Hepatitis Nursing Care Plans
Imbalanced Nutrition: Less than Body Requirements
Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to compromised absorption and metabolism secondary to hepatitis as evidenced by lack of diet interest, abdominal pain with associated weight loss.
Desired Outcome: The patient will be able to initiate lifestyle changes to regain lost weight and maintenance of laboratory values within normal values.
What Can You Do If You Develop Nausea And Vomiting
- See your doctor urgently if you develop ‘red flag’ symptoms.
- See your doctor if your vomiting lasts for more than 48 hours and is not improving.
- Avoid a lack of fluid in your body : drink little and often to replace any fluid you have lost. Consider using rehydration drinks, such as Dioralyte®.
- If you have motion sickness and you do not have access to medicines:
- Try breaking the journey to have some fresh air, drink some cold water and, if possible, take a short walk.
- Try to change your seating (for example, move to the front of a car, or to the middle of the deck of a boat.
- Breathe fresh air and avoid strong smells .
- Close your eyes . This reduces ‘positional’ signals from your eyes to your brain and reduces the confusion.
- Don’t try to read.
- Metabolic conditions – for example:
- Diabetes, particularly if poorly controlled. Diabetic ketoacidosis occurs most commonly on patients who are on insulin, and is usually caused by being unwell and not using enough insulin. It can cause persisting, increasing vomiting.
- Addison’s disease. This rare condition develops over several months and also causes severe fatigue, weight loss, low blood pressure and other symptoms.
- Hypercalcaemia. A high calcium level is most commonly due to parathyroid gland overactivity, but it can also be caused by certain cancers.
Is Hepatitis A Contagious
The hepatitis A virus is found predominantly in the stools of people with hepatitis A. HAV is transmitted when a person puts something in his or her mouth that has been contaminated with the feces of an affected person. This is referred to as fecal-oral transmission. However, variations of this primary way in which a contagious person transmits the disease are as follows:
- Food or drinking water contaminated with stool from an infected person can cause the virus to quickly spread to anyone who drinks or swallows the contaminated food or water.
- Eating raw or undercooked shellfish collected from water that has been contaminated by sewage
- Blood transfusions, although this is extremely rare
- Sexual contact, especially oral/anal
Hepatitis A Transmission
People who are infected can start spreading the infection about 1 week after their own exposure. People who do not have symptoms can still spread the virus. Infection with HAV occurs throughout the world.
- The risk of infection is greatest in developing countries with poor sanitation or poor personal hygiene standards.
- Infection rates are also higher in areas where direct fecal-oral transmission is likely to occur, such as daycare centers, prisons, and mental institutions.
People at increased risk for hepatitis A infection include:
Individuals who work in professions such as health care, food preparation, and sewage and wastewater management are not at greater risk of infection than the general public.
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Central Nervous System And Psychiatric Conditions
Any condition that increases intracranial pressure can result in vomiting with or without nausea. Patients with central nervous system pathology usually present with additional neurologic signs such as cranial nerve dysfunction or long-tract signs. Conditions that affect the labyrinthus may cause nausea and vomiting and are often associated with vertigo. Migraine headaches classically cause nausea and vomiting.
Patients may also experience symptoms in response to emotional or physical stressors. Psychiatric diagnoses such as anorexia nervosa, bulimia nervosa, depression, and anxiety should be considered.
Who Should Be Vaccinated
Children
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
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Diagnosis And Clinical Features
HG presents in the first trimester of pregnancy, usually starting at 4 to 5 weeks gestation. In addition to severe nausea and vomiting, 60% of women with HG also have excess salivation or ptyalism . Patients may also complain of gastroesophageal reflux symptoms such as retrosternal discomfort and heartburn. A pregnancy-unique quantification of emesis and nausea score that is calculated using the number of hours of nausea per day, number of episodes of emesis per day and number of episodes of retching per day can be used to track the severity of symptoms .
Patients may present with signs of dehydration such as dry mucus membranes, tachycardia, poor skin turgor, and postural hypotension. Severely affected patients may also have muscle wasting and weakness and/or mental status changes.
Laboratory abnormalities in women with HG may include increased serum blood urea nitrogen, creatinine, and hematocrit, as well as ketonuria and increased urine specific gravity. In addition, electrolyte disturbances supporting a diagnosis of either hypochloremic metabolic alkalosis or metabolic acidosis with severe volume contraction may be found . Pre-albumin levels may be low, reflecting poor protein nutrition status in the mother and possibly predicting lower fetal birth weights . Vitamin and mineral deficiencies such as vitamin B1 , iron, calcium, and folate are also possible .
Hepatitis C Meds And Your Stomach
Treating Hepatitis C to relieve your stomach pain, nausea, and bathroom problems can be a bit of a double-edged sword. Many of medications that treat hepatitis C may also contribute to intestinal woes. For example, certain antivirals such as interferon can cause nausea, , and . Other drugs, too, including ribavirin, Incivek , or Victrelis , list intestinal symptoms as possible side effects on their labels. These symptoms should resolve once your course of treatment is completed. Ask your doctor if your hepatitis C medication could be responsible for your intestinal symptoms. He or she can help you troubleshoot by suggesting coping strategies. These may include:
Read Also: How Does One Get Hepatitis B
Vaccines And Immune Globulin
Vaccines to prevent hepatitis A and hepatitis B are available in the United States. A vaccine for hepatitis E is currently available only in China. No vaccines against hepatitis C or D virus are available. However, vaccination against hepatitis B virus also reduces the risk of infection with hepatitis D virus. Hepatitis vaccines are given by injection into muscle.
Routine vaccination with the hepatitis A vaccine Hepatitis A Vaccine read more and hepatitis B vaccine Hepatitis B Vaccine read more is recommended in the United States for all children and for adults at high risk of getting hepatitis Hepatitis is common throughout the world. Hepatitis can be Acute read more ).
As with most vaccines, protection requires allowing a number of weeks for the vaccine to reach its full effect as the immune system gradually creates antibodies against the particular virus.
If people who have not been vaccinated are exposed to hepatitis A virus, they are given a single dose of hepatitis A vaccine or an injection of standard immune globulin, depending on their age and health. Standard immune globulin contains antibodies obtained from blood collected from a large group of people who have a normal immune system. Immune globulin prevents infection or decreases its severity. However, the amount of protection it provides varies, and the protection is only temporary.
Babies born to mothers with hepatitis B are given hepatitis B immune globulin and hepatitis B vaccine.
Hepatitis Nursing Care Plans Diagnosis And Interventions
Hepatitis NCLEX Review and Nursing Care Plans
Hepatitis is the clinical term for inflammation of the liver. It is characterized by the swelling of the liver tissues, consequently damaging it and hindering normal biologic functions.
Hepatitis can arise from an acute or chronic injury arising from various factors such as infection, medication abuse, etc.
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Treatment For Nausea And Vomiting
The treatment of nausea and vomiting may depend on the cause. However, the following general measures are appropriate for any patient with significant nausea and vomiting.
What Are The Signs And Symptoms Of Hepatitis A
- Many people with HAV infection have no symptoms at all.
- Sometimes symptoms are so mild that they go unnoticed.
- Older people are more likely to have symptoms than children.
- People who do not have symptoms can still spread the virus so it is difficult to know when a person has been exposed to the virus.
Symptoms of hepatitis A usually develop between 2-6 weeks after infection. The symptoms are usually not too severe and go away on their own, over time. The most common hepatitis A symptoms are as follows:
- Nausea
- Jaundice
- Urine is dark brownish in color, like cola or strong tea.
- Pain in the area of the liver, on the right side of the abdomen just under the rib cage
If the vomiting is severe, dehydration may occur. Dehydration may become serious and life-threatening in some affected individuals, so symptoms of dehydration need to be quickly addressed, often by a medical caregiver. Symptoms of dehydration include the following:
- Feeling weak or tired
- Feeling confused or unable to concentrate
- Rapid heartbeat
- Urinating less frequently than usual
- Irritability
Symptoms of hepatitis A infection usually last less than 2 months, although they may last as long as 9 months. Some people infected with hepatitis A have symptoms that come and go for 6-9 months.
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What Is Viral Hepatitis
Viral hepatitis is an infection of the liver caused by a virus that attacks liver cells. The resulting inflammation may impair the liver’s ability to aid in digestion of food and to remove toxins from the blood. Symptoms range from mild to severe, but some individuals have no symptoms. Infrequently, acute infections can be fatal.
There are several types of viral hepatitis, called A, B, C, D, E, F and G. Of all types of hepatitis, A, B and C are the most common in the US and so will be described below.
How Serious Is It
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 1020 years
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Chronic Or Acute Nausea
Acute nausea might be caused by a condition that comes on suddenly, which is called acute. Acute nausea may be caused by a virus that affects the stomach and causes nausea and vomiting .
Food poisoning is another cause of nausea that will occur suddenly and usually resolves on its own when the bacteria clears the body.
Other common causes of acute nausea that usually resolve on their own include:
- Car sickness
- Stress
- Trauma
Chronic nausea is when the nausea may be present all the time or it may come and go. In some cases the nausea may come on after a triggering factor, such as eating, only to improve and then come on again after the next meal.
When the nausea is chronic, and theres no clear cause such as pregnancy, its time to talk to a doctor about why it might be happening. There won’t be one particular test that can help determine the cause of nausea so testing will depend on what might be the suspected caused.
Viral Hepatitis And Hepatitis A Outbreak
Southeast Michigan is experiencing an outbreak of hepatitis A. Information about this outbreak is at the Michigan Department of Health and Human Services website. Vaccination is recommended to prevent hepatitis A.
if you are concerned about symptoms or risk for viral hepatitis, and you are a U-M student or other UHS patient, you may call for Nurse Advice by Phone.
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Hepatitis Nursing Care Plan 3
Nursing Diagnosis: Fatigue related to episodes of discomfort secondary to hepatitis as evidenced by observed reports of lack in energy levels and intolerance in doing activities of daily living.
Desired Outcome: The patient will be able to report improved energy levels and renewed desire to increase activities of daily living.
Causes Of Acute Viral Hepatitis
Other viruses can also cause acute viral hepatitis. These viruses include the Epstein-Barr virus , which is the virus that causes infectious mononucleosis Infectious Mononucleosis Epstein-Barr virus causes a number of diseases, including infectious mononucleosis. The virus is spread through kissing. Symptoms vary, but the most common are extreme fatigue, fever, sore throat… read more .
Engaging in certain activities, such as getting a tattoo or body piercing, sharing needles to inject drugs, or having several sex partners, increases the risk of developing hepatitis.
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Acute Hepatitis B Symptoms
There are three phases of acute hepatitis B infection, and symptoms may differ depending on the stage. Early in the disease, called the prodromal phase, symptoms may include:
- Fever
- Dark urine and light stool color
During the icteric phase:
- Jaundice develops
- Anorexia, nausea and vomiting may worsen
- Irritated skin lesions may develop
- Other symptoms may subside
What Is Hepatitis A
Hepatitis A accounts for 20 percent to 25 percent of hepatitis cases in developed countries. Hepatitis A is usually transmitted through the fecal-oral route, meaning a person somehow ingests contaminated feces from an infected person. If an infected person did not wash his or her hands properly after using the bathroom, the disease may spread from the persons hands. The incubation period is two to six weeks, during which the infected individual is contagious.
Another cause of hepatitis A is eating shellfish harvested from contaminated water. Developing countries experience hepatitis A epidemics caused by drinking water contaminated with raw sewage.
The prognosis for hepatitis A patients is excellent with self-limiting course, and recovery is complete. About 85 percent of people with hepatitis A recover within three months, and almost all recover within six months. The disease does not become chronic, and there are no long-term health implications.
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Evaluation Of Nausea And Vomiting
KEITH SCORZA, MD, AARON WILLIAMS, DO, J. DANIEL PHILLIPS, MD, and JOEL SHAW, MD
Dewitt Army Community Hospital Family Medicine Residency, Fort Belvoir, Virginia
Am Fam Physician. 2007 Jul 1 76:76-84.
Nausea is the unpleasant, painless sensation that one may potentially vomit. Vomiting is an organized, autonomic response that ultimately results in the forceful expulsion of gastric contents through the mouth. Vomiting is intended to protect a person from harmful ingested substances. However, chronic nausea and vomiting are typically a pathologic response to any of a variety of conditions.1
Nausea and vomiting significantly affect quality of life. In a study of 17 gastrointestinal conditions in the United States, it was estimated that the cost of acute gastrointestinal infections exceeds $3.4 billion annually.2,3 When other causes of nausea and vomiting are taken into account, the associated medical costs and loss of worker productivity are considerable.
This article reviews common and significant causes of nausea and vomiting, offers an approach to evaluation, and provides a brief overview of treatment options.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Most causes of acute nausea and vomiting can be determined from the history and physical examination.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Most causes of acute nausea and vomiting can be determined from the history and physical examination.
Symptoms Of Nausea And Vomiting
Nausea is often referred to as a queasy sensation” or a feeling of being sick to the stomach. Nausea may occur with or without vomiting and vomiting can occur without nausea. These symptoms may be accompanied by a sensation of flushing, sweating, salivation, lightheadedness and upper abdominal discomfort. Important associated symptoms include: anorexia, a decreased interest in eating sitophobia, a fear of eating due to unpleasant symptoms and early satiety, feeling full early after eating only a small amount of food. Associated symptoms and circumstances prior to the onset of nausea and vomiting can help your doctor determine the cause. The cause of acute nausea and vomiting can very often be diagnosed by doctors just by listening to the patients history and performing a physical examination. However, chronic nausea and vomiting, which by definition is when symptoms have lasted longer than 1 month, is more challenging to diagnose and treat.
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