Self-Assessment Questions (SAQs) for Study Session 7

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the following questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 7.1 (tests Learning Outcomes 7.1 and 7.3)

  • a.What is meant by a safe injection?
  • b.Give three examples of possible programme errors in vaccine preparation or administration.

Answer

  • a.A safe injection is one that does not harm the client, does not expose the provider to any avoidable risk and does not result in dangerous waste.
  • b.Look back at Box 7.3 for descriptions of programme errors, i.e. due to incorrect immunization practices.

SAQ 7.2 (tests Learning Outcomes 7.1, 7.2, 7.3 and 7.5)

Which of the following actions could result in an infection being transmitted to your clients when you inject them with a vaccine? In each case, explain why or why not.

  • A  Allowing a freeze-sensitive vaccine to become colder than +1oC for a short time.
  • B  Allowing opened multi-dose vials of vaccine to become submerged in melted water in a vaccine carrier.
  • C  Using auto-disable syringes for every immunization.
  • D  Removing the cap from a disposable needle and holding it by the adaptor before you fit it onto the syringe.
  • E  Attempting to replace the cap on a used needle before you place it in the safety box.

Answer

The actions that could expose your clients to infection when you immunize them are:

  • B  Allowing opened multi-dose vials of vaccine to become submerged in melted water in a vaccine carrier. Contaminated water can infect the vaccine if it leaks into the vial through the tiny holes made by the needles used to withdraw vaccine previously.
  • D  Removing the cap from a disposable needle and holding it by the adaptor before you fit it onto the syringe. Infection could be transferred from your hands to the needle.

Actions A, C and D do not pose in infection risk to your clients, but you should know that:

  • A  Allowing a freeze-sensitive vaccine to become too cold will reduce its effectiveness.
  • C  Using auto-disable syringes for all immunizations is the best way to avoid any infection risk to your clients.
  • E  Attempting to replace the cap on a used needle poses an infection risk to you!

SAQ 7.3 (tests Learning Outcomes 7.1, 7.2 and 7.4)

Five minutes after you immunized a 6-week-old baby with her first dose of pentavalent vaccine, she became short of breath and developed a widespread rash. Her pulse became rapid and her blood pressure dropped.

  • a.What is the name for this condition?
  • b.What action should you take? (You will need to think back to earlier Modules in this curriculum to answer this part of the question fully.)

Answer

  • a.These are the symptoms of a severe acute allergic reaction, with signs of shock (fast pulse and low blood pressure).
  • b.You should refer the child immediately to the nearest health facility – this is a potentially life-threatening reaction to the vaccine. As you should know from earlier Modules, you should keep the baby warm at all times, tell the mother to continue breastfeeding if the child will suckle and go with them if you can. If you cannot go you should send a clearly written referral note listing all the relevant details.

SAQ 7.4 (tests Learning Outcomes 7.2, 7.3 and 7.4)

Which of the following children should not be given an immunization and why?

  • a.A healthy-looking one-week-old baby girl who you know is probably HIV-positive.
  • b.A 10-week-old boy who developed a low-grade fever soon after the first pentavalent immunization, which lasted about 24 hours.
  • c.A 10-week-old boy who had a convulsion soon after the first pentavalent immunization.

Answer

  • a.This HIV-positive infant is well, so she can receive the birth dose of BCG vaccine and all the routine EPI immunizations according to the normal schedule at the age of 6 weeks.
  • b.Immunization with pentavalent vaccine can result in low-grade fever, which usually resolves within 24 hours. This is not a contraindication, so the child should be immunized with the second dose of pentavalent and the other routine EPI vaccines scheduled at 10 weeks.
  • c.This child should not be given another pentavalent immunization. Convulsions soon after immunization are an absolute contraindication to further immunization with the same vaccine.

SAQ 7.5 (tests Learning Outcomes 7.1 and 7.5)

List one potential disadvantage of each of the following methods of disposal of a safety box containing used needles and syringes after an immunization session:

  • a.An incinerator at a health centre.
  • b.Burning in a metal container.
  • c.Burning in an open pit.
  • d.Burying without burning in a sharps pit.

Answer

The potential disadvantages of disposing of a safety box containing used needles and syringes after an immunization session, using one of the following methods, are:

  • a.An incinerator at a health centre may be too far away to be a realistic method of regular waste disposal.
  • b.Burning in a metal container will leave fragments of waste that must be scraped out of the drum and buried safely.
  • c.Burning in an open pit may result in fragments being blown about by the wind and scattered around the pit, or not being completely burnt if the fire goes out too soon.
  • d.Burying without burning in a sharps pit could result in waste being exposed by soil being washed away, or children or animals digging it up.

Summary of Study Session 7