HEPATITIS Presentation

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HEPATITIS:

HEPATITIS By Brandi O’Neal, Cara Hammond and Elizabeth Critelli

What is Hepatitis?:

What is Hepatitis? A broad term that means an inflammation of the liver.

Etiology of Hepatitis:

Etiology of Hepatitis Viral infection ( Hep . A, B, C, D and E) Autoimmune disease Secondary to: Drugs Alcohol Medications Toxins

Pathophysiology:

Pathophysiology Liver damage is initiated by cytotoxic cytokines and natural killer cells that cause lysis of the infected liver cells called hepatocytes. This causes an inflammation response that can obstruct bile flow and cause fibrosis that can lead to cirrhosis and possible liver failure. (Lewis, Dirksen, Heitkemper & Bucher, 2014, pg. 1009)

Clinical Manifestations:

Clinical Manifestations Subjective Fatigue Right upper quadrant pain Flu-like symptoms Pruritus Weight loss/loss of appetite Constipation or diarrhea Objective Dark urine Pale stool Yellow skin and eyes (jaundice)

Diagnostic:

Diagnostic Physical assessment Blood test Antibody test & viral genotype test Ultrasound Liver biopsy

Collaborative Care:

Collaborative Care Rest according to level of fatigue. IV fluid and electrolyte replacement as indicated. Small frequent feedings of a high-calorie, low fat diet. Avoid alcohol intake and drugs detoxified by the liver.

Drug Therapy:

Drug Therapy Hepatitis B Peglyated interferon Entecavir Tenofovir Hepatitis A vaccine Hepatitis C Long-acting injectable interferons Peginterferon Alfa-2A in combination with oral anti-viral Ribavirin Boceprevir Telaprevir

Nursing Diagnosis:

Nursing Diagnosis Imbalanced Nutrition: Less Than Body Requirements R/T effects of liver dysfunction Deficient Fluid Volume R/T nausea and vomiting Activity Intolerance R/T anorexia and liver dysfunction Deficient Knowledge R/T transmission

Potential Complications:

Potential Complications Fibrosis Cirrhosis of the Liver Cancer of the Liver

Complications Cont.:

Complications Cont. Liver Failure Glomerulonephritis Cryoglobulinemia

Complications Cont.:

Complications Cont. Hepatic Encephalopathy

Complications Cont.:

Complications Cont. Portal Hypertension Porphyria Viral Co-Infection

References:

References About Health. (2016). 10 Complications of Hepatitis. Retrieved 1 April 2016, from about health: http://www.hepatitis.about.com/od/complications/tp/Ten- Complications.htm Ackley , B. J., Ladwig , G. B. (2014). Nursing Diagnosis Handbook : An Evidence-Based Guide to Planning Care (10 th ed.). Maryland Heights, MO: Elsevier. Lewis, S. L., Dirksen, S. R., Heitkemper , M. M. & Bucher, L. (2014). Medical-Surgical Nursing: assessment and management of clinical problems (9 th ed.). St. Louis, MO: Elsevier. Nettina , S. M., & Lippincott Williams & Wilkins. (2014). Lippincott Manual of Nursing Practice . Philadelphia, PA: Wolters Kluwer Health.

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