can a child with leukemia receive varicella zoster immune globulin??

  1. Hi, there, I am reviewing SAUNDERS Comprehensive for NCLEX-RN exam and a practice question in chapter 45(Oncological Disorder-pediatric nursing) makes me very coufused. I hope someone here can help me out. The question is as below:

    A 9-year-old child with leukemia is in remission and has returned to school. The school nurse calls the mother of the child and tells the mother that a classmate has just been diagnosed with chickenpox. The mother immediately calls the clinic nurse because the leukemic child has never had chickenpox. The most appropriate response by the clinic nurse to the mother is: 1)"Monitor the child for an elevated temperature, and call the clinic if a temperature occurs" 2)"Keep the child out of school for a 2-week period" 3)" There is no need to be concerned" 4)"Bring the child into the clinic for a vaccine"

    The correct answer in SAUNDERS is No. 4--- Bring the child into the clinic for a vaccine. The rationale is: Immunocompromised children are unable to fight varicella adequately. Chickenpox can be deadly to the immunocompromised child. If an immunocompromised child who has not had chickenpox is exposed
    to someone with varicella, the child should receive varicella zoster immune globulin within 96 hours of exposure.

    However, my answer is No.2. Because varicella zoster immune globulin is a live vaccine and it is contraindicated to be given to a immunocompromised individual, such as a someone with HIV infection or leukemia.

    Am I right or Saunders? Why?

    Thanx for your help!
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  2. 3 Comments

  3. by   gauge14iv
    If the child is in remission and has resturned to school, he is no longer immunocompromised and can safely be given the vaccine.

    You are correct about the vaccine being live, but as long as he is not immunocompromised (he wouldn't be allowed to attend school if he was) he can have it.
  4. by   gauge14iv
  5. by   alina_zhuang
    Gauge14iv, thanks a lot for the clear explaintation and the useful website!!! I've got it!!! Have a nice day!

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