Critical Thinking Question 1. You are taking the general history of a 13-year-ol

Question

Critical Thinking Question 1. You are taking the general history of a 13-year-old female patient. You discover that she never had a second measles-mumps-rubella (MMR) vaccination. What special considerations, if any, should be taken into account before administering the vaccination? 2. While unloading the autoclave you discover that some of the sterilization indicators in the center of the load are not activated (no color change has occurred). What actions should you take? 3. You notice that a coworker is not washing her hands between patients or before eating lunch. What steps should you take? How would you explain the importance of hand washing to your coworker?

Explanation / Answer

1. MMR or measles-mumps-rubella vaccination is done in childern in two doses. One is for 12 to 15 months old children and the other is for 4 to 6 years old children. The gap between two doses are atleast 4 weeks or 28 days. One dose of MMR vaccine secures 95% protection against these three diseases but taking two doses increases the protection to 99%. If anyone has not taken the 2nd dose, that person can certainly take 2nd dose afterwards. Here before administration of 2nd dose to the 13 years old female patient, some points should be taken into account. These are:

1. She must not produce any allergic reaction to any of the components of MMR vaccine.

2. To check if she has any life threatening allergic reaction to the previous exposure of MMR dose.

3. If she has any complicated disease like HIV/AIDS, cancer which lowers immune system effectiveness.

4. If she is sick at the time of administration of second dose.

2. Autoclave is used to sterilize or to destroy complete set of microorganisms including the spores. The mode of action is mainly associated with the goodness of killing microorganisms by moist heat. In general the operation time of autoclave is 121 degree celsius for 15 minutes in 15lb pressure. To autoclave, the materials are loaded with sterilization indicators at the center of the loading materials. Reaching steam at the center needs maximum time and once it reaches and changes the color of the indicators then it can be deduced that the load is fully sterilized. In this case, it is seen that within the set time frame some of the indicators has not changed color so it can be assumed the load is not fully sterilized. So, it is needed to increase the time of autoclaving and reload the materials and thus autoclave again.

3. Maintaining personal hygiene is a basic learning process and a necessary for all. If a coworker is not washing hands betweens patients or before eating lunch then one should tell that person that hand washing is a necessary step toward leading to healthy life.

Taking care of patients means handling different germs or microorganisms which are pathogenic or can cause disease in others. If the disease is contagious then more preventive measures must be taken. Hand washing is a necessity between patients because if one patient has contagious disease or have disease caused by pathogenic microorganisms can be spread to others. By washing hands one can keep microorganisms at bay as this is a sanitization process.

Before eating lunch one should always wash hands otherwise germs present on our hands will get straight entry to our digestive system via mouth. If pathogens are present then that person gets sick by the disease causing microorganisms. Sickness can also become serious illness. So taking preventive measures like hand washing is very much necessary.

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