HEPATITIS Flashcards
What is Hepatitis?
Inflammation of the liver
Caused by virus/toxin/alcohol
Acute or chronic
What are the 3 Phases of Hepatitis?
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
What are some common S&S for all 3 types of Hepatitis?
Abdominal pain Nausea, vomiting, anorexia Fever Joint pain Fatigue Jaundice
What are the priority nursing diagnosis for Hepatitis?
Imbalanced Nutrition Risk for Impaired Skin Integrity Infection Fatigue Deficient Knowledge Nausea
What is the normal Value for ALT?
4 - 36 units / L
What is the normal levels for AST?
0 - 35 units / L
What is the normal level for Total Bilirubin?
0.1 - 1.2 mg/dL
What Diagnostic Tests will be increased with Hepatitis?
ALT (4-36units/L)
AST (0-35 units/L)
Total bilirubin (0.1-1.2 mg/dL)
What are some nursing care items for Hepatitis That relate to Fever and pain, and nutrition?
Fever and pain control
No acetaminophen
Limit physical activity
Nutrition
High calorie, high carbohydrate
Small meals with supplemental snacks
No alcohol
What are some nursing care items for Hepatitis That relate to skincare and fatigue?
Skin Care
Nonrestrictive clothing
Antihistamines
Fatigue
Planned rest periods
Provide for 4 week recovery period
What are some common facts about Hep A?
Transmission: fecal-oral
No carrier state, incubation 4 weeks
Symptomatic for < 2 months with spontaneous recovery
Medication: supportive
How can you prevent Hep A?
- hand washing
- bottled water
- Vaccination
- peeling raw fruit / vegetables
What are the risk factors for Hep A?
Risk factors
Contaminated food/water*
Close personal contact with infected person
What are some risk factors for Hep B & how can it be prevented?
Risk factors
Sexual contact*
Shared needles
Healthcare worker
Prevention
Vaccine
Safe sex
Standard precautions
What are some common Facts about Hep B?
Transmission: blood and body fluids, perinatal
Carrier state
Incubation 6-24 weeks
> 95% recover spontaneously
What medications can treat Hep B?
chronic - interferons, adefovir, lamivudine
What are some risk factors and prevention items for Hep C?
Risk factors Shared needles Healthcare worker exposure Blood products before 1992 Sexual contact
Prevention
Safe sex
Standard pecautions
What are some common facts about Hep C?
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
What disease can chronic Hep B and C increase your risk for?
Cirrhosis
Liver failure
Liver cancer
What is the goal of drug therapy when treating Hepatitis?
The goal of drug therapy is to the viral load and so prevent repeated episodes of inflammation that cause these complications.
What is paracentesis?
removal of fluid from the abdominal cavity
What are some Pre-procedure items a nurse will need to take for a paracentesis?
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)
What are some Intra-procedure items a nurse will need to take for a paracentesis?
help client remain still during procedure
Measure and record BP throughout procedure periodically
Monitor for signs of vascular Collapse
What are some signs of Vascular Collapse?
Increase pulse (HR) Decreased BP
What are some Post-procedure items a nurse will need to take for a paracentesis?
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
