7 Hepatitis Nursing Care Plans


Hepatitis is a widespread inflammation of the liver that results in degeneration and necrosis of liver cells. Inflammation of the liver can be due to bacterial invasion, injury by physical or toxic chemical agents (e.g., drugs, alcohol, industrial chemicals), viral infections (hepatitis A, B, C, D, E, G), or autoimmune response. Although most hepatitis is self-limiting, approximately 20% of acute hepatitis B and 50% of hepatitis C cases progress to a chronic state or cirrhosis and can be fatal.

Nursing Care Plans

Nursing care planning and management for patients with hepatitis includes: reducing the demands of the liver while promoting physical well-being, preventing complications of hepatitis, enhance self-concept, acceptance of situation, and providing information about the disease process, prognosis, and treatment.

This post includes seven (7) nursing care plans and nursing diagnosis for patients with hepatitis:

  1. Imbalanced Nutrition: Less Than Body Requirements
  2. Risk for Deficient Fluid Volume
  3. Fatigue
  4. Risk for Impaired Skin Integrity
  5. Deficient Knowledge
  6. Situational Low Self-Esteem
  7. Risk for Infection
  8. Other Possible Nursing Care Plans

Imbalanced Nutrition: Less Than Body Requirements

Nursing Diagnosis

  • Imbalanced Nutrition: Less Than Body Requirements

May be related to

  • Insufficient intake to meet metabolic demands: anorexia, nausea/vomiting
  • Altered absorption and metabolism of ingested foods: reduced peristalsis (visceral reflexes), bile stasis
  • Increased calorie needs/hypermetabolic state

Possibly evidenced by

  • Aversion to eating/lack of interest in food; altered taste sensation
  • Abdominal pain/cramping
  • Loss of weight; poor muscle tone

Desired Outcomes

  • Initiate behaviors, lifestyle changes to regain/maintain appropriate weight.
  • Demonstrate progressive weight gain toward goal with normalization of laboratory values and no signs of malnutrition.
Nursing InterventionsRationale
Monitor dietary intake and caloric count. Suggest several small feedings and offer “largest” meal at breakfast.Large meals are difficult to manage when patient is anorexic. Anorexia may also worsen during the day, making intake of food difficult later in the day.
Encourage mouth care before meals.Enhances appetite by eliminating unpleasant taste.
Recommend eating in upright position.Reduces sensation of abdominal fullness and may enhance intake.
Encourage intake of fruit juices, carbonated beverages, and hard candy throughout the day.These supply extra calories and may be more easily digested or tolerated than other foods.
Consult with dietitian, nutritional support team to provide diet according to patient’s needs, with fat and protein intake as tolerated.Useful in formulating dietary program to meet individual needs. Fat metabolism varies according to bile production and excretion and may necessitate restriction of fat intake if diarrhea develops. If tolerated, a normal or increased protein intake helps with liver regeneration. Protein restriction may be indicated in severe disease (fulminant hepatitis) because the accumulation of the end products of protein metabolism can potentiate hepatic encephalopathy.
Monitor serum glucose as indicated.Hyperglycemia or hypoglycemia may develop, necessitating dietary changes and insulin administration. Fingerstick monitoring may be done by patient on a regular schedule to determine therapy needs.
Administer medications as indicated:
  • Antiemetics: metoclopramide (Reglan), trimethobenzamide (Tigan)
Given 1/2 hr before meals, may reduce nausea and increase food tolerance. Prochlorperazine (Compazine) is contraindicated in hepatic disease.
  • Antacids: Mylanta, Titralac
Counteracts gastric acidity, reducing gastric irritation and risk of bleeding.
  • Vitamins: B complex, C, other dietary supplements as indicated
Corrects deficiencies and aids in the healing process.
  • Steroid therapy: prednisone (Deltasone), alone or in combination with azathioprine (Imuran)
Steroids may be contraindicated because they can increase risk of relapse and development of chronic hepatitis in patients with viral hepatitis; however, anti-inflammatory effect may be useful in chronic active hepatitis (especially idiopathic) to reduce nausea and vomiting and enable patient to retain food and fluids. Steroids may decrease serum aminotransferase and bilirubin levels, but they do not affect liver necrosis or regeneration. Combination therapy has fewer steroid-related side effects.
Provide supplemental feedings and TPN if needed.May be necessary to meet caloric requirements if marked deficits are present and symptoms are prolonged.


Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:


Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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