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.
- Imbalanced Nutrition: Less Than Body Requirements
- Risk for Deficient Fluid Volume
- Risk for Impaired Skin Integrity
- Deficient Knowledge
- Situational Low Self-Esteem
- Risk for Infection
- Other Possible Nursing Care Plans
Imbalanced Nutrition: Less Than Body Requirements
- 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
- 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.
|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:|
||Given 1/2 hr before meals, may reduce nausea and increase food tolerance. Prochlorperazine (Compazine) is contraindicated in hepatic disease.|
||Counteracts gastric acidity, reducing gastric irritation and risk of bleeding.|
||Corrects deficiencies and aids in the healing process.|
||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 nursing diagnosis and nursing care plan books and resources.
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.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans