1. The nurse should ensure that a healthy 89-year-old client admitted to a skilled nursing facility has received which vaccinations? Select all that apply.
1. The nurse should ensure that a healthy 89-year-old client admitted to a skilled nursing facility has received which vaccinations? Select all that apply.
. Pneumococcal.
. Hepatitis B (series of 3).
. Tetanus.
. Influenza.
. Meningococcal.
. Zoster.
. Diphtheria.
Test-Taking Tip
Know the high-risk groups for each virus and the effect of aging.
Content Area: Geriatrics, Immunological; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Health Promotion and Maintenance/Immunizations
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Answer 1 is correct because pneumococcus is an important cause of pneumonia in the elderly. Clients who were vaccinated more than 5 years previously or who were under 65 years old when they received the vaccination should receive a booster. Answer 2 is incorrect because, unless there are clients with developmental disabilities residing at the skilled nursing facility, vaccination of residents is not necessary. Answer 3 is correct because fewer than 100 people per year become infected with tetanus in the United States, thanks to the efficiency of this vaccine. The wounds that become infected are often "inconsequential," such as pricking your finger on a rosebush thorn. Boosters are required every 10 years. Answer 4 is correct because influenza virus is an important cause of morbidity and mortality in the elderly. Although the vaccine does not always prevent disease, it lessens the severity of disease that does occur. Frequent mutation of the virus necessitates a new vaccination each year preceding or during the flu season. Answer 5 is incorrect because a skilled nursing facility is not considered a high-risk setting for contracting meningococcal infections. Answer 6 is correct because varicella vaccination should be administered once, to reduce the incidence of shingles. Answer 7 is incorrect because, although a skilled nursing facility in the United States is an unlikely place to contract diphtheria, the product most often used to provide tetanus contains different vaccines as well (Td—tetanus/diphtheria).