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NURS 3512 - Class 1-6 > Week 6 - Hepatits > Flashcards

Week 6 - Hepatits Flashcards

1
Q

what is hepatitis

A
  • inflammation of the liver
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2
Q

what are some causes of hepatitis (7)

A
  • viruses
  • chemicals
  • drugs
  • alcohol
  • autoimmune diseases
  • metabolic disorders
  • genetic abnormalities
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3
Q

what is the function of the liver (7)

A
  • filter the blood coming from the digestive tract, before passing it to the rest of the body
  • detoxifies chemicals and metabolizes drugs
  • secretes bile that ends up back in the intestines
  • makes proteins important for blood clotting and other functions.
  • bile –> fat metabolism
  • helps regulate BG by storing glucose
  • ammonia –> urea
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4
Q

what are some symptoms of hepatitis during the acute phase (10)

A
  • GI symptoms
  • RUQ discomfort
  • altered taste & smell
  • nonspecific symptoms
  • hepatomegaly
  • lymphadenopathy
  • splenomegaly
  • hepatic jaundice (increased conj and unconj)
  • darkened urine (d/t increased conj)
  • light, clay colored stool (inflammation = swelling = conjugated bilirubin cant flow out of liver)
  • pruritis
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5
Q

what are some GI symptoms present in hepatitis (6)

A
  • anorexia
  • NV
  • CD
  • altered taste & smell
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6
Q

what nonspecific symptoms are present in the acute phase of hepatitis (6)

A
  • malaise
  • fatigue
  • headache
  • low-grade fever
  • arthralgia
  • skin rashes
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7
Q

what symptoms are present in chronic hepatitis (2)

A
  • no symptoms

- or non specific symptoms

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8
Q

what are some nonspecific symptoms present in chronic hepatitis (5)

A
  • malaise
  • easy fatigability
  • mylagia
  • arthralgia
  • hepatomegaly
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9
Q

what are 2 possible complications of hepatitis

A
  • fulminant hepatitis

- cirrhosis

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10
Q

what is fulminant hepatitis

A
  • acute clinical syndrome that results in severe impairment or necrosis of liver cells and potential liver failure
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11
Q

what can be used to diagnose hepatitis (3)

A
  • viral serological tests
  • serum liver enzymes
  • liver function tests
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12
Q

what are viral serological tests

A
  • uses serological markers (viral antigens and antibodies) to diagnose viral hepatitis
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13
Q

what are serum liver enzymes useful for

A
  • cannot differentiate between different types of hepatitia, but can determine the type of liver injury –> if due to liver cell injury or bile duct abnormality
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14
Q

what serum liver enzymes are assessed to diagnose hepatitis (4)

A
  • AST
  • ALT
  • ALP
  • GGT
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15
Q

what is assessed during liver function tests (4)

A
  • serum albumin
  • serum bilirubin
  • prothrombin time
  • INR
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16
Q

what is the goal of collaborative care for hepatitis

A
  • prevention of cirrhosis & hepatocellular cancer
17
Q

describe the typical treatment/management for hepatitis (3)

A
  • no specific treatment or therapy for acute viral hep
  • most pts managed at home
  • emphasis on resting the body and receiving adequate nutrients
18
Q

what drug therapy is used for hep B (2)

A
  • interferon (IFN)

- antivirals

19
Q

what antivirals are used for treatment of hep B (2)

A
  • nucleosides
  • nucelotide analogues
  • inhibit viral DNA synthesis*
20
Q

what drug therapy is used for hep C (2)

A
  • IFN

- ribavirin (rebetol) = antiviral

21
Q

what education can be given to help avoid hep A (4)

A
  • vaccination
  • personal & environmental hygeine
  • handwash before and after BM
  • handwash before and after eating
22
Q

what education can be given to help avoid hep B (4)

A
  • vaccination
  • handwashing & use of gloves when expecting contact w blood
  • condom use
  • do not share razors, toothbrushes, and other personal items
23
Q

what education can be given to help prevention of hep C (4)

A
  • no vaccine
  • screen blood, organ, and tissue donors
  • infection control precautions
  • rest the same as hep B
24
Q

where is jaundice usually first observed

A
  • sclera of eyes

- then in skin

25
Q

what are acute interventions for hepatitis (4)

A
  • relieve pruritis
  • headache
  • arthralgias
  • ensure adequate nutrition
26
Q

why is nutrition a concern w hepatitis (5)

A
  • d/t altered taste & smell
  • and anorexia
  • NV
  • impaired glucose and fat metab
  • helps regenerate liver
27
Q

describe nutritional therapy for hepatitis (4)

A
  • small frequent meals preferable to 3 large ones
  • utilize measures to stimulate appetitie
  • adequate hydration
  • measures to counteract nausea
28
Q

what are some measures that can be used to stimulate appetite (3)

A
  • mouth care
  • antiemetics
  • attractively serves meals in pleasant surrounds
29
Q

what methods can be used to help counteract nausea (3)

A
  • carbonated beverages
  • ginger
  • avoid very hot or very cold foods
30
Q

what else is important in acute intervention of hepatitis

A
  • rest
31
Q

why is rest imp when treating acute hepatitis

A
  • pts have fatigue and decreased energy
  • rest to conserve energy
  • help regenerate liver
32
Q

what nursing interventions can help a pt with hep rest (3)

A
  • space activities to conserve energy & avoid overexcretion
  • assess pt’s response to rest and the activity plan & revise as needed
  • assess symptoms and LFTs as a guide to activity
33
Q

describe patient teaching to someone w hepatitis (11)

A
  • rest important
  • caution overexertion
  • how to prevent transmission among household members
  • symptoms of worsening liver function should be reported to HCP
  • regular followups for at least 1 year after diagnosis
  • if unable to resolve acute hep, and progress to chronic, referral to hepatologist
  • avoid excessive use of alcool
  • if remain seropositive, do not donate blood, semen, or organs
  • how to administer subcut injection
  • side effects of therapy (flu-like symptoms)
  • dietary teaching
34
Q

what are signs of worsening liver function (5)

A
  • bleeding tendencies (d/t increased INR)
  • abdominal swelling & pain (ascites)
  • confusion (encephalopathy)
  • jaundice
  • pruritis
35
Q

a possible nursing diagnosis r/t hepatitis is imbalanced nutrition. what nutrition therapy can be done for this

A
  • complete nutritional assessment to determine baseline nutritional state
  • monitor food/fluid ingested
  • calculate daily caloric intake
  • keep food diary
  • determine, in collab w dietician, number of cal and type of nutrients needed to meet nutrition requirements
  • present food in attractive, pleasing manner, consider color, texture, and variety –> stimulate pts appetitie
36
Q

a nursing diagnosis r/t hep is imbalanced nutrition. what nausea management can be done to help meet nutrition requirements

A
  • teach use of nonpharmacological techniques to manage nausea w/o use of drugs requiring hepatic metabolism
  • encourage eating small amts of foods that are appealing
  • monitor effects of nausea management to determine change in status
  • weight regularly
  • encourage frequent oral hygeine to promote comfort
37
Q

what nonpharmacological techniques can be used to manage nausea (7)

A
  • biofeedback
  • hypnosis
  • relaxation
  • guided imagery
  • music therapy
  • distraction
  • acupressure
38
Q

a nursing diagnosis r/t hep is activity intolerance d/t fatigue & generalized weakness. what energy management interventions can be done to increase activity intolerance (7)

A
  • use valid instruments to measure fatigue for baseline comparison
  • assist pt to schedule rest periods to prevent stress on liver fnxn
  • encourage pt to choose activities that gradually build endurance
  • limit enviro stimuli (light, noise) to facilitate relaxation
  • instruct pt and caregiver to recognize signs of fatigue that require reduction in activitiy
  • teach activity organization and time management
  • monitor pt for evidence of excess physical and emotional fatigue
39
Q

a nursing diagnosis r/t hep is risk for impaired liver function. what teaching can be done to help maintain liver function throughout the infectious process (7)

A
  • explain patho of disease
  • describe rationale behind management & treatment
  • describe possible chronic complications
  • discuss lifestyle changes (avoid alcohol, infection control measures, etc.) to prevent further comp & control disease
  • explore possible resources or support for long term disease mngmt
  • instruct pt on S&S of worsening liver function to report
  • instruct pt on measures to control/minimize symptoms

NURS 3512 - Class 1-6 (47 decks)

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