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47 Cards in this Set
- Front
- Back
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What is Hep A also known as?
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Infectious Hepatitis
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What is the route of transmission of Hep A?
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Fecal-oral route, rare by blood, not transmitted by kissing or sharing utensils
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What kind of people get Hep A?
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Older children, young adults, particularly custodial or day-care situations
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What are the signs and symptoms of Hep A?
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Jaundice, Faigue, and Anorexia, nausea, fever
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What is the incubation period of Hep A? Is the onset of acute symptoms abrupt or insidious? How long do acute symptoms generally last?
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Incubation period: ~28 days
Abrupt onset, recovery within 4-6wks |
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Can Hep A be a chronic condition? Can a person be a carrier of Hep A?
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No and no
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Hepatitis B is spread how?
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Blood and Body Fluid transmission.
Needles & sexual contact |
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How long is the incubation period of Hep B?
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70-80 days
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What does chronic hep B put the client at risk for?
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CIrrhosis, liver failure, and Liver cancer
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Hep C is transmitted how?
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IV Drug users; blood transfusions; sexual contact; needle stick injuries
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Describe the onset & symptoms of Hep C
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Incidious, Often nonicteric (not jaundiced)
Infections can continue for 30 years without any symptoms |
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The chronic carrier is at greater risk (Hep C) for what? How often does chronic Hep C develop? Can chronic Hep C be cured?
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Most likely to cause long-term liver damage (liver disease, liver cancer, cirrhosis)
80% of cases develop chronic infection Can be cured - drug therapy aimed at completely eradicating the virus |
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Hep D only occurs if a client already has this form of Hepatitis?
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Hep B - Hep D cannot survive on it's own. Requires the helper function of HBV to replicate
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Differentiate which type of Hepatitis are RNA viruses and which are DNA viruses?
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RNA: Hep A, Hep C
DNA: Hep B |
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What does the presence of Anti-HAV IgM in serum indicate?
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Acute Hep A
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What does the presence of Anti-HAV IgG in serum indicate?
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Past infection of Hep A or vaccine
Lifelong immunity |
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What forms of Hepatitis have a vaccine available?
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Hep A & B, not C
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List 2 drugs commonly used to treat Hepatitis. When are they indicated?
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interferon - chronic B & C
hep B immune globulin - prevent infection in pts known to be exposed ribavirin - chronic C |
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What is the action of interferon?
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Interferons are proteins capable of modifying immune response. Antiviral properties with decreased progression of hepatic damage.
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What should the nurse watch for in patients on interferon?
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Assess for signs of: neuropsychiatric disorders (irritability, anxiety, depression, suicidal ideation, aggressive behavior); infection (vital signs, WBC); cardiovascular disorders (pulse, BP, chest pain); colitis (abdominal pain, bloody diarrhea, fever) and pancreatitis (nausea, vomiting, abdominal pain)
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What is the action of Hep B immune globulin?
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An immune gamma-globulin fraction containing high titers of antibodies to the hepatitis B surface antigen. Confers passive immunity to hepatitis B infection.
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What should a nurse be aware of when caring for a pt given Hep B immune globulin?
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For passive immunity, determine the date of exposure to infection. Hepatitis B immune globulin should be administered preferably within 24 hr but not later than 7 days after exposure to hepatitis B. Assess patient for signs of anaphylaxis (hypotension, flushing, chest tightness, wheezing, fever, dizziness, nausea, vomiting, diaphoresis) after administration. Epinephrine and antihistamines should be available for treatment of anaphylactic reactions.
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What is the action of ribavirin (Rebetol)?
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Inhibits viral DNA and RNA synthesis and subsequent replication
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What should the nurse consider when caring for a pt on ribavirin (Rebetol)?
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Assess patient for signs of depression, cardiovascular disorders (pulse, BP, chest pain - may cause myocardial infarction), colitis (abdominal pain, bloody diarrhea, fever) and pancreatitis (nausea, vomiting, abdominal pain). Assess pulmonary status (lung sounds, respirations) periodically.
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What does it mean to have chronic Hep B and how often does it occur?
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2-10% of cases develop chronic infection. Those with chronic infectious remain carriers. Symptoms range from sx free to severe liver disease.
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Which people are most at risk for developing Hep B?
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Young adults, particularly immigrants and refugees from endemic areas, drug abusers, and hemodialysis pts and personnel
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What does the presence of HBsAG in the blood twice between 6-12 months indicate?
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chronic infection & carrier
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What does the presence of anti-HBs IgG signify?
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immunity via vaccination
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What does the presence of anti-HBc IgM indicate?
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active acute infection
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What does the presence of anti-HBc IgG indicate?
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immunity, had the disease
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Hep D is also called...
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delta virus
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Describe the pathophysiology of hepatitis during an acute infection
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Widespread inflammation of the liver: Liver cell damage -> hepatic cell necrosis -> proliferation & enlargement of Kupffer cells to clean up dead cells
Inflammation of periportal ares may interrupt bile flow -> cholestasis |
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What are 6 systemic effects of hepatitis?
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Rash, angioedema, arthritis, fever, malaise, flu-like symtpoms
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Sometimes hepatitis can be asymptomatic. In which types of hepatitis does this occur and what is the incidence?
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Hep B - 30%
Hep C - 80% |
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What are the 3 clinical phases of hepatitis?
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Preicteric phases - preceeds jaundice
Icteric phase Posticteric phase - jaundice is disappearing |
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What are the clinical manifestations of the pericteric phase and how long does it usually last?
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Anorexia, N/V, abdominal discomfort (RUQ)
Lasts 1-21 days a.k.a. Abdominal phase, prodromal phase |
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What are the clinical manifestations of the icteric phase and how long does it usually last?
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Jaundice, pruritis (bile salts coming to skill -> inflammatory response, neutrophils, basophils, hisatmine)
Lasts 2-4 weeks |
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What are the clinical manifestations of the posticteric phase and how long does it usually last?
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Malaise, easy fatigability (liver still not able to store & release sugar)
Lasts weeks to months |
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What should be considered when assessing jaundice in pts with viral hepatitis?
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Not all pts have jaundice - anicertic hepatitis
You can't judge how infectious someone is based on jaundice |
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Most pts with acute viral hepatitis recover completely with no complications. 10% will go on to have complications. Name 4 possible complications of hepatitis
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Fulminant hepatic failure - liver suddenly severely impaired
Chronic hepatitis Cirrhosis Liver cancer |
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What types of support drug therapy are appropriate in caring for pts with hepatitis?
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Antiemetics (Gravol): N&V
diphenhydramine (Benedryl): puritis chloral hydrate: promote rest |
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Describe the specific drugs used to treat certain types of hepatitis.
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Chronic Hep B: interferon
Chronic Hep C: interferon & ribavirin |
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What information about past health history would be important during an assessment of a client with hepatitis?
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Hemophilia
Exposure to infected persons Ingestion of contaminated food or water |
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What medications are significant to take note of when assessing a client with hepatitis?
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Acetaminophen (liver must detoxify)
phenytoin halothane (anesthetic) methyldopa (anti-hypertensive) herbal meds |
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What additional questions should be addressed when assessing a client with hepatitis?
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IV drug & alcohol abuse
Weight loss, dark urine, fatigue RUQ pain |
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What interventions, in priority, should be taken in a client with hepatitis
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Rest
Jaundice - assess degree, suggest small, frequent meals |
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What should the nurse teach their client about hepatitis
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Diet - high carbs
Assessment for complications Regular follow-up for at least 1yr after diagnosis (for chronicity) Avoid alcohol Medication administration (interferon IM or SQ) |
