Hepatitis : Types, Diagnosis, Nursing management, Complications

Hepatitis:

Hepatitis is an inflammation of the liver. Hepatitis is a viral infection of the liver associated with a blood spectrum of clinical manifestation from asymptomatic infection through icetrie hepatitis to hepatic necrosis.

Five types of hepatitis virus have been identified.

1.     Type A -  Hepatitis (HAV)

2.     Type B -  Hepatitis (HBV)

3.     Type C -  Hepatitis (HCV)

4.     Type D -  Hepatitis (HDV, Delta hepatitis)

5.     Type E -  Hepatitis (HEV).

Diagnosis:

Clinical evaluation

Elevated serum for all forms of hepatitis. (Liver function test)

Liver biopsy to detect chronic active disease, progression, and response to therapy.

Diagnosis:

1.     Serum liver function test [Elevated serum transferase level in all forms of Hepatitis.

2.     Hepatitis C -antibody may not be detected for 3-6 months after onset of HCV illness.

3.     Liver biopsy to detect chronic active disease, progression and response to therapy.

Management:

1.     Rest according to patient' s level of fatigue.

2.     Hospitalisation for projected nausea and vomiting or life threatening complication.

3.     Small frequent feeding of high -caloric, low-fat diet and protein are restricted.

4.     Vitamin K injected if prothrombin time is prolonged.

5.     Intravenous fluid and electrolyte  replacement as indicated.

6.     Administration of antiemetics for nausea.

7.     After jaundice has cleared, gradual increase in physical activity.

Nursing management:

Maintain adequate nutrition.

1.     Encourage frequent small feedings.

2.     High calorie and low fat diets.

3.     Avoid large protein during acute phase of illness.

4.     Administer or teach self-administration of antiemetics.

Maximum adequate fluid intake

1.     Provide frequent  oral fluids as tolerated.

2.     Administer fluids for problems with inability to maintain oral fluids.

3.     Monitor intake and output chart.

Maintain adequate rest.

Promote period of test during symptomatic phase.

Promote comfort by administring analegics as prescribed.

Provide emotional support and diversional activities.

Encourage mild exercises during convalescent period.

Ensuring prevention of disease transmission.

1.     Educate the patient about diseases and mode of transmission.

2.     Encourage good hand washing and hygienic measures while toileting.

3.     Avoidance of sexual activity

4.     Avoidance of sharing needles, eating utensils, and tooth brush. Prevent blood or body fluids contact.

5.     Report all cases of hepatitis to public health officials.

6.     Avoid trauma that may cause bruising and limit invasive procedures.

7.     Encourage vaccination for HBV with series of three doses. (At birth, 1 to 6 months) for high risk individuals, such as health care workers or institutionalized persons.

Complications:

1.     Dehydration,

2.     hypokalemia

3.     Hepatitis.

4.     Hepato cellular carcinmua.