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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:
- Imbalanced Nutrition: Less Than Body Requirements
- Risk for Deficient Fluid Volume
- Fatigue
- Risk for Impaired Skin Integrity
- Deficient Knowledge
- Situational Low Self-Esteem
- Risk for Infection
- Other Possible Nursing Care Plans
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Imbalanced Nutrition: Less Than Body Requirements
Nursing Diagnosis
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- 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
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- 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 Interventions | Rationale |
|---|---|
| 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. |
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Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
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
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