Questions about HIV in Pediatrics

[OneWhisper]

Hello! I have a question. I am studying for the NCLEX. I found a sheet on this website that said "For HIV kids avoid OPV (oral poliovirus vaccinations) and Varicella vaccinations (live), but give Pneumococcal and influenza. MMR is avoided only if the kid is severely immunocompromised."

In my book, it just says "Immunizations against childhood diseases is recommended for all children exposed to an infected with HIV." "Live virus vaccines generally are not administered with individuals with severely deficient immune systems."

"If a child has symptomatic HIV infection or has severe immunosuppression, guidelines are as follows:

- Only the inactivated influenza vaccine that is given IM should be used (influenza vaccine should be given yearly)

- Measles vaccine should NOT be given; immunoglobulin may be prescribed after measles exposure

- Only the inactivated polio vaccine that is given IM should be used

- Rotavirus vaccine should NOT be given

- Varicella-zoster virus vaccine should NOT be given; varicella-zoster immunoglobulin may be prescribed after chickenpox exposure

- Tetorifice immunoglobulin may be prescribed for tetorifice-prone wounds.

So, my book doesn't say anything about the OPV - just about giving the inactivatd polio vaccine that is given IM. It doesn't say anything about the pneumococcal vaccine, which I am guessing is because it is okay to administer. It doesn't say anything about MMR, just the measles vaccine and that it should NOT be given. So I just want a clear idea of what is avoided for children with HIV and what can be administered. Should I go by what my NCLEX book states?

My next question is, the same sheet stated, "A positive Western blot in a child

My book stated Western blot age-appropriate use is 18 mo of age or more. If used and found to be positive in infants

p24 antigen age-appropriate use is

My book doesn't say anything about p24 antigen being used at any age. Just that it's age-appropriate use is less than 18 mo of age, and it is very accurate for diagnosing infants 1 - 4 mo of age.

So, can the p24 antigen test be used at any age? I assume that it can be. Is it just more accurate when diagnosing infants 1 - 4 mo of age?

Thanks for any help!

[JustBeachyNurse, LPN]

OPV is live virus. IPV is inactivated. The only live flu virus was the nasal version which is no longer available. PCV is not a live virus

[3peas]

You're getting lost in the trees. Most* get IPV, I've entered 5000+ shot records and never seen OPV. I couldn't tell you if any were HIV+ or not. But to address the real issue-you will NEVER and I mean NEVER know it all and you will still pass. You are meant to fail, it's just how bad will you fail? Critically think about it, rule out the obvious, and proceed.

[bgxyrnf, MSN, RN]

The probability of such details appearing on the NCLEX is very, very, very low. I wouldn't consider time focusing on such minutiae to be well invested. If you have the major themes down then take the exam; otherwise study the big themes.

[Rionoir, ADN, RN]

In micro our professor said OPV isn't used anymore on ANYONE because it has actually caused polio in a couple of instances.

[JustBeachyNurse, LPN]

In micro our professor said OPV isn't used anymore on ANYONE because it has actually caused polio in a couple of instances.

It's still used overseas when an outbreak occurs.

[OneWhisper]

The probability of such details appearing on the NCLEX is very, very, very low. I wouldn't consider time focusing on such minutiae to be well invested. If you have the major themes down then take the exam; otherwise study the big themes.

What major themes would you suggest? I looked at the NCLEX test plan and I tried to keep to that, but it lists so many topics and then I seem to get off track focusing on little things - like this with the immunizations!