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

Risk for Deficient Fluid Volume

Nursing Diagnosis

Risk factors may include

  • Excessive losses through vomiting and diarrhea, third-space shift
  • Altered clotting process

Possibly evidenced by

  • Not applicable. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.

Desired Outcomes

  • Maintain adequate hydration, as evidenced by stable vital signs, good skin turgor, capillary refill, strong peripheral pulses, and individually appropriate urinary output.
  • Be free of signs of hemorrhage with clotting times WNL.
Nursing Interventions Rationale
Monitor I&O, compare with periodic weight. Note enteric losses: vomiting and diarrhea. Provides information about replacement needs and effects of therapy. Diarrhea may be due to transient flu-like response to viral infection or may represent a more serious problem of obstructed portal blood flow with vascular congestion in the GI tract, or it may be the intended result of medication use (neomycin, lactulose) to decrease serum ammonia levels in the presence of hepatic encephalopathy.
Assess vital signs, peripheral pulses, capillary refill, skin turgor, and mucous membranes. Indicators of circulating volume and perfusion.
Check for ascites or edema formation. Measure abdominal girth as indicated. Useful in monitoring progression and resolution of fluid shifts.
Use small-gauge needles for injections, applying pressure for longer than usual after venipuncture. Reduces possibility of bleeding into tissues.
Have patient use cotton or sponge swabs and mouthwash instead of toothbrush or use soft bristled toothbrush. Avoids trauma and bleeding of the gums.
Observe for signs of bleeding: hematuria, melena, ecchymosis, oozing from gums, puncture sites Prothrombin levels are reduced and coagulation times prolonged when vitamin K absorption is altered in GI tract and synthesis of prothrombin is decreased in affected liver.
Monitor periodic laboratory values: Hb/Hct, Na, albumin, and clotting times. Reflects hydration and identifies sodium retention/protein deficits, which may lead to edema formation. Deficits in clotting potentiate risk of bleeding and hemorrhage.
Administer antidiarrheal agents: diphenoxylate with atropine (Lomotil). Reduces fluid and electrolyte loss from GI tract.
Provide IV fluids (usually glucose), electrolytes. Protein hydrolysates. Provides fluid and electrolyte replacement in acute toxic state.
Administer medications as indicated: 
  • Vitamin K
Correction of albumin and protein deficits can aid in return of fluid from tissues to the circulatory system. Because absorption is altered, supplementation may prevent coagulation problems, which may occur if clotting factors and prothrombin time (PT) is depressed.
  • Antacids or H2-receptor antagonists: cimetidine (Tagamet).
Neutralize and reduce gastric secretions to lower risk of gastric irritation and bleeding.
Infuse fresh frozen plasma, as indicated. May be required to replace clotting factors in the presence of coagulation defects.

See Also

You may also like the following posts and care plans:

Gastrointestinal Care Plans

Care plans covering the disorders of the gastrointestinal and digestive system:

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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