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Hepatitis B (formerly serum hepatitis) - Coggle Diagram
Hepatitis B (formerly
serum hepatitis)
Assessment
Symptoms
weight loss, anorexia
taste change
skin rash, hives, pruritis
right upper quadrant pain, tenderness, feeling of fullness
jaundice
dark urine
light coloured stools
fatigue
Diagnostics
prolonged prothrombin time
Elevated serum total bilirubin level
Positive antigen test
Abnormal findings on radiological imaging
anemia
bilirubin in urine
Health history
Exposure to infected person
Blood or blood product infusions
Misuse of alcohol
Organ transplant
Family history
Hemodialysis
Exposure to contaminated needles
Current medications
Exposure to new drug therapies or prescriptions
Misuse of acetaminophen
Etiology
Transmission
infected blood
hemodialysis
health care worker exposure
sex
passed to fetus during pregnancy
contaminated needles
IV drug use
Tattoos or piercings
accidental needle-stick punctures
infected body secretions
Cause
hepatitis B virus
double-strand DNA virus
3 antigens
2 core antigens
HBcAg
HBeAg
1 surface antigen
HBsAg
Stimulate antibody production
Prevention
vaccine available for long-term protection
Series of 3 injections in deltoid muscle
Hepatitis B virus immune globulin available for short-term protection
Screen at-risk individuals and educate them on ways to reduce risk of transmission
average incubation period is 2 months
facilitates transmission and is a barrier to contact tracing
50% of cases are asymptomatic
Nursing Care
Administration of drug therapy
interferon (IFN)
Indications
Reduction of viral load
Normalization of ALT levels
loss of antigens
Forms
Pegylated IFN
Long-acting, weekly, subcutaneous injection
Preferred form
Conventional IFN
Frequent subcutaneous administration
Treatment duration of 48 week recommended
Monitor blood cell counts and liver enzymes at least every 4 weeks during treatment
Adverse effects
Fever
Fatigue
Chills
Help client create a rest & activity plan
Will help them conserve energy when experiencing fatigue
Refer client to hepatologist for chronic cases
Client Education
Nutritious diet
Caution against overexertion
Symptoms to report to healthcare provider
Bleeding tendencies
Abdominal swelling
Confusion
How to avoid transmission
Instruct that client should have regular follow-up for at least 1 year after diagnosis
Avoidance of alcohol
Prevent addition disease progression
Drug administration, effects, and potential adverse effects
Pathophysiology
Liver cells damaged via cell-mediated immune response to hepatitis B virus
Cell damage leads to inflammation and necrosis in liver
May lead to biliary stasis and backup of bile into blood
Hepatic cells may regenerate, or fibrous tissue may form instead if damage is extensive
Chronic inflammation defined as inflammation and necrosis in liver for 6+ months
Leads to fibrosis and cirrhosis