Viral Hepatitis

Overview of Viral Hepatitis

  • Definition: Viral hepatitis is defined as a viral infection of the liver, specifically causing necrosis and inflammation of hepatic cells. This can progress to cirrhosis of the liver. Over time, the manifestations can become similar to cirrhosis itself.

Types of Hepatitis

  • Five Types Categorized by Transmission:
    • Hepatitis A and E: Transmitted via fecal-oral route.
    • Hepatitis B: Transmitted through body fluids.
    • Hepatitis C: Commonly associated with liver cancer and the need for liver transplant.
    • Hepatitis D: Usually occurs in conjunction with Hepatitis B; related to IV drug use.
  • Focus of the Lesson: This lesson primarily addresses Hepatitis B, but knowledge of all five types focusing on their transmission is required.

Clinical Manifestations of Viral Hepatitis

  • Incubation Period: Lasts from 1 to 6 months during which the virus can be transmitted.
  • Common Symptoms:
    • Arthralgia (joint pain) and rashes
    • Anorexia (loss of appetite)
    • Malaise (general feeling of discomfort)
    • Weakness
    • Jaundice (yellowing of the skin and eyes) and dark urine
    • Vague epigastric distress, including nausea, heartburn, and flatulence
    • Enlarged liver (hepatomegaly) and abdominal tenderness

Diagnostics for Hepatitis

  • Key Diagnostic Tests:
    • Increased Liver Enzymes:
    • Alanine Aminotransferase (ALT): Normal range is 4-36 IU/L
    • Aspartate Aminotransferase (AST): Normal range is 0-35 U/L
    • Positive Antibodies: Presence of antibodies for hepatitis in blood tests.
    • Liver Biopsy:
    • Most important diagnostic tool.
    • Involves using a needle to extract liver tissue, necessitating close monitoring due to potential null coagulation properties of the client.

Treatment for Hepatitis

  • Main Treatment Methods:
    • Alpha-Interferon Injections: Administered three times weekly for 16-24 weeks.
    • Antiviral Agents:
    • Entecavir
    • Tenofovir
    • Resting and Dietary Changes: Patients should be on bed rest until manifestations resolve and dietary adjustments are made.
    • Liver Transplantation: May be necessary in severe cases.

Nursing Diagnoses and Interventions

  • Common Nursing Diagnoses:
    • Activity intolerance
    • Fatigue
    • Imbalanced nutrition
    • Acute pain
    • Social isolation
    • Knowledge deficit
  • Nursing Interventions:
    • Encourage physical activity, while advising against sexual activity during infection period.
    • Recognize hepatitis infections may become chronic, potentially lasting a lifetime and need for lifelong management.
    • Address psychosocial issues and concerns associated with the diagnosis.
    • Provide client education focusing on self-care and prevention of complications related to hepatitis infection, including lifestyle changes and regular monitoring.