Hepatitis

Question 1

PATHOPHYSIOLOGY

Answer 1

• inflammation of the liver
• impedes processes and function of the liver
• prevalent throughout the world
• generally results from underlying infectious agent or virus
• may be acute or chronic
• mild or life threatening

Question 2

ETIOLOGY AND PATHO

Answer 2

1. INFLAMMATORY PROCESS
   - damages hepatic cells
   - disrupts liver function

2.DEGREE OF IMPAIRMENT DEPENDS ON CAUSE, SPEED OF DEVELOPEMENT

3. CAUSES
   - virus, toxins, other pathogen
   - alcohol or drug abuse

Question 3

ETIOLOGY

Answer 3

• cell mediated immune response ( damage hepatocytes, kupffer cells leads to hyperplasia and necrosis)
• locally in liver or as systemic disease
• non-viral hepatitis
• viral hepatitis
  (HAV,HBV,HCV,HDV,HEV)
  (chronic hepatitis caused by B,C,E)
  (fulminant hepatits)

Question 4

RISK FACTORS AND PREVENTION

Answer 4

-risk factors, preventive actions vary according to cause of hepatitis

MOST COMMON:
autoimmune disorders 
alcoholism 
contaminated food, water 
infected blood 
sexual contact with contaminated blood , body fluids

Question 5

CLINICAL MANIFESTATIONS

Answer 5

• similar for acute and chronic

- can manifest with no or nospecific symptoms or debilitating symptoms

Question 6

INCUBATION PHASE

Answer 6

• usually asymptomatic for acute hepatitis
• HBeAg in blood indicates high degree of HBV infection
• as incubation progresses, HBsAg appears

Question 7

PRODROMAL PHASE

Answer 7

• occurs between exposure to virus and appearance of clinical manifestations
• jaundice, nausea, vomiting, malaise, fatigue
• mild RUQ pain, fever

Question 8

ICETERIC PHASE

Answer 8

-begins 5-10 days after initial symptoms manifest

Question 9

CONVALESCENT PHASE

Answer 9

• follows 2-3 weeks of acute illness

Question 10

COLLABORATION

Answer 10

-treatment primarily supportive
(rest, proper nutrition, may need to increase protein, avoid alcohol)

• client education
  (prevention, long term management , address risky behaviors)

Question 11

DIAGNOSTIC TESTS

Answer 11

• show extent of liver impairment
  -ALT
  ALP
  LDH
  AST
  GGT
  serum bilirubin
  liver biopsy

Question 12

PHARMOCOLOGIC THERAPY

Answer 12

-most clients with acute hepatitis recover without pharmacologic treatment

- medications available :
vaccines
immune globulin 
interferon alpha (chemo type drug)
antiretroviral drugs

Question 13

NURSING PROCESS

Answer 13

• alleviate symptoms

- provide client education regarding nutrition , lifestyle management

Question 14

ASSESSMENT

Answer 14

• health history
• physical assessment
  abdominal, epigastric pain
  nausea,vomiting,anorexia
  fever, joint pain, malaise, jaundice
  assess for infection transmission, nutritional status

Question 15

DIAGNOSES

Answer 15

• imbalanced nutrition
• risk for impaired skin integrity
• infection
• fatigue
• deficient knowledge
• nausea

Question 16

PLANNING

Answer 16

Goals may include:

• relieving discomfort
• preventing spread of infection
• teaching long- term management of hepatitis

Question 17

IMPLEMENTATION

Answer 17

• assessing medications taken to reduce pain, fever
• encouraging client to eat healthy diet, follow nutritionists recommendations
• instructing client to wear cool, light weight clothes, use cool water for bathing
• AVOID TYLENOL
• preventing spread of infection
• encouraging rest periods, limited activities
• using fatigue level to determine resumption of activities

Question 18

EVALUATION

Answer 18

• client is free from pain
• client free from anorexia, nausea, vomiting
• client maintains weight
• clients skin is intact , without pruitis
• client verbalizes understanding of hepatitis -prevention of spread of infection
• client is free from fatigue