The inflammation of the liver is called hepatitis and may be the result of lifestyle factors, chronic or autoimmune disorders, or viral agents. Some forms of hepatitis are curable while other forms last a lifetime. Management and treatment of the disease depend on the causative factor. The widespread inflammation results in degeneration and necrosis of the liver. 70% of hepatitis cases (B and C) progress to a chronic state, cirrhosis or become fatal.
About half of all hepatitis cases are attributed to hepatitis viruses A, B, and C. Chronic alcohol use, drugs and excessive use of some medications (acetaminophen, statins) as well as infection such as Epstein-Barr (mononucleosis), can impair the liver’s ability to filter toxins, produce and store metabolic chemicals and store vitamins and minerals.
Minimize progressive degeneration and necrosis of the liver, improve healthy lifestyle habits, maintain optimal nutrition and functionality of liver
Hepatitis Nursing Care Plan
- Loss of appetite
- Muscle/joint aches
- RUQ abdominal pain
- Itchy skin
- Dark-colored urine
- Pale colored stools
Nursing Interventions and Rationales
- Initiate bleeding precautions per facility protocol
- No straight razors
- Use a soft toothbrush and good oral hygiene
- Use stool softeners to avoid straining with bowel movements
Coagulation chemicals such as prothrombin and fibrinogen. Damage to the liver may alter the production of these chemicals and increase the risk of bleeding.
- Monitor fluid and electrolyte balance
- Monitor I & O
- Daily weights
- Assess skin turgor
Liver impairment may also affect renal function. Ascites and dependent edema may be indicators of hyponatremia. Diarrhea and vomiting may cause fluid imbalances.
- Provide routine oral care before meals with a soft toothbrush
Bleeding gums and lack of oral hygiene can lead to infection and poor appetite. Provide oral care before meals to enhance flavor and encourage adequate nutrition.
- Encourage and assist with positioning
Recommend patients eat sitting upright to reduce abdominal fullness and encourage dietary intake.
- Administer medications appropriately and monitor for effectiveness and adverse reactions. Monitor lab values before administration.
Medications may be given to manage electrolytes, and symptoms of nausea or to assist with alcohol or drug detox. Avoid giving acetaminophen. Antiviral medications may be given to treat certain types of hepatitis.
- Provide and monitor supplemental feedings and TPN as necessary
In chronic disease, it may be necessary to provide adequate nutrition and caloric intake
- Nutrition and Lifestyle education, prevention and protection
- Avoid alcohol and illicit drugs
- Avoid exposure to dirty needles
- Avoid contact with bodily fluids such as semen, blood, stool, and vomit
- Encourage vaccines for high-risk patients and their families
High-risk behavior and lifestyle modifications may be necessary. Encourage patients to avoid alcohol and drug use and unprotected sex as viral hepatitis is easily transmitted. Provide nutrition education to promote low fat, low sugar diet. Wheat, gluten, dairy, and artificial sweeteners are difficult for the liver to digest.
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell