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
Risk for Deficient Fluid Volume
- Risk for Deficient Fluid Volume
Risk factors may include
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.
- 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.
|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:|
||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.|
||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.|
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Gastrointestinal Care Plans
Care plans covering the disorders of the gastrointestinal and digestive system:
- 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