5U10 Assignment

nA Chart for Adult Screening

nName

nInstitution

nCourse

nDate

nSummary

nAdult screening and immunization for persons aged between 21-65 years should include vaccinations of various diseases such as influenza, tetanus, diphtheria and acellular pertussis vaccination, Hepatitis A, and pneumonitis. For instance, 1 dose per year for influenza vaccine should be used for persons who are immunocompromised. It is also important to conduct cancer screening for breast cancer, colon cancer, lung cancer and cervical cancer. Preventive services must be conducted for cardiovascular disease, Type 2 diabetes and depressions. Furthermore, it is essential to include services for well person visits such counselling and screening for illnesses such as osteoporosis, preconception counselling and menopause management.

nTable SEQ Table * ARABIC 1 A Chart for Adult Screening

nTopic Description Special populations

nAdult Immunization

nInfluenza vaccination -LAIV must not be used during 2016-17 influenza season

n- Inactivated influenza vaccine should be used to adults with past case of egg allergy (CDC, 2017)

n- Age-appropriate recombinant influenza vaccine (RIV) or IIV should be used to patients having prior cases of egg allergy accompanied with symptoms of light-headedness, respiratory distress, angioedema) (CDC, 2017)

n-1 dose per year for persons who are immunocompromised (excluding HIV), HIV positive patients with CD4+ count less than 200, Patients with kidney failure, asplenia, MSM, healthcare personnel, diabetes, liver disease, chronic alcoholism, & lung or heart disease (CDC, 2017)

nTd/Tdap (tetanus, diphtheria and acellular pertussis vaccination) Tdap should be substituted once

nLater TD booster will be administered for every decade (CDC, 2017) -Pregnant mothers must acquire 1 dose of Tdap in every pregnancy (CDC, 2017)

nMMR vaccination 1 dose of MMR to Persons born from 1957 to date without proper records of MMR immunity (CDC, 2017) -1 dose of MMR to Pregnant without immunity of rubella

n- 1 dose to women in their childbearing age with low immunity of rubella (CDC, 2017)

n- Persons who have acquired immunodeficiency should not be immunized

n- 2 doses for persons with HIV and low (>200CD4+)

n- 2 doses for persons working in the healthcare facilities (CDC, 2017)

nAdults immunized prior to 1979

nVaricella immunization 2 doses should be given to:

n-Adults with no varicella immunity

n-individuals without varicella immunity (CDC, 2017) – Pregnant mothers must be monitored for immunity to varicella

n-It should not be given to persons with malignant conditions

n2 doses for persons with HIV and low (>200CD4+) (CDC, 2017)

nHerpes Zoster 1 dose should be administered to adults with 60 years and above irrespective of the previous cases of herpes zoster(CDC, 2017) -Exclude persons with medical complications e.g. severe immunodeficiency, and pregnancy

n-exclude Adults suffering from malignant conditions especially those affecting lymphatic systems

n-Exclude persons with HIV and low (>200CD4+) (CDC, 2017)

nHuman papillomavirus vaccine -3 doses of HPV vaccines to Adult males and females through age 21 and 26 respectively (CDC, 2017)

n-2 doses of the vaccines should be administered to Adult female and male who failed to complete the dose before 15 years (CDC, 2017)

n-3 doses for MSM population through 26 years old

n-3 doses of adults with immunocomprising conditions

n- it should be administered to pregnant mothers

n-1 dose to persons at risk of meningococcal disease (CDC, 2017)

nPneumococcal immunization -Immuno-competent persons with 65 years or older must receive PCV13 then PPCV-23

n-Adults must acquire a dose of PCV13 or

n-3 doses of PPCV23 based on indication

n(CDC, 2017) -Adults 21-64 years suffering from chronic heart disease

n-Adults with immunocomprising diseases should be vaccinated with a dose of PCV13 and PPSV23 after 2 months of PCV13

n-Adults with cochlear implant or cerebrospinal fluid leak

nmust acquire a dose of PCV13 and PPSV23 after 2 months of PCV13 (CDC, 2017)

nHepatitis A immunizations Adults at risk of Hepatitis A should acquire 1 doses of Hep A vaccine (CDC, 2017) -Vaccination should be given to Persons with; chronic liver conditions, interaction with primates infected, injects drugs, MSM, and utilizing clotting factor concentrates

n-Persons who travel in regions with endemic of the disease

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nCancer screening recommendations

nBreast cancer Adults with a high risk of the disease (AHRQ, 2017) -Persons with previous history of the disease

n-Adults whose child, sibling or parents have breast cancer (AHRQ, 2017)

nCervical cancer Screening for Cervical cancer should be done for every three years for persons using Pap test or HPV testing for every 5 years

nAdults over 65 years of age should not be screened if there is no case of the disease (AHRQ, 2017) -Persons infected with HPV should participate in screening

n-Individuals with records of cervical dysplasia (AHRQ, 2017)

n-Persons with HIV

n- adults with immunocompromised systems

n- Adults exposed to diethylstilboestrol (DES)

nColon cancer -Persons aged 21-49 years should not be screened regularly unless they are at risk

n-Persons aged above 50 years should screened every 10 years (AHRQ, 2017) -Persons with inflammatory bowel disease

n-Adults with precancerous polyps

n-Adults with certain genetic syndromes (AHRQ, 2017)

nLung cancer -Individuals should be screened annually

n-Screened are stopped in cases the duration of time from quitting exceeds 15 years -Present smokers with over 30 years of smoking

n-Adults who cessed smoking in the last 15 years

nPreventive services, counselling and screening

nCardiovascular health -Screening should be conducted for lipid disorder

n-Assessing blood pressure

n-Monitoring of abdominal aortic aneurysm (US Preventative Services Task Force, 2017)

n-Adults with abdominal aortic aneurysms, high cholesterol and hypertension

n-high risk groups include persons with obesity, tobacco use, diabetes, low HDL, hyperlipidaemia, hypertension, heart disease, family history, male gender (US Preventative Services Task Force, 2017)

nType 2 diabetes -Counselling should be initiated on advantages of healthy diet and physical exercise

n-Screening should be conducted every 3 years at 45 years

n-Advise on lifestyle and diet changes (US Preventative Services Task Force, 2017) -Adults over 45 years of age

n-Adults with relatives having the disease

n-Adults who are obese

n-Adults with high blood pressure (>135/80mmHG)

n-Persons with cases of gestational diabetes (US Preventative Services Task Force, 2017)

nDepression -Annual screening for the conditions should be done through PHQ-9/2 tools

n(US Preventative Services Task Force, 2017) -More emphasis should be put to adults with family history of psychiatric, or depression

n-Females at postpartum period

n-Elderly Adults

n-Adults using drugs (US Preventative Services Task Force, 2017)

nWell person visits recommendations

nPreconception counselling -Women in their childbearing age must have intake of multivitamin per day

n-Promote regular visits for preconception guidance

n-Counsels should be given on harmful effects of tobacco, drugs, alcohol

n-benefits of keeping BMI less than 30

n-Advise on advantages of dental care and oral health during pregnancy

n-Discuss travel limits during pregnancy

n(US Preventative Services Task Force, 2017) – Women in their childbearing age (21-49) (US Preventative Services Task Force, 2017)

nOsteoporosis -Advise on preventive process such as intake Vitamin D and dietary calcium, avoid smoking, and weight management

n-Guidance on how to prevent falls

n-Initiate bone mineral density (BMD) testing (USPSTF, 2017) -Persons over 50 years

n-Adults with family history of the disease

n-Adults participating in some medications due to chronic illnesses (USPSTF, 2017)

nMenopause management -Advise symptomatic women

n-Counsel on the benefits and risks of non-hormonal and hormonal therapies

n-Guide against utilization of aggregated progestin and oestrogen based on recommendations (USPSTF, 2017) -Women who are above 40 years

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nReferences

nAHRQ. (2017). Guide to Clinical Preventive Services, 2014. www.ahrq.gov. Retrieved 11 December 2017, from https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

nCDC. (2017). Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2017. Cdc.gov. Retrieved 11 December 2017, from https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf

nUS Preventative Services Task Force. (2017). Recommendations for Primary Care Practice – US Preventive Services Task Force. Uspreventiveservicestaskforce.org. Retrieved 11 December 2017, from https://www.uspreventiveservicestaskforce.org/Page/Name/recommendations

nUSPSTF. (2017). USPSTF A and B Recommendations – US Preventive Services Task Force. Uspreventiveservicestaskforce.org. Retrieved 11 December 2017, from https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/