Hepatitis: 6 Flashcards
3 phases of Hepatitis
Pre-icterus Period
Symptoms?
Elavated?
What marks the start of icterus phase?
Icteric = Jaundice
Non specific flu like symptoms
Elevated AST and ALT followed by increase in bilirubin levels.
The rise in bilirubin levels marks the start of the Icterus phase
Icterus Period of Hepatitis
Comes?
Tenderness where?
2 more symptoms
Comes 7-14 days after the pre icterus phase
Tenderness in RUQ
Mild weight loss
Spider angiomas
What is the physiologic rationale for the presence of jaundice?
Accumalation of excess bilirubin
Describe areas where jaundice can be detected.
Sclera
Mucous membranes
Skin
Under the tongue
Urine/stool
Describe spider angiomas in Icterus phase?
Flat or slightly raised red to purple dot on
the skin that’s similar to a small pimple.
Dot has red to purple lines extending from the
center (that resemble spider legs)
How is Hepatitis A transmitted?
Contact with?
Consuming?
Close?
Fecal-oral route (NOT blood borne)
Contact with an infected person’s stool or blood.
Consuming contaminated food or water
Close contact with an infected person
What populations are at greatest risk for Hepatitis A?
Institutions housing LARGE numbers of people
Preschool and daycare centers, especially if children are not potty trained
Jails/prisons
Colleges/Universities
Long-term care facilities
What are the clinical manifestations associated with Hepatitis A? 3
Onset?
Carrier state?
Onset is abrupt
Fever/Malaise
Dark urine
Jaundice
NO chronic/carrier state!!!
best ways to prevent Hepatitis A? 2
Hep A vaccine and hand washing!!!!
What is the role of the RN if the patient refuses Hep A vaccination?
Teach the patient about the vaccine
Benefits/risk
Let them decide
How is Hepatitis B contracted?
can be spread by?
Contracted via blood OR body secretions
Can be spread by oral or sexual contact
What populations are at greatest risk for Hep B?
Injecting drug users
Multiple sex partners
Healthcare workers- risk of blood exposure and accidental needle injuries
Mother to baby (in utero)
What are the clinical manifestations associated with Hepatitis B and C.
7
Flu like symptoms
Anorexia
Abdominal pain
Joint pain
Clay-colored stools
Dark urine
Jaundice
What is the physiologic rationale for clay-colored stools?
Bile is released in the stool from the liver.
Bile (greening-yellow) gives stool its brown color.
So, when a person has hepatitis B or C, two things could be occurring with bile.
-Liver is not producing enough.
-Flow is blocked
How is Hepatitis C transmitted?
blood transfusions and blood products only.
What populations are at greatest risk for Hepatitis C
Injecting drug users
Multiple sex partners
Healthcare workers- risk of blood exposure and
accidental needle injuries
Mother to baby (in utero)
Tattooing, acupuncture, body piercings
How is Hep C treated?
There is no vaccine for hepatitis C, but it can be
treated with antiviral medications.
What is the difference between a percutaneous liver and transjugular biopsy?
Who may not be a candidate for Percutaneous?
Percutaneous liver biopsy:
Access the liver tissue directly through the skin on the abdomen.
Transjugular biopsy:
Reaches the liver tissue by inserting a needle into a jugular vein in the neck, allowing access to the liver through the hepatic vein, essentially avoiding direct puncture of the liver capsule
A patient who has a bleeding disorder may not be a candidate for a percutaneous liver biopsy because of the risk of bleeding.
Explain analogs’ intended action in treating viral hepatitis.
Used in hep?
What do they do?
First line for Hepatitis B!!!
Analogs inhibit viral DNA replication.
They cant prevent all viral reproduction, but they can lower the amount of virus in the body.
Interferon for viral hepatitis.
Used for?
Used for Hepatitis B and C!!!
Works by stimulating the body’s immune system to fight off the virus
It has antiviral, antiproliferative, and immune-
modulating effects.
Interferon is very expensive with many side effects
TEST QUESTION
What are the side effects associated with Interferon? 3
Patients receiving interferon should have?
Angioedema!!!!
Depression!!!!
Suicidal thoughts!!!!
Blood counts and liver function tests every 4 to 6 weeks!!!!
Explain the rationale for B complex vitamin and Vitamin K s in the treatment of hepatitis.
B-complex – needed for liver function, especially B6 (pyridoxine), B9 (folate), and B12 (cobalamin)
Vitamin K – needed to produce clotting factors
