Hepatitis Flashcards
The following flashcards are going to be on the recording that I took in class on hepatitis
What does hepatitis mean?
inflammation of the liver
what are some causes of hepatitis ?
viral, alcohol, medications, chemicals, autoimmune diseases, metabolic problems
How do you get hepatitis A?
fecal-oral contained food or water
is there a vaccine for hep a?
yes
can hep a be chronic ?
no, but it can lead to mild liver failure
how do you get hep b?
blood, fluid to a patient from someone who is infected
is there a vaccine for hep b?
and are these conditions for life?
yes for both
how do you get hep c?
blood and body fluid
is there a vaccine for hep c?
and why is it dangerous?
no
asymptomatic for the first stage
chronic causes liver damage
and it stays in your body for life
how do you get hep D?
person must have hep B first and then it develops into something more chronic
how do you get hep e?
fecal-oral, not common in US
we do 3 tests for hep b, what are the names?
surfacen antigen (HBSAG)
hep B core antibody (anti-hbc)
surface antibody (anti-hbs)
this will be on the test regarding the hep b bloodwork.
tell me what each of these test mean/indicate for us when we do it on a patient.
surface antigen (HBSAG)
hep B core antibody (anti-hbc)
surface antibody (anti-hbs)
antigens develops weeks after infection
seen at the onset of infection, remains for life
presence indicates immunity to HBV either from prior infection or immunization
example for this bloodwork.
if youre patient core hep b is positive and their surface antibody is positive, how did they develop hep b?
they got hep b from an infection
because their core antibody was positive
in the acute infection of having hepatitis, what is going on patho wise?
large numbers of hepatocytes are being destroyed
after the resolution of the infection or simply a well controlled hep b outbreak, what can the body do ?
regenerate Normal liver cells
however, what is the sad part of having a chronic infection of hep b ? more so what can it cause and progress into ?
fibrosis
progress into cirrhosis
what are some systemic manifestations that can occur when a patient has a hepatitis infection ?
rash
angioedema
arthritis
fever
malasie
cryoglobulinemia
glomoeurloneprhritis
vasculitis
a patient who gets exposed to hep b one day and then gets tested the following day, what will be the results and why ?
negative
the reason why is because it takes time for the infection to develop
what are the main findings that can occur in patient with hepatitis ? (4)
hepatomegaly
lymphadenopathy
splenomegaly
jaundice or anicteric
how long is an acute hep infectious ?
1-6 months
if a patient has icteric (jaundice) or anicteric, what can we find on urine/skin examination ? (3)
dark urine
light-clay colored stools
pruritus
a good thing about liver transplant is what?
you only need a piece of a good liver and the person with the transplant can just regenerate into it !
what are some complications of having hepatitis ?
acute liver failure
chronic hepatitis
cirrhosis
portal hypertension
liver cancer
patients with acute liver failure can end up with encephalopathy, gi bleeding, disseminated intravascular coagulation, fever with leukocytosis, renal manifestations
why do we get hepatic encephalopathy ?
high levels of ammonia which causes the encephalopathy
why do we get ascites ?
high pressures in the blood supply in the liver, it pushes fluid out in the space outside the vessels
what are diagnostic studies?
hep panel
liver biopsy
viral genotype testing
ultrasound
what is the medication we use to help treat hep b?
interferon
what are side effects of hep b medication interferon?
flu like symptoms & depression
Subjective data
Past health history
Hemophilia
Exposure to infected persons
Ingestion of contaminated food or water
Ingestion of toxins
Past blood transfusion (before 1992)
Other risk factors
Medications
Acetaminophen, OTC, or herbal medications
subjective data: Functional health patterns
IV drug and alcohol abuse
Distaste for cigarettes (in smokers)
High-risk sexual behaviors
Weight loss, anorexia, nausea/vomiting
RUQ abdominal discomfort
Urine and stool color
Fatigue/arthralgias/myalgia
Exposure to high-risk groups
Objective data
Low-grade fever
Jaundice
Rash
Hepatomegaly
Splenomegaly
Abnormal laboratory values
Impaired nutritional intake
Activity intolerance
Risk for bleeding
Patient will
Have relief of discomfort
Be able to resume normal activities
Return to normal liver function without complications
Health promotion: Hepatitis A
Personal and environmental hygiene
Active immunization: HAV vaccine
Children at 1 year of age
Adults at risk
Post-exposure prophylaxis with HAV vaccine and immune globulin (IG)
Special precautions for health care personnel
Health promotion: Hepatitis B
General measures
Immunization
Recombivax HB, Engerix-B
Series of three IM injections
All children and at-risk adults
Postexposure prophylaxis: vaccine and hepatitis B immune globulin (HBIG)
Health promotion: Hepatitis C
No vaccine to prevent HCV
General measures to prevent HCV transmission
Screen all persons born between 1945 and 1965
No postexposure prophylaxis; baseline and follow-up testing
Acute care
Assess for jaundice
Comfort measures-antihistamines for itching
Adequate nutrition
Small, frequent meals
Measures to stimulate appetite
Carbonated beverages
Adequate fluid intake
Acute care
Physical rest
Modified activity plan
Psychologic and emotional rest
Diversion activities
Ambulatory care
Plan activities after periods of rest
Teach how to prevent transmission
Symptoms to report
Assessment for complications
Ambulatory care
Regular follow-ups for at least 1 year after diagnosis
No alcohol
Medication education
How to administer interferon
Side effects
No blood donation by HBsAg- or HCV-positive patients
Expected outcomes
Maintain food and fluid intake adequate to meet nutritional needs
Avoid alcohol and other hepatotoxic agents
Show gradual increase in activity tolerance
Perform daily activities with scheduled rest periods
why do we use vitamin k for patients with hep?
for clotting because when you have hep youre more at risk of bleeding
