warts.
5. The vaccine can cause pain, swelling, itching, and
redness at the injection site; fever; nausea; and
dizziness.
6. The vaccine is contraindicated in individuals with a
reaction to a previous injection and in pregnant
women.
X. Reactions to a Vaccine
A. Local reactions
1. Tenderness, erythema, swelling at injection site
2. Low-grade fever
3. Behavioral changes such as drowsiness, unusual
crying, decreased appetite

B. Minimizing local reactions

1. Select a needle of adequate length to deposit vaccine
deep into the muscle or subcutaneous mass.
2. Inject into the appropriate recommended site.

A. Anaphylactic reactions

1. Goals of treatment are to secure and protect the
airway, restore adequate circulation, and prevent
further exposure to the antigen.
2. For a mild reaction with no evidence of respiratory
distress or cardiovascular compromise, a
subcutaneous injection of an antihistamine, such as
diphenhydramine, and epinephrine may be
administered.
3. For moderate or severe distress, establish an airway;
provide cardiopulmonary resuscitation if the child is
not breathing; elevate the head; administer
epinephrine, fluids, and vasopressors as prescribed;
monitor vital signs; and monitor urine output.
B. Refer to Chapter 62 for additional information on allergic
responses and anaphylactic reactions
XI. Developmental Characteristics
A. Infant

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