Tetanus Evolve Case Study
1. You are a physician doing an employment physical for a nurse to be hired at your clinic.
a. Describe what immunizations your patient should have had up to this point.
Td (Tetanus, Diphtheria, Pertussis): This combination vaccine blocks against three different diseases. Tetanus blocks against a bacterial infection due to exposure to rusty (usually metal) objects. Diphtheria is a bacterial infection that causes respiratory distress due to a membrane that covers the airways in the lungs. Pertussis is a disease similar to Diphtheria that comes from bacteria and causes whooping cough.
HPV: This vaccine blocks infection from a virus through sexual contact. It makes its way into the mouth, throat or genitals and causes infections, sometimes cancer. Certain types can cause genital warts. It is important to have three doses …show more content…
of this vaccine through age 26 for females or 21 for males.
MMR (Measles, Mumps, Rubella): This combination vaccine blocks against three different diseases. Measles is a life-threatening disease that attacks the respiratory system. This virus causes a rash on the skin. Mumps is a virus that causes inflammation of the carotid gland. Rubella is a less severe version of Measles, and it also known as German Measles.
Herpes Zoster: This virus is a more severe version of the Chicken Pox. Contracting this as an adult is serious and is similar to herpes or shingles. This vaccine is usually only given to adults who haven’t had the Chicken Pox. This primarily affects adults and those with weak immune systems.
HBV: This virus spreads by body fluids, sexual intercourse, needles, nail salons and childbirth. It is not spread by more casual means of contact. It affects the liver and is also known as Acute Hepatitis B. If not treated, it can cause chronic liver damage. This can be potentially life threatening if not treated. This vaccine is needed to prevent the virus from entering the bloodstream and damaging the liver chronically. It is important to have three doses of this vaccine for it to be complete.
Influenza: This vaccine is needed to prevent an extremely contagious respiratory illness caused by the influenza flu virus. This attacks the body by spreading through the upper and lower respiratory tracks. This disease is especially relevant during winter and early spring times.
Varicella: This vaccine is necessary because remnant of the Chicken Pox virus can remain in the body and reactivate in a more severe manner. It is important to have two doses of this vaccine and to follow through with it.
b.
What vaccinations would you recommend at this visit and why?
Pneumococcal 13- Valent Conjugate: This vaccine protect against a bacteria that can cause serious illnesses, such as bacteremia, meningitis, and pneumonia, which can lead to invasive pneumococcal disease (IPD). This is important to give to those working in immunocompromised conditions.
Pneumococcal Polysaccharide: This vaccine protects against 23 types of this bacteria, including those that are more likely to causing serious types of disease. This type of vaccine is used when strains of the disease have become resistant to other drugs, such as penicillin.
Meningococcal: This bacteria causes meningitis, which is a serious, life-threatening disease that causes inflammation of the membranes covering the brain and spinal cord. There can also be presence of a life-threatening infection in the blood.
HAV: This virus spreads by fecal oral. The vaccine is given to protect against inflammation of the liver caused by the virus and if not treated it can cause jaundice, abdominal pain and fatigue. If not taken care of, the patient can develop acute renal failure or may require a liver
transplant.
HiB: This is a live attenuated vaccine, since it made from pieces of the HiB bacterium. This disease affects the ears, brain, lungs, bones, joints or blood. It can be severe and life-threatening if not treated. 2. Your next patient is a 17 year old high school student. He is an avid video game player. After a complete history and physical exam, you find him to be healthy with a BMI of 24.5.
a. What risk factors does this patient have?
Even though he is in the upper limits of a BMI range, the patient is healthy but should look into lifestyle changes. Even though he is healthy at the moment, his avid videogame playing habits could be risky in the future and put him over the healthy BMI range. At this point after the physical exam, is a window of opportunity to alert the patient of his habits and educate on he might want to change his lifestyle to better his health in the long run. One possible risk is obesity if this patient does not maintain his healthy BMI range and endure in frequent physical activity around the house, whether it is chores or walking a pet, since he spends most of his time sitting and not moving his body to get blood flow going. Not moving his body frequently or engaging in strenuous physical activity/exercise may also put him at risk or increased blood pressure. Also, with the risk of not maintaining his healthy BMI range and becoming obese comes the possible increased risk of coronary heart disease, as plaque builds up in the coronary arteries from increased BMI, strokes, from blocked blood and oxygen to his brain, type 2 diabetes, if he does not participate in physical activity/exercise to turn excess glucose into energy.
b. Which of the following forms of prevention would be useful in your management of this patient: primary, secondary, tertiary? Provide examples of interventions and how they would be appropriate for this patient.
The most useful form of prevention in this scenario would be primary. As mentioned before, after the patient’s physical exam is the window of opportunity intervention to educate and promote healthier ideas to incorporate into his lifestyle. In this moment, it is important to ask the patient what he thinks about his health and if he has any ideas of changing his current behaviors. In the case the patient does not, one can use the social learning/cognitive theory intervention by asking if he has any friends that like playing sports and/or any activities (e.g. walking, jogging, bike riding) that include physical work and if not, ask why he does not like them, because it would benefit his health now and in the long run. This is the use of observational learning from his friends and could influence him to start thinking about (contemplation stage) changing his own lifestyle and behaviors to exercise. One could also ask if the patient has a credible role model that they follow and look up to. Role models are extremely influential and help pave a path towards excellence and/or change from current bad habits. As the health professional, one could suggest to participate in a school sport, like football, soccer, or field of interest. One could also ask about the patient’s diet and suggest making changes in it if his on the verge BMI index is related to a beginning of malnutrition.
Works Cited http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6140a4.htm
http://www.nlm.nih.gov/medlineplus/ency/article/002023.htm
Katz, D. L., Jekel, J. F., Elmore, J. G., Wild, D. M. G., & Lucan, S. C. (2014). Jekel 's epidemiology, biostatistics, preventive medicine, and public health. Philadelphia, Pa: Saunders.
a. Describe what immunizations your patient should have had up to this point.
Td (Tetanus, Diphtheria, Pertussis): This combination vaccine blocks against three different diseases. Tetanus blocks against a bacterial infection due to exposure to rusty (usually metal) objects. Diphtheria is a bacterial infection that causes respiratory distress due to a membrane that covers the airways in the lungs. Pertussis is a disease similar to Diphtheria that comes from bacteria and causes whooping cough.
HPV: This vaccine blocks infection from a virus through sexual contact. It makes its way into the mouth, throat or genitals and causes infections, sometimes cancer. Certain types can cause genital warts. It is important to have three doses …show more content…
of this vaccine through age 26 for females or 21 for males.
MMR (Measles, Mumps, Rubella): This combination vaccine blocks against three different diseases. Measles is a life-threatening disease that attacks the respiratory system. This virus causes a rash on the skin. Mumps is a virus that causes inflammation of the carotid gland. Rubella is a less severe version of Measles, and it also known as German Measles.
Herpes Zoster: This virus is a more severe version of the Chicken Pox. Contracting this as an adult is serious and is similar to herpes or shingles. This vaccine is usually only given to adults who haven’t had the Chicken Pox. This primarily affects adults and those with weak immune systems.
HBV: This virus spreads by body fluids, sexual intercourse, needles, nail salons and childbirth. It is not spread by more casual means of contact. It affects the liver and is also known as Acute Hepatitis B. If not treated, it can cause chronic liver damage. This can be potentially life threatening if not treated. This vaccine is needed to prevent the virus from entering the bloodstream and damaging the liver chronically. It is important to have three doses of this vaccine for it to be complete.
Influenza: This vaccine is needed to prevent an extremely contagious respiratory illness caused by the influenza flu virus. This attacks the body by spreading through the upper and lower respiratory tracks. This disease is especially relevant during winter and early spring times.
Varicella: This vaccine is necessary because remnant of the Chicken Pox virus can remain in the body and reactivate in a more severe manner. It is important to have two doses of this vaccine and to follow through with it.
b.
What vaccinations would you recommend at this visit and why?
Pneumococcal 13- Valent Conjugate: This vaccine protect against a bacteria that can cause serious illnesses, such as bacteremia, meningitis, and pneumonia, which can lead to invasive pneumococcal disease (IPD). This is important to give to those working in immunocompromised conditions.
Pneumococcal Polysaccharide: This vaccine protects against 23 types of this bacteria, including those that are more likely to causing serious types of disease. This type of vaccine is used when strains of the disease have become resistant to other drugs, such as penicillin.
Meningococcal: This bacteria causes meningitis, which is a serious, life-threatening disease that causes inflammation of the membranes covering the brain and spinal cord. There can also be presence of a life-threatening infection in the blood.
HAV: This virus spreads by fecal oral. The vaccine is given to protect against inflammation of the liver caused by the virus and if not treated it can cause jaundice, abdominal pain and fatigue. If not taken care of, the patient can develop acute renal failure or may require a liver
transplant.
HiB: This is a live attenuated vaccine, since it made from pieces of the HiB bacterium. This disease affects the ears, brain, lungs, bones, joints or blood. It can be severe and life-threatening if not treated. 2. Your next patient is a 17 year old high school student. He is an avid video game player. After a complete history and physical exam, you find him to be healthy with a BMI of 24.5.
a. What risk factors does this patient have?
Even though he is in the upper limits of a BMI range, the patient is healthy but should look into lifestyle changes. Even though he is healthy at the moment, his avid videogame playing habits could be risky in the future and put him over the healthy BMI range. At this point after the physical exam, is a window of opportunity to alert the patient of his habits and educate on he might want to change his lifestyle to better his health in the long run. One possible risk is obesity if this patient does not maintain his healthy BMI range and endure in frequent physical activity around the house, whether it is chores or walking a pet, since he spends most of his time sitting and not moving his body to get blood flow going. Not moving his body frequently or engaging in strenuous physical activity/exercise may also put him at risk or increased blood pressure. Also, with the risk of not maintaining his healthy BMI range and becoming obese comes the possible increased risk of coronary heart disease, as plaque builds up in the coronary arteries from increased BMI, strokes, from blocked blood and oxygen to his brain, type 2 diabetes, if he does not participate in physical activity/exercise to turn excess glucose into energy.
b. Which of the following forms of prevention would be useful in your management of this patient: primary, secondary, tertiary? Provide examples of interventions and how they would be appropriate for this patient.
The most useful form of prevention in this scenario would be primary. As mentioned before, after the patient’s physical exam is the window of opportunity intervention to educate and promote healthier ideas to incorporate into his lifestyle. In this moment, it is important to ask the patient what he thinks about his health and if he has any ideas of changing his current behaviors. In the case the patient does not, one can use the social learning/cognitive theory intervention by asking if he has any friends that like playing sports and/or any activities (e.g. walking, jogging, bike riding) that include physical work and if not, ask why he does not like them, because it would benefit his health now and in the long run. This is the use of observational learning from his friends and could influence him to start thinking about (contemplation stage) changing his own lifestyle and behaviors to exercise. One could also ask if the patient has a credible role model that they follow and look up to. Role models are extremely influential and help pave a path towards excellence and/or change from current bad habits. As the health professional, one could suggest to participate in a school sport, like football, soccer, or field of interest. One could also ask about the patient’s diet and suggest making changes in it if his on the verge BMI index is related to a beginning of malnutrition.
Works Cited http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6140a4.htm
http://www.nlm.nih.gov/medlineplus/ency/article/002023.htm
Katz, D. L., Jekel, J. F., Elmore, J. G., Wild, D. M. G., & Lucan, S. C. (2014). Jekel 's epidemiology, biostatistics, preventive medicine, and public health. Philadelphia, Pa: Saunders.