Page 870 - Saunders Comprehensive Review For NCLEX-RN

IX. Rubella Vaccine

A. Given subcutaneously before hospital discharge to a nonimmune
postpartum client
B. Administered if the rubella titer is less than 1:8
C. Adverse effects: Transient rash, hypersensitivity
D. Contraindicated in a client with a hypersensitivity to eggs (check
with the OB regarding administration)
E. Interventions
1. Assess for allergy to duck eggs and notify the OB
before administration if an allergy exists.
2. Question administration if the client or other family
members are immunocompromised.

The client should avoid pregnancy for 1 to 3 months (or as

prescribed) after immunization with rubella vaccine. Inform the client
about the need to use a contraception method during this time.
X. Lung Surfactants
A. Description
1. Replenish surfactant and restore surface activity to the
lungs to prevent and treat respiratory distress
syndrome.
2. Administered to the newborn by the intratracheal
route.
B. Use: To prevent or treat respiratory distress syndrome in
premature newborns
C. Adverse effects and contraindications
1. Adverse effects include transient bradycardia and
oxygen desaturation; pulmonary hemorrhage, mucus
plugging, and endotracheal tube reflux can also occur.
2. Surfactants are administered with caution in newborns
at risk for circulatory overload.

D. Interventions

1. Instill surfactant through the catheter inserted into the
newborn’s endotracheal tube; avoid suctioning for at
least 2 hours after administration.
2. Monitor for bradycardia and decreased oxygen
saturation during administration.
3. Monitor respiratory status and lung sounds and for
signs of adverse effects.
XI. Eye Prophylaxis for the Newborn
A. Description

1. Preventive eye treatment against ophthalmia
neonatorum in the newborn is required by law in the

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