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
May be related to
- Lack of exposure/recall; information misinterpretation
- Unfamiliarity with resources
Possibly evidenced by
- Questions or statements of misconception; request for information
- Inaccurate follow-through of instructions; development of preventable complications
- Verbalize understanding of disease process, prognosis, and potential complications.
- Identify relationship of signs/symptoms to the disease and correlate symptoms with causative factors.
- Verbalize understanding of therapeutic needs.
- Initiate necessary lifestyle changes and participate in treatment regimen.
|Assess level of understanding of the disease process, expectations and prognosis, possible treatment options.||Identifies areas of lack of knowledge or misinformation and provides opportunity to give additional information as necessary. Liver transplantation may be needed in the presence of fulminating disease with liver failure.|
|Provide specific information regarding prevention and transmission of disease: contacts may require gamma-globulin; personal items should not be shared; observe strict handwashing and sanitizing of clothes, dishes, and toilet facilities while liver enzymes are elevated. Avoid intimate contact, such as kissing and sexual contact, and exposure to infections, especially URI.||Needs and recommendations vary with type of hepatitis (causative agent) and individual situation.|
|Plan resumption of activity as tolerated with adequate periods of rest. Discuss restriction of heavy lifting, strenuous exercise and/or contact sport.||It is not necessary to wait until serum bilirubin levels return to normal to resume activity (may take as long as 2 mo), but strenuous activity needs to be limited until the liver returns to normal size. When patient begins to feel better, he or she needs to understand the importance of continued adequate rest in preventing relapse or recurrence (Relapse occurs in 5%–25% of adults). Energy level may take up to 3–6 mo to return to normal.|
|Help patient identify appropriate diversional activities.||Enjoyable activities promote rest and help patient avoid focusing on prolonged convalescence.|
|Encourage continuation of balanced diet.||Promotes general well-being and enhances energy for healing process and tissue regeneration.|
|Identify ways to maintain usual bowel function: adequate intake of fluids and dietary roughage, moderate activity and exercise to tolerance.||Decreased level of activity, changes in food and fluid intake, and slowed bowel motility may result in constipation.|
|Discuss the side effects and dangers of taking OTC and prescribed drugs (acetaminophen, aspirin, sulfonamides, some anesthetics) and necessity of notifying future healthcare providers of diagnosis.||Some drugs are toxic to the liver; many others are metabolized by the liver and should be avoided in severe liver diseases because they may cause cumulative toxic effects and chronic hepatitis.|
|Discuss restrictions on donating blood.||Prevents spread of infectious disease. Most state laws prevent accepting as donors those who have a history of any type of hepatitis.|
|Emphasize importance of follow-up physical examination and laboratory evaluation.||Disease process may take several months to resolve. If symptoms persist longer than 6 mo, liver biopsy may be required to verify presence of chronic hepatitis.|
|Review necessity of avoidance of alcohol for a minimum of 6–12 mo or longer based on individual tolerance.||Increases hepatic irritation and may interfere with recovery.|
|Refer to community resources, drug/alcohol treatment program as indicated.||May need additional assistance to withdraw from substance and maintain abstinence to avoid further liver damage.|
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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