Health Promotion and Maintenance / 09

Make sure to:

  • Ensure the administration of age-appropriate immunizations in accordance with healthcare facility policy.
  • Conduct health screenings and follow up accordingly.
  • Encourage the reduction or cessation of high-risk behaviors among clients.

Health promotion and early detection activities are undergoing evolution due to advancements in technology and scientific breakthroughs. As a result, healthcare facilities are updating their policies and procedures, while organizations are revising their recommendations for the standard of care delivered to clients. It is essential for nurses to stay up-to-date with these revisions and updates, integrating them into their clients’ care plans.

In this learning experience, learners will gain knowledge about promoting health via immunizations, reducing or ceasing high-risk behaviors, and conducting early detection through health screenings.

4.1 Immunization

Immunizations are administered to clients of all ages to prevent diseases and to mitigate their severity if they occur. The Advisory Committee of Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC) issue recommendations and guidelines for immunization schedules for individuals ranging from newborns to adults aged 18 years and older. Nurses, upon receiving a healthcare provider’s order based on the ACIP/CDC schedule, are tasked with administering these immunizations. It is crucial to assess whether clients have any contraindications to being immunized. In the absence of contraindications, nurses should educate clients about the purpose of each immunization, potential adverse effects, appropriate actions in case of severe or mild reaction, and the necessity for follow-up if further doses are indicated. Vaccines are universally contraindicated for clients who have had a severe allergic reaction to a previous dose.
Documentation in the client’s electronic health record must adhere to the healthcare facility’s policy. This includes recording details such as the lot number and expiration date of the administered immunization, along with its name, site of administration, and the identity of the person who administered it. Table 1 provides an overview of common childhood and adolescent immunizations along with relevant nursing considerations.

Table 1

Common Immunizations and Their Schedule for Newborns to 18-Year-Old Clients, Including Nursing Considerations

Adapted from Centers for Disease Control and Prevention. (2023a). Child Immunization Notes. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-schedule-notes.html#note-covid-19; Centers for Disease Control and Prevention. (2023b). Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger. https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf; Centers for Disease Control and Prevention. (2023c). Adult Immunization Schedule by Age: Recommendations for Ages 19 Years or Older. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html; Kaplan Nursing. (2023a). NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination (9th ed.). Kaplan Test Prep.

It is important for nurses to know the immunization schedule for their adult clients available at https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html, some of which are included in Table 1.

4.2 Health Screenings

Nurses adhere to their healthcare facility’s policies and procedures for carrying out health screenings, as well as for determining what constitutes normal and abnormal results and interventions. They:

  • Obtain orders for health screenings.
  • Ensure that screenings are conducted.
  • Communicate the results to the healthcare providers who requested them.
  • Incorporate the results into their nursing care plans.
  • Provide education and support clients upon receiving the results.

Nurses can use Kaplan Nursing (2023a) for an age-appropriate health screenings framework (Table 2). It is important to remember to operate within their professional scope of practice, adhere to the healthcare facility’s policies and procedures, and maintain the standard of care when performing and interpreting health screenings results.

Table 2

Age-appropriate Health Screenings

Adapted from Kaplan Nursing. (2023a). NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination (9th ed.). Kaplan Test Prep.

4.3 High Risk Behaviors

Clients sometimes engage in high-risk behaviors, which can lead to illness, disease, and even death (Kaplan Nursing, 2023b). It is essential for nurses to assess their clients and educate them about the potential consequences of engaging in such behaviors. Kaplan Nursing (2023b) discusses examples of these behaviors and their consequences:  

  • Consequences of engaging in unprotected sexual activity (oral, vaginal, or anal) include:
    • Unplanned pregnancy.
    • Sexually Transmitted Diseases/Infections (STDs/STIs).
    • HIV/AIDS.
  • Additional high-risk behaviors leading to HIV/AIDS include:
    • Exposure to infected body fluids.
    • Sharing needles.
    • Using contaminated needles.
  • Accidents or death may result from failure to:
    • Wear a seatbelt while in automobiles.
    • Wear a helmet while cycling.
    • Use crosswalks when available.

When educating clients about avoiding high risk behaviors, it is important to use effective teaching/learning principles. According to Kaplan Nursing (2023b), these principles include:

  • Assessing clients’ ability to learn and their readiness to learn:
    • Considering age and stage of development, such as sharing internet sources with adolescents for independent information access.
    • Encouraging active participation by helping clients set their goals.
    • Providing opportunities for clients to demonstrate their understanding of the information.
  • Incorporate learning preferences, which may include:
    • Visual aids such as pamphlets, pictures, diagrams, videos for visual learners.
    • Audio resources like recording, discussion, and lectures for auditory learners.
    • Experiential opportunities like hands-on activities for kinesthetic/tactile learners.
  • It is also important to identify and address barriers to learning, such as:
    • Financial constraints.
    • Lack of motivation.
    • Misconception.
    • Impaired vision and/or hearing.
    • Negative experiences within the healthcare system.

Upon concluding this topic, learners will acquire a deeper understanding of health promotion and early detection. The provided resources will assist learners to gain proficiency in models for immunizations, health screenings, and high-risk behavior reduction/cessation. The goals are to assist with success on the NCLEX examination and in the workplace.

After reviewing the resources, take time to reflect and identify specific areas for improvement, and concentrate on them.

  • Centers for Disease Control and Prevention. (2023a, December 6). Child Immunization Notes. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-schedule-notes.html#note-covid-19
  • Centers for Disease Control and Prevention. (2023b,  November 16). Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger. https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf.
  • Centers for Disease Control and Prevention. (2023c, November 16). Adult Immunization Schedule by Age: Recommendations for Ages 19 Years or Older. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
  • Kaplan Nursing. (2023a). NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination (9th ed.). Kaplan Test Prep.
  • Kaplan Nursing. (2023b). Next Generation NCLEX-RN Prep 2023-2024: Practice Test + Proven Strategies (9th ed.).  Kaplan Test Prep.

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