Hepatitis Flashcards
Risk factors for Hepatitis
Autoimmune disorders
Alcoholism
Contaminated food, water
Infected blood
Sexual contact with body fluids
List the clinical manifestations of Hepatitis
Abdominal pain
Irritability
Pruritus
Malaise
Fever
Nausea
Vomiting
Jaundice
Elevated liver enzymes
Common flu like symptoms
decreased appetite
tachycarda
Complications of hepatitis
Chronic hepatitis
Cirrhosis
Liver Cancer
Liver failure
What to assess in a patient with Hepatitis
Monitor VS
Monitor LFTs
Monitor Bilirubin
Assess skin color and sclera
Monitor nutritional intake
Daily weights
Intake & Output
s/s of organ rejection post-transplant
Nursing dx for Hepatitis
- Activity intolerance
- Acute pain
- Altered nutrition
- Altered thought process
- Knowledge deficit
Hepatitis
What does it stand for
Expected outcome for a patient with Hepatitis
Stable vital signs
Stable weight
Understanding risk factors, transmission, and treatment regimen
Most common form of hepatitis in children
Hepatitis A
Which kinds of hepatitis have a vaccine
A &B
How and when is the Hepatitis B vaccine given
series of three injections:
1. at birth before leaving hospital
2. at least 4 weeks after 1st injection
3. at least 8 weeks after 2nd injection but no earlier than 24 weeks of age and at least 16 weeks after initial dose
Contraindications to the hep B vaccine
Do not give to preemies
Do not give if previous allergic reaction to Hep B injection
How and when is the Hepatitis A vaccine given
series of 2 injections:
1. at 12-15 months initial dose
2. at 18-33 months or 6-18 months after initial dose.
What kind of diet does a child with hepatitis need to follow
Low-fat, well-balanced diet
After changing a childs diaper with hepatitis what needs to be done?
Disinfect diaper changing surfaces thoroughly with bleach solution
How long should enteric precautions be utilized with a hepatitis patients?
at least 1 week after jaundice appears
When caring for a patient with hepatitis, when would you notify the provider
neurological status change, bleeding occurs, or fluid retention
What to teach parents of children with hepatitis
Strict handwashing
May require hospitalization with enteric precautions
Use enteric precautions at least 1 week after jaundice appears
Jaundice may look worse before it resolves
Give new meds cautiously because the liver is responsible for detoxification and excretion of meds (explain this to parents)
Notify provider immediately if change in neurological status, bleeding occurs, or fluid retention as these are signs of worsening condition
Do not share toys
Disinfect diaper changing surfaces thoroughly with bleach solution
Maintain comfort and provide for rest
Low-fat, well-balanced diet
Inflammation of liver cells most commonly caused by a virus that impairs its ability to function normally.
Hepatitis
Medications used to treat Hep B
- tenofovir, entecavir, lamivudine, telbivudine. All oral agents are given once a day for 1 year or longer.
- IMs = interferon - alpha several times a week ( 6-12 months), pegyalted interferon weekly Inj ( 6-12m )
Medication used to treat Hep C
- pegylated interferons ribavirin, peginterferon with ribavirin, interferon with ribavirin.
- Interferon therapy last 12-8 months, ribavirin therapy last 48 weeks
- Harvoni ( sofosbuvir + ledipasvir )= polymerase inhibitor 8-12 weeks of ttmt.
Oral medications used to treat Hep B, how long are they taken?
tenofovir, entecavir, lamivudine, telbivudine
Given once a day for one year
IM medications used to treat Hep B and how long they are given
- interferon - alpha several times a week ( 6-12 months)
- pegyalted interferon weekly Inj ( 6-12m )
What kind of hepatitis is a polymerase inhibitor given and for how long?
Hep C, 8-12 wks
To treat Hep C how long is interferon therapy and ribavirin therapy?
Interferon: 12-8 months
Ribavirin: 48 wks
What kind of diet should someone with hepatitis follow
high carb, high calorie, moderate fat and moderate protein diet, small - frequent meals.
How to promote hepatic rest and regeneration of tissue
◦ Avoid alcohol
◦ Limit physical activity
Nursing interventions/care for Hepatitis
- Enforce contact precautions if indicated
- Provide high carb, high calorie, moderate fat and moderate protein diet, small - frequent meals.
- Promote hepatic rest and regeneration of tissue
◦ Avoid alcohol
◦ Limit physical activity - Preventative measures for transmission
- Provide culturally sensitive care
- Administer med / antiemetic
- Monitor vital signs, serum liver enzymes, serum bilirubin, color of skin,
- Monitor nutritional intake, daily weight, I/O’s, signs of organ rejection
A patient with hepatitis should avoid sex for how long?
until hepatitis antibodies are negative
Medications patients with hepatitis should avoid
- Tylenol
- aspirin
- sedatives
- statins
- anabolic steroids
- azathiopine
- methotrexate
- isoniazid
- valporic acid
- tetracyclines
- phenytoin
Toxins that need to be avoided by hepatitis patients
Industrial chemichals
Carbon tetrachloride
phosphorus
mushrooms
Teaching for a patient with hepatitis
- Discuss use of interest in complementary or integrative therapies W/ client as away to improve quality of life
- Avoid sex until hepatitis antibodies are neg
- Avoid Tylenol, aspirin, sedatives
◦ Med to avoid: Statins, anabolic steroids, azathiopine, methotextrate, isoniazid, vampiric acid, tetracyclines, phenytoin,
◦ Toxins: industrial chemicals, carbon tetrachloride, phosphorus, mushrooms - Perform proper hand hygiene
- Educate importance of vaccinations to prevent hep A and B
- Safe public water supply.
Expected labs in a patient with hepatitis
- AST / ALT will be elevated
- Bilirubin will be elevated
- Ammonia will be elevated
What type of hepatitis is this?
- Acute only
- Transmission: fecal oral-food and water
- dx with +IgM & IgG
- treated with supportive therapy and rest
- Has a vaccine
Hep A
What type of hepatitis is this?
- Acute & chronic
- Transmission: Body fluids - Birth, sex, childbirth, IV drug use, blood
- Dx: +HBsAG & Anti-HB
- Treatment: Acute-supportive therapy & rest chronic-Antivirals
- Has a vaccine
Hep B
What type of Hepatitis is this?
- Acute & Chronic
- Transmission: Body fluids - IV drug use
- Dx: +Anti-HCV
- Treatment: antivirals
- No vaccine
Hep C
What type of hepatitis is this?
- Acute & Chronic
- Transmission: only occurs if pt has hep B
- Dx: +HDAg & Anti-HDV
- Treatment: Antivirals & Interferon
- No vaccine
Hep D
What type of hepatitis is this?
- Acute only
- Transmission: Fecal & oral - Food & water (uncooked meats, 3rd world countries)
- Dx: Anti-HEV
- Treatment: Support therapy & rest
- No vaccine
Hep E
Medications used to treat hepatitis
- Antivirals
- Pegylated interferon injections
- Immunizations
- Antiemetics
