The nurse is reviewing the medical records for five patients who are scheduled for their yearly physical examinations in September. Which patients should receive the inactivated influenza vaccination (select all that apply)?
a. A 76-year-old nursing home resident
b. A 36-year-old female patient who is pregnant
c. A 42-year-old patient who has a 15 pack-year smoking history
d. A 30-year-old patient who takes corticosteroids for rheumatoid arthritis
e. A 24-year-old patient who has allergies to penicillin and cephalosporins
ANS: A, B, D
Current guidelines suggest that healthy individuals between 6 months and age 49 receive intranasal immunization with live, attenuated influenza vaccine. Individuals who are pregnant, residents of nursing homes, or are immunocompromised or who have chronic medical conditions should receive inactivated vaccine by injection. The corticosteroid use by the 30-year-old increases the risk for infection.
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