Hepatitis

Question 1

what is hepatitis?

Answer 1

inflammation of the liver

Question 2

Etiology of hepatitis

Answer 2

• virus
• substnaces (alcohol, anabolic steroids, cholesterol lowering like statins, antibiotics, chemicals like carbon tetrachloride)
• autoimune disease
• metabolic abnormalities (ex, non alchoholic fatty liver disease) fat building up in the liver can be related to his cholesterol, diabetes, HTN

Question 3

pathophys of hepatitis

Question 4

each viral type for hepatitis, mode of transmission and source of infection, preventative measures

Answer 4

A - fecal contamination of food or water
preventative measures: vaccination, hand hygeine

B- through blood and bodily fluids
preventative measures: vaccination, avoid sharing razors and needles, safer SEX

C - transmitted through blood
preventative measures: avoid sharing needles, syringes, safer sex
ESP DURING LABOR
are treatments that can cure people if caught

D - through blood and bodily builds
CAN ONLY OCCUR IN THE PRESENCE OF HEP B
prevention: hep b vaccine (no hep d infection), avoid sharing needles and syringes

E - fecal oral route
prevention: clean drinking water
NO VACCINE, usually self recover

Question 5

acute vs. chronic hepatitis symptoms

Answer 5

Acute - inflammation begins suddenly and lasts a few weeks, usually asymptomatic but you can recover

some symptoms that last 2-3 weeks : anorexia, lethargy, nausea, vomiting, low grade fever, skin rashes, diarrhea or constipation, malaise, myalgies, right upper quadrant tenderness, jaundice

Chronic - inflammation lasts greater than 6 months

Question 6

phases of acute hepatitis

Answer 6

1.) Prodromial - Anorexia, nausea, vomiting, malaise, arthralgias, myalgias, headache, dark urine

(flu like symptoms, loss of appetite)

2.) Icteric phase - jaundice
5 -10 days after prodromal, mild weight loss, RUQ pain

3.) Convalescent phase - can last weeks to months
symptoms resolve

Question 7

complications of hepatitis

Answer 7

Acute:
- acute liver failure

• chronic hepatitis
• cirrhosis of the liver
  (late stage scarring of liver)
• portal hypertension
• hepatocellular carcinoma (liver cancer)

Chronic:
- anemia
- ascites (accumulation of serous fluid in the peritenol cavity)
- bleeding abnormalities
- palmar erythema

Question 8

diagnostics

Answer 8

Labs:
- presence of specific antigens or antibodies
- liver function tests

• liver biopsy percutaneous: (needle inserted through skin or transjugular for ppl with bleeding disorders or ascites, through jugular vein and catheter)
• ultrasound

Question 9

interprofessional care, nursing management

Answer 9

acute hepatitis: drug therapy ,

nutritional therapy (vitamin k , b complex, avoid alcohol) , are they tolerative specific foods, what are their eating patterns?

rest, get you back to living your live

chronic - drug therapy: direct activating antivirals that target specific step siwhtin the viruses life cycle or interferons

nutritional therapy (focusing on calories, no specific diet)

rest , dec metabolic demands so liver can regenerate

nursing management:
physical assessment
- present of jaundice
- quality of urine (dark brown cause eof bilirubin?)

Question 10

what is cirrhosis?

Answer 10

end-stage liver disease
characterized by extensive degeneration of liver cells
liver tissue replaced by fibrosis (scar tissue)

Question 11

etiology od cirrohisis

Answer 11

hepatitis (b,c,d) , blood or bodily fluids

alcohol-induced liver disease

nonalcoholic fatty liver disease

cardiac cirrhosis

billary causes (cant be excreted and build up)

Question 12

pathophys of cirrhosis

Answer 12

Liver cells attempt to regenerate but process is disorganized and leads to overgrowth of fibrous connective tissue

abnormal blood vessel and bile duct creative

Question 13

clinical manifestations of cirrhosis

Answer 13

compensated/ EARLY: fatigue, enlarged liver (stage 3 of ESLD)

decompensated/ Late: Jaundice, skin lesions, hematologic problems, endocrine problems, peripheral neuropathy (stage 4)

Question 14

complications of cirrohissi

Answer 14

• portal hypertension : structural changes lead to obstruction of blood flow in and out of liver. body is trying to reduce pressure and find alternative circulatory pathways.
• esophageal (MOST LIFE THREATENING cause of hemorrhage) & gastric varices
• dilated vein , fragile and prone to bleeding
• peripheral edema
• abdominal ascites
• hepatic encephalopathy - results from high levels of ammonia, crosse blood brain barrier
  causes impaired consciousness, change in mental responsiveness, etc
• hepatorenal syndrome -
  renal failure in patients with severe liver disease

portal hypertension leading to renal vasoconstriction leading to this
clinical manifestations: azotemia, oliguria, intractable ascite s

Question 15

diagnostic studies of cirrhosis

Answer 15

Liver function tests
Liver biopsy (GOLD STANDARD)

Question 16

interprefessional care of cirrhosis

Answer 16

Ascites, make sure they dont retain excess fluid : low sodium diet , diuretics, paracentesis (fluid aspirated out to drain)

Esophageal & gastric varices - stopping the bleeding somehow
meds: octreotide , propanol

hepatic encephalopathy - antibiotics, lactulose , rifaximin

Question 17

nursing management of resultant complications of cirrhosis

Answer 17

nutritional therapy: high calorie diet , high carbs, low fat, high protein, low sodium

physical activity
skin care
maintain fluid balance
respiratory status
hematologic problems