2. You see a 69-year-old patient who recently moved to town and does not remember his last
tetanus shot. What would you do?
3. E. D. is a 78-year-old
... [Show More] woman who does not remember if she has ever had the immunization for
herpes zoster. She does remember having chicken pox as a child. What would you recommend for
her?
Correct
Answer: You could do one of two strategies: perform serologic testing for tetanus and
diphtheria antitoxin to see if they are immune, or give one dose of Tdap, followed
by Td at least 4 weeks later, followed by another dose of Td 6–12 months later.
Tetanus/Tdap:
In older adults, if the recommended childhood series was not done at all, the
recommendation is one dose of Tdap, followed by Td at least 4 weeks later,
followed by another dose of Td 6–12 months later. If vaccination documentation
is incomplete, the provider can either consider serologic testing for tetanus and
diphtheria antitoxin or assume that no vaccinations have been received and
administer vaccine as directed above for patients who have not been vaccinated.
2
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Correct
Answer: All influenza vaccines have the potential to cause an egg-related allergic
reaction. Persons with a history of egg allergy who have experienced only
urticaria after exposure to egg should receive influenza vaccine.
Correct
Answer: Before travel, older adults should be up to date on routine vaccines. Older
adults should also receive other vaccines recommended for the countries they
are visiting. These are listed by country on the CDC's Destinations Pages.
Correct
Answer: Older individuals are more likely to experience a severe infection, develop
pneumonia, require hospitalization, or die. Mortality rates in patients 75 years
and older are four to eight times higher than those seen for patients aged 65 to
74 years, and over 50 times higher than those seen before the age of 65 years. A
total of 90% of deaths attributable to influenza occur in individuals aged 60 years
and older. Following an acute care hospitalization, many older adults fail to return
to their previous level of function.
Nearly 40% of relatively healthy community-dwelling older adults who reported
the presence of influenza or influenza-like illness required more than 2 weeks to
recover, 20% required new assistance with daily functional tasks, and 13.9%
were hospitalized. Aging impairs the ability of the immune system to adequately
respond to influenza vaccination and infection, both in terms of humoral
(antibody) and cell-mediated responses. The magnitude of these aging-related
declines is increased in the presence of both frailty and chronic cytomegalovirus
infection.
4. Name the most common allergic response to the flu vaccine,
5. Many older adults travel worldwide when they retire. For patients who are planning to travel
overseas, what would you recommend?
6. Give three reasons why older adults are especially vulnerable to complications of influenza
infections.
7. You have an 89-year-old patient on hospice care in a long-term care facility. The protocol is for flu
vaccine to be given to all patients each fall. Would you vaccinate? Why, or why not?
Correct [Show Less]