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Liver > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What is hepatitis A?

A

HAV is a virus that causes inflammation of the liver. It does not lead to chronic disease.

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2
Q

How is hepatitis A spread?

A
  1. Transmitted by fecal/oral (anal/oral sex) route
  2. Close person to person contact
  3. Ingestion of contaminated food and water
  4. Hand to mouth after contact with feces, such as changing diapers
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3
Q

S/Sx of hepatitis A

A
  1. Children may have none
  2. Adults may have light stools
  3. Dark urine
  4. Fatigue
  5. Fever
  6. N/V
  7. Abdominal pain
  8. Jaundice
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4
Q

People at high risk for hepatitis A

A
  1. Men who have sex with men
  2. IV drug users
  3. Day care staff
  4. Healthcare personnel
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5
Q

Hepatitis A vaccine doses

A

Two doses (6 months apart) of vaccine to anyone over 1 year of age

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6
Q

Prevention of hepatitis A

A
  1. Vaccination or globulin within 2 weeks of exposure
  2. Washing hands with soap and water after going to the toilet
  3. Use household bleach to clean surfaces contaminated with feces, such as changing tables
  4. Safer sex
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7
Q

Medical Management of hepatitis A and E

A
  1. Bed rest
  2. Nutritious diet - small, frequent meals; increase PO fluids
  3. Antiemetics
  4. IV glucose
  5. Gradual return to activity
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8
Q

Nursing Management of hepatitis A and E

A
  1. At home unless severe s/sx
  2. Instruct on diet, rest, F/U blood work, avoid alcohol, hand washing and BM and before eating, environmental sanitation, condoms
  3. Report hepatitis A to health department
  4. Caution with OTC drugs that affect the liver
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9
Q

What is hepatitis B?

A

HBV is a virus that causes inflammation of the liver. It can cause liver cell damage, leading to cirrhosis and cancer

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10
Q

How is hepatitis B spread?

A
  1. Contact with infected blood, seminal fluid, vaginal secretions
  2. Contact with contaminated needles including tattoo and body piercing tools
  3. Infected mother to newborn (must do a C-section)
  4. Human bite
  5. Sexual contact
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11
Q

S/Sx of hepatitis B

A
  1. May have none
  2. Some persons have mild flu-like symptoms
  3. Dark urine
  4. Light stools
  5. Jaundice
  6. Fever
  7. Fatigue
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12
Q

Treatment of chronic hepatitis B

A

Alpha interferon and antivirals

  1. Peginterferon
  2. Entecavir
  3. Tenofovir
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13
Q

Hepatitis B vaccine

A

Three doses may given to persons of any age

First dose, then 1 month second dose, then 6 month third dose

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14
Q

People at high risk for hepatitis B

A
  1. Infants born to infected mother
  2. Having sex with an infected person or multiple partners
  3. IV drug users
  4. Emergency responders
  5. Healthcare workers
  6. Persons engaging in anal/oral sex
  7. Hemodialysis patients
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15
Q

Hepatitis B Prevention

A
  1. Vaccination gives 5-10 years immunity
  2. Clean up blood with household bleach and wear protective gloves
  3. Do not share razors, toothbrushes, or needles
  4. Safer sex
  5. Hep B immune globulin for vaccine non-responders after exposure
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16
Q

Medical Management of Hepatitis B and D

A
  1. Alpha interferon and antivirals (injections 3 times per week for 1-2 years)
  2. Bed rest
  3. Restrict activity until there is a decrease in hepatic enlargement, decrease serum albumin, and decrease in liver enzymes
  4. Nutrition - restrict protein
  5. Antacid/Antiemetic
  6. IVF - hospitalization for prolonged vomiting/dehydration
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17
Q

Nursing Management of Hepatitis B and D

A
  1. Convalescence 3-4 months (90% develop antibodies and recover in 6 months; 10% carrier state)
  2. Gradually resume physical activity
  3. Isolation/separation issues
  4. Family involvement/home care
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18
Q

What is hepatitis C?

A

HCV is a virus that causes inflammation of the liver. It can cause liver cell damage, leading to cirrhosis and cancer

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19
Q

How is hepatitis C spread?

A
  1. Contact with infected blood, contaminated IV needles, razors, and tattoo and body piercing tools
  2. Infected mother to newborn
  3. Not easily spread through sex
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20
Q

S/Sx of Hepatitis C

A
  1. May have none
  2. Some persons have mild flu-like symptoms
  3. Dark urine
  4. Light stools
  5. Jaundice
  6. Fatigue
  7. Fever
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21
Q

Treatment of chronic hepatitis C

A

Peginterferon with ribaviron and serine protease adjuncts

22
Q

People at risk for hepatitis C

A
  1. Blood transfusions before 1992
  2. Healthcare workers
  3. IV drug users
  4. Hemodialysis patients
  5. Infants born to infected mother
  6. Multiple sex partners
23
Q

Hepatitis C Prevention

A
  1. Clean up spilled blood with household bleach
  2. Wear gloves when touching blood
  3. Do not share razors, toothbrushes, or needles with anyone
  4. Safer sex
24
Q

Medical Management of Hepatitis C

A
  1. Antiemetics
  2. Increase fluid intake
  3. Healthy diet
  4. Interferon and Ribovirnin (lots of side effects)
25
Q

Nursing Management of Hepatitis C

A
  1. No activity restrictions
  2. No diet restrictions
  3. Teach prevention
  4. Encourage HIV testing if hep C positive
26
Q

What is Hepatitis D?

A

HDV is a virus that causes inflammation of the liver only in persons with HBV. It can cause cirrhosis and cancer.

27
Q

How is Hepatitis D spread?

A
  1. Contact with infected blood
  2. Contaminated needles
  3. Sexual contact with HDV infected person
28
Q

S/Sx of Hepatitis D

A
  1. May have none
  2. Some persons may have mild flu-like symptoms
  3. Dark urine
  4. Light stools
  5. Jaundice
  6. Fatigue
  7. Fever
29
Q

Treatment of chronic Hepatitis D

A

Peginterferon with varying success

30
Q

Vaccine for hepatitis D

A

The HBV vaccine prevents HDV infection

31
Q

People at risk for hepatitis D

A
  1. IV drugs users
  2. Persons engaging in anal/oral sex
  3. Persons having sex with an HDV infected patient
32
Q

Hepatitis D Prevention

A
  1. Hepatitis B vaccine to prevent HBV/HDV infection

2. Safer sex

33
Q

Nursing Management of Hepatitis D

A

Hepatitis D patients are more likely to progress to chronic active hepatitis and cirrhosis

34
Q

What is hepatitis E?

A

HEV is a virus that causes inflammation of the liver. It is rare in the U.S. It can cause chronic disease.

35
Q

How is hepatitis E spread?

A
  1. Transmitted through fecal/oral route

2. Outbreaks associated with contaminated water supply in other countries

36
Q

S/Sx of Hepatitis E

A
  1. Children may have none
  2. Light stools
  3. Dark urine
  4. Fatigue
  5. Fever
  6. N/V
  7. Jaundice
  8. Abdominal pain
37
Q

Treatment of chronic hepatitis E

A

Ribovirin for chronic hepatitis E but needs confirmation

38
Q

Hepatitis E vaccine

A

None commercially available

39
Q

People at risk for Hepatitis E

A
  1. Travelers to developing countries, especially pregnant women
  2. Close contact with swine and ingestion of pork products and venison
40
Q

Hepatitis E Prevention

A
  1. Avoid drinking or using potentially contaminated water, fruits, or vegetables
41
Q

What is nonviral hepatitis/toxic hepatitis?

A

Meds or chemicals induce toxic effects on the liver = “hepatotoxic”
*Results in extensive liver damage

42
Q

Causes of Nonviral/Toxic Hepatitis

A
  1. Carbon tetrachloride
  2. Phosphorus
  3. Chloroform
  4. Gold compounds
  5. Isoniazid
  6. Halothane
  7. Acetaminophen
  8. Antibiotics
  9. Anesthetics
43
Q

S/Sx of Nonviral/Toxic Hepatitis

A
  1. A/N/V
  2. Jaundice
  3. Hepatomegaly
  4. Fever
  5. Hematemesis
  6. Hemorrhage
  7. GI symptoms
  8. Delirium
  9. Coma
  10. Seizure
  11. Hepatic failure
44
Q

Treatment of nonviral/toxic hepatitis

A

ID and remove offending agent the earlier the better

  1. Restore/maintain F/E balance
  2. Blood replacement
  3. Comfort/supportive measures
  4. Liver transplant
45
Q

Causes of drug induced hepatitis

A
  1. Anesthetic agents
  2. Rheumatic/MS meds
  3. Antidepressants
  4. Psychotropics
  5. Anticonvulsants
  6. Anti-TB meds
46
Q

S/Sx of drug induced hepatitis

A
  1. Abrupt onset
  2. Chills
  3. Fever
  4. Rash/pruritis
  5. Arthralgia
  6. Anorexia
  7. Nausea
  8. Jaundice
  9. Dark urine
  10. Hepatomegaly
47
Q

Treatment of drug induced hepatitis

A
  1. D/C offending medication
  2. Short course of high dose steroids
  3. Liver transplant
48
Q

What is fulminant hepatic failure?

A

Sudden, severely impaired liver function in previously healthy person within 8 weeks of first symptoms; survival rate 20-50%

49
Q

Cause of fulminant hepatic failure

A
  1. Viral hepatitis
  2. Toxic medications: acetaminophen
  3. Toxic chemical: carbon tetrachloride
50
Q

S/Sx of fulminant hepatic failure

A
  1. Jaundice
  2. Anorexia
  3. Coagulation deficiencies
  4. Renal failure
  5. Electrolyte disturbances
  6. Infection
  7. High BG
  8. Encephalopathy
  9. Cerebral edema
51
Q

Medical Management of fulminant hepatic failure

A
  1. Rapid diagnosis and rapid treatment
  2. Plasma exchange
  3. Transplant
  4. Cerebral edema - monitor pressure, fluid balance, quiet environ, diuresis
  5. Increased ICP - anesthesia, paralysis, sedation
  6. High mortality rate

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