The nurse is preparing a 3-day-old infant for discharge from the hospital. When checking the record for completeness, the nurse checks to see that the infant has had which of the following?
DTP and polio immunizations
MMR immunization and tuberculin test
Pneumococcal vaccine and HIV test
Hepatitis B vaccine and PKU test
The correct answer and explanation is :
Correct Answer: Hepatitis B vaccine and PKU test
At discharge, a 3-day-old infant should have had a Hepatitis B vaccine and a PKU test (Phenylketonuria screening). These are part of routine newborn screening and early preventive healthcare measures recommended shortly after birth.
Explanation:
- Hepatitis B Vaccine:
- The Hepatitis B vaccine is the first vaccine recommended in the standard immunization schedule for newborns.
- It is typically administered within 24 hours of birth, especially if the mother is Hepatitis B surface antigen-positive (HBsAg+) or her status is unknown.
- This early vaccination helps prevent perinatal transmission of the Hepatitis B virus, which can lead to chronic infection and serious liver disease later in life.
- PKU Test (and Newborn Screening Panel):
- PKU (Phenylketonuria) is a genetic disorder in which the body cannot break down the amino acid phenylalanine.
- If left untreated, PKU can lead to intellectual disability and other serious health issues.
- The PKU test is part of the newborn metabolic screening, which is usually done between 24 and 72 hours after birth, often before discharge from the hospital.
- A small blood sample is taken from the infant’s heel (heel stick) and tested for PKU and other metabolic, genetic, and endocrine disorders.
Incorrect Options:
- DTP and Polio immunizations: These vaccines are given at 2 months of age, not during the newborn period.
- MMR and Tuberculin test: MMR (Measles, Mumps, Rubella) is given at 12–15 months, and tuberculin testing is not routine in newborns.
- Pneumococcal vaccine and HIV test: Pneumococcal vaccine begins at 2 months, and routine HIV testing is not standard in newborns unless indicated by maternal history.
Ensuring the infant has received the Hepatitis B vaccine and newborn screening including PKU is critical for early disease prevention and healthy development.