Week 6 - Hepatits Flashcards
1
Q
what is hepatitis
A
- inflammation of the liver
2
Q
what are some causes of hepatitis (7)
A
- viruses
- chemicals
- drugs
- alcohol
- autoimmune diseases
- metabolic disorders
- genetic abnormalities
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
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
5
Q
what are some GI symptoms present in hepatitis (6)
A
- anorexia
- NV
- CD
- altered taste & smell
6
Q
what nonspecific symptoms are present in the acute phase of hepatitis (6)
A
- malaise
- fatigue
- headache
- low-grade fever
- arthralgia
- skin rashes
7
Q
what symptoms are present in chronic hepatitis (2)
A
- no symptoms
- or non specific symptoms
8
Q
what are some nonspecific symptoms present in chronic hepatitis (5)
A
- malaise
- easy fatigability
- mylagia
- arthralgia
- hepatomegaly
9
Q
what are 2 possible complications of hepatitis
A
- fulminant hepatitis
- cirrhosis
10
Q
what is fulminant hepatitis
A
- acute clinical syndrome that results in severe impairment or necrosis of liver cells and potential liver failure
11
Q
what can be used to diagnose hepatitis (3)
A
- viral serological tests
- serum liver enzymes
- liver function tests
12
Q
what are viral serological tests
A
- uses serological markers (viral antigens and antibodies) to diagnose viral hepatitis
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
14
Q
what serum liver enzymes are assessed to diagnose hepatitis (4)
A
- AST
- ALT
- ALP
- GGT
15
Q
what is assessed during liver function tests (4)
A
- serum albumin
- serum bilirubin
- prothrombin time
- INR
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
what are acute interventions for hepatitis (4)
- relieve pruritis
- headache
- arthralgias
- ensure adequate nutrition
26
why is nutrition a concern w hepatitis (5)
- d/t altered taste & smell
- and anorexia
- NV
- impaired glucose and fat metab
- helps regenerate liver
27
describe nutritional therapy for hepatitis (4)
- small frequent meals preferable to 3 large ones
- utilize measures to stimulate appetitie
- adequate hydration
- measures to counteract nausea
28
what are some measures that can be used to stimulate appetite (3)
- mouth care
- antiemetics
- attractively serves meals in pleasant surrounds
29
what methods can be used to help counteract nausea (3)
- carbonated beverages
- ginger
- avoid very hot or very cold foods
30
what else is important in acute intervention of hepatitis
- rest
31
why is rest imp when treating acute hepatitis
- pts have fatigue and decreased energy
- rest to conserve energy
- help regenerate liver
32
what nursing interventions can help a pt with hep rest (3)
- 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
describe patient teaching to someone w hepatitis (11)
- 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
what are signs of worsening liver function (5)
- bleeding tendencies (d/t increased INR)
- abdominal swelling & pain (ascites)
- confusion (encephalopathy)
- jaundice
- pruritis
35
a possible nursing diagnosis r/t hepatitis is imbalanced nutrition. what nutrition therapy can be done for this
- 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
a nursing diagnosis r/t hep is imbalanced nutrition. what nausea management can be done to help meet nutrition requirements
- 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
what nonpharmacological techniques can be used to manage nausea (7)
- biofeedback
- hypnosis
- relaxation
- guided imagery
- music therapy
- distraction
- acupressure
38
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)
- 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
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)
- 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
