HEPATITIS

Question 1

What is Hepatitis?

Answer 1

Inflammation of the liver
Caused by virus/toxin/alcohol
Acute or chronic

Question 2

What are the 3 Phases of Hepatitis?

Answer 2

Prodromal phase- exposure to then symptoms begin
Jaundice, nausea, vomiting, malaise, fatigue
Mild RUQ pain, fever

Icteric phase - begins 5 - 10 days after initial symptoms

Convalescent phase - follows 2 - 3 weeks of acute illness

Question 3

What are some common S&S for all 3 types of Hepatitis?

Answer 3

Abdominal pain 
Nausea, vomiting, anorexia 
Fever
Joint pain
Fatigue
Jaundice

Question 4

What are the priority nursing diagnosis for Hepatitis?

Answer 4

Imbalanced Nutrition 
Risk for Impaired Skin Integrity 
Infection 
Fatigue 
Deficient Knowledge 
Nausea

Question 5

What is the normal Value for ALT?

Answer 5

4 - 36 units / L

Question 6

What is the normal levels for AST?

Answer 6

0 - 35 units / L

Question 7

What is the normal level for Total Bilirubin?

Answer 7

0.1 - 1.2 mg/dL

Question 8

What Diagnostic Tests will be increased with Hepatitis?

Answer 8

ALT (4-36units/L)
AST (0-35 units/L)
Total bilirubin (0.1-1.2 mg/dL)

Question 9

What are some nursing care items for Hepatitis That relate to Fever and pain, and nutrition?

Answer 9

Fever and pain control
No acetaminophen
Limit physical activity

Nutrition
High calorie, high carbohydrate
Small meals with supplemental snacks
No alcohol

Question 10

What are some nursing care items for Hepatitis That relate to skincare and fatigue?

Answer 10

Skin Care
Nonrestrictive clothing
Antihistamines

Fatigue
Planned rest periods
Provide for 4 week recovery period

Question 11

What are some common facts about Hep A?

Answer 11

Transmission: fecal-oral

No carrier state, incubation 4 weeks

Symptomatic for < 2 months with spontaneous recovery

Medication: supportive

Question 12

How can you prevent Hep A?

Answer 12

• hand washing
• bottled water
• Vaccination
• peeling raw fruit / vegetables

Question 13

What are the risk factors for Hep A?

Answer 13

Risk factors
Contaminated food/water*
Close personal contact with infected person

Question 14

What are some risk factors for Hep B & how can it be prevented?

Answer 14

Risk factors
Sexual contact*
Shared needles
Healthcare worker

Prevention
Vaccine
Safe sex
Standard precautions

Question 15

What are some common Facts about Hep B?

Answer 15

Transmission: blood and body fluids, perinatal

Carrier state
Incubation 6-24 weeks
> 95% recover spontaneously

Question 16

What medications can treat Hep B?

Answer 16

chronic - interferons, adefovir, lamivudine

Question 17

What are some risk factors and prevention items for Hep C?

Answer 17

Risk factors
Shared needles
Healthcare worker exposure
Blood products before 1992
Sexual contact

Prevention
Safe sex
Standard pecautions

Question 18

What are some common facts about Hep C?

Answer 18

Transmission: blood and body fluids
Carrier state

Incubation 5-12 weeks
May be asymptomatic for decades* - leading cause of liver disease/transplant
Only 15% spontaneous recovery

Question 19

What disease can chronic Hep B and C increase your risk for?

Answer 19

Cirrhosis
Liver failure
Liver cancer

Question 20

What is the goal of drug therapy when treating Hepatitis?

Answer 20

The goal of drug therapy is to the viral load and so prevent repeated episodes of inflammation that cause these complications.

Question 21

What is paracentesis?

Answer 21

removal of fluid from the abdominal cavity

Question 22

What are some Pre-procedure items a nurse will need to take for a paracentesis?

Answer 22

Check for signed consent form
Instruct Patient to void
Gather supplies and place patient in upright position at edge of bed with feet supported on a stool -or- Fowler’s portion if confined to bed
Place Sphygmomanometer Cuff around Arm (BP cuff)

Question 23

What are some Intra-procedure items a nurse will need to take for a paracentesis?

Answer 23

help client remain still during procedure
Measure and record BP throughout procedure periodically
Monitor for signs of vascular Collapse

Question 24

What are some signs of Vascular Collapse?

Answer 24

Increase pulse (HR)
Decreased BP

Question 25

What are some Post-procedure items a nurse will need to take for a paracentesis?

Answer 25

return patient to bed or place in a comfortable sitting position
Measure, describe and record the fluid collected
Label any samples collected and send to lab
Monitor vitals every 15 mins for 1 hour
Then every 30 min for 2 hours; then every 4 hrs
Assess site for bleeding, leakage, hypovolemia, mental status, and encephalopathy
Stress the importance of not lifting anything and moving slowly