Page 579 - Saunders Comprehensive Review For NCLEX-RN

▪ A vaccine information statement needs to be given to the parents or individual,
and informed consent for administration needs to be obtained.
▪ Check the expiration date on the vaccine bottle.
▪ Parenteral vaccines are given in separate syringes in different injection sites.

▪ Vaccines administered intramuscularly are given in the vastus lateralis muscle
(best site) or ventrogluteal muscle (the deltoid can be used for children 36
months of age and older).
▪ Vaccines administered subcutaneously are given in the fatty areas in the lateral
upper arms and anterior thighs.
▪ Adequate needle length and gauge are as follows: intramuscular, 1 inch, 23-25
gauge; subcutaneous, {⅝} inch, 25 gauge (needle length may vary depending on
the child’s size).
▪ Mild side effects include fever, soreness, swelling, or redness at injection site.
▪ A topical anesthetic may be applied to injection site before the injection.
▪ For painful or red injection sites, advise the parent to apply cool compresses for
the first 24 hours, and then use warm or cold compresses as long as needed.
▪ An age-appropriate dose of acetaminophen or ibuprofen, per health care
provider’s preference, may be administered every 4 to 6 hours for vaccine-
associated discomfort.

▪ Maintain an immunization record—document day, month, year of
administration; manufacturer and lot number of vaccine; name, address, and
title of person administering the vaccine; and site and route of administration.
▪ A vaccine adverse event report needs to be filed and the health department
needs to be notified if an adverse reaction to an immunization occurs.

Box 18-5

Recommended Childhood and Adolescent

Immunizations: 2018

Birth: Hepatitis B vaccine (HepB)
1 month: HepB
2 months: Inactivated poliovirus vaccine (IPV); diphtheria, tetanus, acellular
pertussis (DTaP) vaccine; Haemophilus influenzae type b conjugate vaccine
(Hib); pneumococcal conjugate vaccine (PCV), rotavirus (RV)
4 months: DTaP, Hib, IPV, PCV, RV
6 months: DTaP, Hib, HepB, IPV, PCV, RV (dose may be needed depending on
type of vaccine used for first and second doses)
12-15 months: Hib; PCV; measles, mumps, rubella (MMR) vaccine; hepatitis A,
first dose (second dose is given 6-18 months after the first dose); varicella
vaccine
15-18 months: DTaP
18-33 months: Hepatitis A (second dose given 6-18 months after the first dose)
4-6 years: DTaP, IPV, MMR, varicella vaccine

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