Hepatitis Flashcards
What is hepatitis?
inflammation of the liver
What are the phases of hepatitis?
- pre-icterus period
- icterus period
- recovery period
What are the clinical manifestations of the pre-icterus phase?
- Malaise and fatigue
- Myalgia and arthralgia
- Anorexia, N/V/D, Constipation
- Jaundice is not present yet
-“icteric” means jaundice, therefore BEFORE jaundice
What are the clinical manifestations of the icterus phase?
- Jaundice becomes visible
- RUQ tenderness
- Mild weight loss
- Spider angioma
aka the jaundice phase, remember, -“iceterus” = jaundice
What happens during the recovery phase?
- Increased sense of well-being
- Appetite returns
- No more jaundice
Why does jaundice occcur?
- Accumulation of bilirubin in the skin and mucous membranes
- This can be due to:
- Change in normal bilirubin metabolism
- Bile flow is disrupted
Describe spider angiomas.
- Flat or slightly raised red/purple dot on the skin (kinda like a small pimple)
- Red/purple lines extend out from the center (resemble spider legs)
How is Hepatitis A transmitted?
- Contracted via oral-fecal route
- Spread through:
- Contacting an infected person’s stool or blood.
- Consuming contaminated food or water
- Close contact with an infected person
Not considered a blood-borne virus
Who is at greatest risk for HAV?
- Institutions housing large numbers of people
- Preschool and daycare centers, especially if children are not potty trained
- Young children are usually asymptomatic
- Play a significant role in transmission
- Jails/prisons
- Colleges/Universities
- Long-term care facilities
What are the clinical manifestations associated with Hepatitis A?
- Fever and malaise
- Dark urine
- Jaundice
- Note: Hep A does not lead to a chronic/carrier state
onset is abrupt
What is the best way to prevent HAV?
- HAV vaccine
- handwashing
What is the role of the RN if the patient refuses the vaccination?
- Listen to the patient’s concerns
- Provide clear, accurate information about the benefits/risks
- Respect their decision
- Ensure they understand the consequences
- Document the refusal and the conversation
How is Hepatitis B transmitted?
- Contracted via blood or body secretions
- Can spread by oral or sexual contact
How is Hepatitis C transmitted?
Primarily through blood transfusions
and blood products
Who is at greatest risk for HBV and HCV?
- Injecting drug users
- Multiple sex partners
- Healthcare workers
- blood exposure and accidental needle injuries
- Mother to baby (in utero)
- Tattooing, acupuncture, body piercings
What are the clinical manifestations associated with HBV and HCV?
- Fatigue and fever
- Anorexia, Nausea/Vomiting
- Abdominal and joint pain
- Dark urine
- Clay-colored stools
- Jaundice
What causes clay-colored stools?
- Bile is released in the stool from the liver
- Bile gives stool its brown color
- When a person has hepatitis B or C, two things could be occurring with bile:
- Liver is not producing enough
- Flow is blocked
What is a percutaneous liver biopsy?
- Acute Hepatitis only
- Needle is inserted directly into the liver to take a sample
determines degree of inflammation and cirrhosis
What is a transjugular liver biopsy?
- Patients with bleeding disorder
- Needle is inserted into a vein in the neck (jugular vein), and liver tissue is obtained through a rigid cannula
determines degree of inflammation and cirrhosis
What is analogs’ intended action in treating viral hepatitis?
- first-line therapy
- blocks the virus’s ability to replicate
What are types of analogs?
- lamivudine (Epivir)
- adefovir (Hepsera)
What is interferon’s intended action in treating viral hepatitis?
- boosting the body’s immune system
- immune cells are better at recognizing/fighting the virus
- reduces the virus’s ability to replicate
very expensive and many side effects
What are the side effects associated with Interferon?
- angioedema
- depression, suicidal, self harm
Patients should have blood counts and liver function tests every 4-6 wks
Why are Vitamin B and K used to treat/manage hepatitis?
- Vitamin B: needed for liver function, especially B6, B9, and B12
- Vitamin K: needed to produce clotting factors
