The document provides information about Hepatitis A, B, and C. It defines each type of hepatitis virus, describes how each is transmitted, lists common symptoms, and outlines methods for diagnosis, treatment, prevention and patient education. Key points include that Hepatitis A is usually spread through contaminated food or water, Hepatitis B can be transmitted through bodily fluids and from mother to child, and Hepatitis C is transmitted through exposure to infected blood. Vaccines exist to prevent Hepatitis A and B. Treatment focuses on symptom relief and may include antiviral medication.
Image result for gastritis
Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers.
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
Image result for gastritis
Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers.
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
GEMC- Typhoid Fever, Infectious Diarrhea, Diphtheria, and Pertussis- for NursesOpen.Michigan
This is a lecture by [[[AUTHOR]]] from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Search Results
Featured snippet from the web
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral
This file contains the informational about hepatitis. templates used in this are self made. This is an educational and medical oriented ppt made for the school project. dark vibrant color combination add a glimpse of flavour in it.
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
GEMC- Typhoid Fever, Infectious Diarrhea, Diphtheria, and Pertussis- for NursesOpen.Michigan
This is a lecture by [[[AUTHOR]]] from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Search Results
Featured snippet from the web
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral
This file contains the informational about hepatitis. templates used in this are self made. This is an educational and medical oriented ppt made for the school project. dark vibrant color combination add a glimpse of flavour in it.
GEMC - Abdominal Emergencies- For NursesOpen.Michigan
This is a lecture by Elizabeth Tamm from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Global Medical Cures™ | What I Need To Know About HEPATITIS C
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.
COUNSELLING IN HIV/AIDS
Qurrot Ulain Taher
P.G Diploma in Nutrition & Dietetics
Dietetic Techniques & Patient Counseling
HIV/AIDS
HIV stands for Human Immunodeficiency Virus. AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a result of the development of the HIV virus into a more serious condition. AIDS was first recognised by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s.
Understanding HIV
HIV is a contagious infection which attacks the immune system, reducing its effectiveness and leaving the body susceptible to infections. The HIV infection damages the cells the body needs to fight illnesses. AIDS can be diagnosed when the number of immune system cells (CD4 cells) in the blood of a person with HIV drops below a certain level.
There is no cure for HIV or AIDS, but there are treatments that can slow down the disease, and help prevent the onset of AIDS. It takes around ten years for someone with HIV to develop AIDS, but it can be prevented with early detection and treatment of the HIV
PREVENTION OF Mother to child transmission
Treatment for HIV and AIDS
HAART
TYPES OF HIV TESTS
Why Is Counseling Necessary
Objectives
Whom to counsel
Characteristics of a Counselor
Skills Required in Counseling
Stages of Counseling
Risk assessment counseling
Pre test counseling
Post test counseling
Follow up counseling
Role of Counselor
Advocacy role
Health education
Referral
Clinical and therapeutic role
Special Situations in HIV Counseling
Pregnant women
Childless couples
Breast feeding positive mothers
Spouse and family members of HIV infected persons
Hepatitis C continues to infect individuals in Saskatchewan. While Hep-C may be treatable, untreated Hep-C is a significant health threat. Transmission routes include shared drug equipment, dry blood contact, exposure during vacations, tattoos or piercing, and exposure through personal items such as razors and toothbrushes.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Jim Holliman, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Alterations in Body Temperature: The Adult Patient with a Fever- Reside...Open.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Rapid Sequence Intubation & Emergency Airway Support in the Pediatric E...Open.Michigan
This is a lecture by Michele Nypaver, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Disorders of the Pleura, Mediastinum, and Chest Wall- Resident TrainingOpen.Michigan
This is a lecture by Andrew Barnosky, DO from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Dental Emergencies and Common Dental Blocks- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Arthritis and Arthrocentesis- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Bursitis, Tendonitis, Fibromyalgia, and RSD- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Right Upper Quadrant Ultrasound- Resident TrainingOpen.Michigan
This is a lecture by Jeff Holmes from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Nursing Process and Linkage between Theory and PracticeOpen.Michigan
This is a lecture by Jeremy Lapham from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
2014 gemc-nursing-lapham-general survey and patient care managementOpen.Michigan
This is a lecture by Dr. Jeremy Lapham from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Jessica Holly from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: The Role of Radiography in the Initial Evaluation of C-Spine TraumaOpen.Michigan
This is a lecture by Dr. Stephen Hartsell from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Jim Holliman from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Chapter 3 - Islamic Banking Products and Services.pptx
GEMC - Hepatitis - for Nurses
1. Project: Ghana Emergency Medicine Collaborative
Document Title: Hepatitis
Author(s): Katherine A. Perry (University of Michigan), RN, BSN 2012
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3. Hepa((s
A
Virus
(HAV)
• Hepatitis A is an acute infectious disease of the liver
• Usually spread fecal-oral route; transmitted person-to-person by
ingestion of contaminated food or water or through direct
contact with an infectious person
• Closely associated with poor sanitation and a lack of personal
hygiene habits, such as hand-washing
• An estimated 1.4 million cases of hepatitis A occur annually
(WHO)
3
4. Transmission
of
HAV
People almost always get hepatitis A from fecal
contamination:
• Food handlers who have the disease did not wash their hands after having a BM
• Drinking water or eat raw shellfish (clams, oysters) that came from unclean water
areas
• You were in a place with poor sanitary conditions (dirty) where the hepatitis A virus is
common
• There other ways you may get hepatitis A, but these are much less common:
– Day care workers who do not wash their hands after changing a diaper
– Men who have sex with men
– The blood of an infected person getting into your blood
– Users of both injectable and non-injectable street drugs can get it by using dirty
or used needles.
4
5. HAV
Symptoms
Range from mild to severe including
• Fever
• Malaise
• Loss of appetite
• Diarrhea
• Nausea
• Abdominal discomfort
• Dark-colored urine, and light-colored BM’s
• Jaundice (a yellowing of the skin and whites of the eyes)
You are most contagious in the two weeks before getting jaundiced
and the first week after getting jaundice
5
6. Treatment
of
HAV
• There is no specific treatment for hepatitis A
• Recovery from symptoms following infection may be slow
and take several weeks or months
• Therapy is aimed at maintaining comfort and adequate
nutritional balance, including replacement of fluids that are
lost from vomiting and diarrhea
6
7. Preven(on
• Improved sanitation and Hepatitis A immunization are the
most effective ways to combat the disease
• Adequate supplies of safe-drinking water and proper disposal
of sewage within communities, combined with personal
hygiene practices, such as regular hand-washing, reduce the
spread of HAV
• Several hepatitis A vaccines are available internationally. All
are similar in terms of how well they protect people from the
virus and their side-effects. No vaccine is licensed for children
younger than one year of age.
7
8. Pa(ent
Educa(on
• When you have an appetite again, eat healthy foods from all of the 5 food groups:
fruits, vegetables, breads, dairy products, meat and fish
• Try to avoid alcohol since it makes your liver work harder
• Drink 6 to 8 glasses of liquid each day. Limit the amount of caffeine you drink such as
coffee, tea, and soda
• Your friends and family may need to get a shot to keep them from getting hepatitis A
• Do not share dishes and eating utensils. Wash dishes and utensils in boiling water or
a dishwasher. You may want to use disposable (throw-away) dishes
• Do not make food or meals for other people
• Wash your hands well before eating and after using the toilet
• Wash clothing and bedding in the hottest water setting
• Clean toilets with a product that kills germs
8
9. Pa(ent
Educa(on
CONTACT A CAREGIVER IF:
• You cannot drink liquids or keep food down
• Your skin is itchy, swollen, or has a rash. Your medicine may be causing these
symptoms. This may mean you are allergic
• You are bruising easily
SEEK CARE IMMEDIATELY IF:
• You feel confused or unusually sleepy. The sleepiness may switch with feeling
irritable or jittery
• You have bad abdominal pain
• You have BMs that are red or black and sticky
• Your vomit is red or looks like coffee grounds
• You are too dizzy to stand up
9
10. Hepa((s
B
Virus
(HBV)
• Hepatitis B is irritation and swelling (inflammation) of the liver
due to infection with the hepatitis B virus (HBV)
• The infection is called acute when a person first becomes
infected with HBV
• The infection becomes chronic (long-term) when a person
has symptoms, such as liver swelling, for six months or longer
• Acute HBV infections are more common in adults. Infants and
young children have a higher risk for chronic HBV
10
11. Transmission
HBV
• Contact with infected blood or body fluids, such as saliva and semen
• Once HBV is in your blood, it travels to your liver and injures your
liver cells
• HBV can enter your body through a cut or scratch in your skin or
through your mucous membranes
• Mucous membranes include your gums and the lining of your rectum
or a woman's vagina
• HBV can live on objects and surfaces for seven or more days, with or
without visible blood
• HBV can also spread from a mother to her unborn child.
11
12. Symptoms
of
HBV
• It can take from 1 to 6 months before symptoms occur
• Some people will have no signs and symptoms and may not know they have been
infected. When signs and symptoms do occur, they may last from a few days to
months:
– Dark-colored urine or light-colored or gray bowel movements (BMs).
– Fatigue (feeling more tired than usual) and weakness.
– Fever (high body temperature).
– Loss of appetite for food, nausea (upset stomach), and vomiting (throwing up).
– Jaundice (yellowing of the skin or the whites of the eyes). You may also get skin
rashes.
– Joint pain and body aches.
– Pain in the right upper side of the abdomen (stomach)
12
13. Complica(ons
of
HBV
• Liver cirrhosis: scarring of the liver caused by infection and inflammation.
Increased risk for cirrhosis if you drink alcohol or smoke. Increased risk if
you have human immunodeficiency virus (HIV), hepatitis C; or hepatitis D
• Liver failure: Liver failure occurs when the liver can no longer function as it
should. Risk for liver failure increases if you have cirrhosis.
• Liver cancer: Chronic HBV may lead to liver cancer. The risk for liver
cancer increases if you are male and if you have other family members with
liver cancer. Your risk also increases if you have liver cirrhosis or if you are
also infected with hepatitis C.
• Kidney problems: HBV can lead to inflammation and problems with your
kidney function. Your kidneys are organs that remove waste from your body
as urine
13
14. Diagnosis
• Blood tests: to give information about how the patients
body is working
• Abdominal ultrasound: pictures of the liver may be
done to check for signs of HBV and to look for other
liver problems
• Liver biopsy: a small sample of the liver is removed
and sent to a lab to check for swelling, scarring, and
other damage. A liver biopsy may help caregivers learn
if you need treatment for HBV
14
15. HBV
preven(on
Getting vaccinated against HBV is the best way to decrease your risk and prevent the disease
• The HBV vaccine is given in three doses over a period of months
• Some people may not respond to the vaccine as well as others
• After being vaccinated, some may need a blood test to check his/her response
Photographer's Mate Airman Apprentice Christopher D. Blachly, Wikimedia Commons
15
16. Treatment
of
HBV
• The goal of treatment is to prevent the disease from getting worse and
leading to more serious liver problems
• Treatment may help improve the function of your liver and decrease
your symptoms of liver disease
• HBV may last a short time and go away on its own without treatment
• HBV may become chronic, leading to liver damage and disease
16
17. Treatment
of
HBV
Medicines:
• Antiviral medicines: Antiviral medicine may be given to help stop
the virus from spreading in your body
• Immune globulin: Hepatitis B immune globulin (HBIG) is medicine
given if you have been exposed to HBV. Immune globulin helps your
body fight the HBV infection. HBIG is also given to newborn babies
who were exposed to HBV while in the womb.
• Liver transplant: Some patients may need a liver transplant if they
have severe liver disease or liver failure.
• Hepatitis A vaccination: If you are diagnosed with HBV, your
caregiver may vaccinate you against hepatitis A.
17
18. HBV
preven(on
The following people should be vaccinated against HBV:
• Any person not already vaccinated against HBV
• Healthcare workers and workers in other care facilities
• Newborn babies born to women with HBV - All newborn babies
should be vaccinated shortly after birth and have additional doses as
directed by a caregiver
• People living in care facilities and inmates of correctional facilities
18
19. HBV
preven(on
• People who have decreased liver function or who are
infected with hepatitis C, hepatitis D, or HIV
• People who inject illegal drugs
• People with kidney failure receiving hemodialysis
treatments. More or higher doses of the vaccine may
be needed for people with kidney failure
• People with more than one sex partner or men having
sex with other men
• People who have had a sexually transmitted disease
(STD) before should also be vaccinated
19
20. HBV
Preven(on
Those who are HBV+:
•
•
•
•
•
•
•
Cover any open cuts or scratches. If blood from a wound gets on a surface, clean the surface
with bleach right away
Dispose of any items with blood or body fluids on them properly
Do not donate blood, sperm, or organs to others
Do not share items that may have infected blood or body fluids on them (includes
toothbrushes, razors, or personal injection items, such as needles)
Tell household and sexual contacts that you have HBV. All close contacts should be
vaccinated. If contacts have not had the vaccination, they may need to start treatment to help
prevent infection.
Also tell medical or dental caregivers you have HBV when getting any kind of treatment
When having sex, always use a condom, even if you have acute HBV and your infection goes
away, you can still spread the virus for up to six months
20
21. Pa(ent
educa(on
Call your caregiver if:
• The palms of your hands are red
• You have a fever
• You have new or increased swelling in your legs,
ankles, or feet
• Your muscles are getting smaller and weaker
• You have questions about your condition,
medicines, or care
21
22. Pa(ent
educa(on
Seek help immediately or call 911 if:
• You have a sudden, severe headache and head pressure
• You have new or increased bruising or red or purple dots on your
skin. You may also have bleeding that does not stop easily
• Your abdomen is swollen
• You have severe nausea or cannot stop vomiting
• You see blood in your urine or bowel movements, or you vomit
blood
• You have new or increased yellowing of your skin or the whites of
your eyes
• You have severe (very bad) pain in your upper abdomen
22
23. Pa(ent
educa(on
• Limit or avoid alcohol: Alcohol can increase your liver damage and can damage
your brain and heart
• Quit smoking: Smoking harms your lungs, blood, and heart. You are more likely to
have a heart attack, lung disease, and cancer if you smoke. You will help yourself
and those around you by not smoking
• Pregnant and have viral hepatitis B?
– Avoid close or intimate contact with others as directed by your caregiver
– Avoid injury to your upper abdomen
– Make sure you eat a healthy diet
– You may need to limit your daily activities and rest more
– After your child is born, you should be able to breastfeed your infant
23
24. GOKLuLe, Wikimedia Commons
Pa(ent
educa(on
• Take your medicine as directed: Call your primary
healthcare provider if you think your medicine is not
working as expected
• Follow-up visit: tell the patient to ask the caregiver
when to return for a follow-up visit. He/she may need
to have blood tests to check the function of your liver.
Keep all appointments. Write down any questions he/
she may have
24
25. Hepa((s
C
Virus
(HCV)
• Hepatitis C is also called non-A or non-B hepatitis
• Inflammation of the liver due to infection caused by a virus
• Similar to Hep A & Hep B, Hepatitis C virus (HCV) attacks and
damages your liver
• CDC estimates worldwide there are 3-4 million people infected with
HCV each year
25
26. Symptoms
HCV
The most common symptom of hepatitis C is fatigue (feeling
more tired than usual) The patient may present with one or
more of the following:
•
•
•
•
•
•
•
Dark orange-colored urine or clay-colored stool
Fever
Itchy skin
Jaundice (yellowing of the skin or the whites of the eyes)
Joint pain, body aches, or weakness
Loss of appetite, nausea or vomiting
Pain in the right side of the abdomen
26
27. Complica(ons
HVC
Hepatitis C may lead to the following problems:
• Liver cirrhosis
• Liver cancer
• Liver failure
• Kidney disease
27
28. Transmission
Hepatitis C virus is carried in the blood and other body fluids, such as semen or vaginal fluids.
Hepatitis C virus may spread by any of the following:
•
•
•
•
•
•
•
•
Childbirth: passed from a pregnant woman to her baby during delivery
Needle stick injury
Long-term dialysis
Blood transfusion or an organ transplant before July 1992
Sharing items that may have infected blood on them, such as razors, toothbrushes, or nail
clippers
Sharing infected needles to use illegal or street drugs
Using dirty needles or instruments for tattooing, body piercing, or other procedures
Sex: Some people may not know they have hepatitis C and and could pass the virus to their
sex partner.
28
29. Diagnosis
•
Enzyme immunoassay test: EIA checks for hepatitis C antibodies (proteins made by the
immune system that attack viruses or bacteria)
•
Genotyping: blood test that tests the genotype of the hepatitis C virus that you have
•
Hepatitis C profile serological test: checks the activity and number of hepatitis C viruses
present in your blood.
•
Liver biopsy: small piece of the liver is removed and sent to a lab for tests
•
Liver function tests: to check the enzymes and other substances made in the liver
29
30. Treatment
• Anti-viral medicines: These medicines work by
keeping the virus from spreading. This may prevent
or decrease more swelling and damage to the liver.
• Surgery: A liver transplant may be done if your liver
stops working. Your diseased liver is removed and
replaced with a healthy and donated liver. You may
also have a part of your liver removed.
30
31. Preven(on
There is no available vaccine to prevent hepatitis C. Following are ways to prevent the spread of hepatitis C:
• Caregivers should wear gloves, masks, gowns, or safety goggles
when handling blood products and instruments
• Consider the risks of getting hepatitis C before having tattoos or
body piercing
• If patients use illegal or street drugs, never reuse or share needles
or syringes
• Do not share toothbrushes, razors, or other personal care items
• Mothers infected with hepatitis C should stop breastfeeding if their
nipples are cracked or bleeding
• Use latex condoms when having sex
31
32. Nursing
management
• Universal Precautions – Gloves are worn when there is to be contact
with blood and body fluid
• Goggles/masks are worn when there is a danger of splashing or
aerosol of blood-contaminated secretions
• Water repellant gown, if there is a danger of splashing
• Always hand washing before and after contact with blood and body
fluid
• Specimens are treated as biohazard. Linen & used material are treated
as infectious.
• Establish if the patient is in the acute phase, a carrier, or not
32
33. Pa(ent
assessment
ACTIVITY/REST
May report:
•
Fatigue, weakness, general malaise
CIRCULATION
May exhibit:
•
Bradycardia (severe hyperbilirubinemia)
•
Jaundiced sclera, skin, mucous membranes
ELIMINATION
May report:
•
Dark urine
•
Diarrhea/constipation; clay-colored stools
•
Current/recent hemodialysis
FOOD/FLUID
May report:
•
Loss of appetite (anorexia), weight loss or gain (edema) Nausea/vomiting
May exhibit:
•
Ascites
33
34. Pa(ent
assesment
NEUROSENSORY
May exhibit:
• Irritability, drowsiness, lethargy, asterixi
PAIN/DISCOMFORT
May report:
• Abdominal cramping, right upper quadrant (RUQ) tenderness
• Myalgias, arthralgias; headache
• Itching (pruritus)
May exhibit:
• Muscle guarding, restlessness
RESPIRATION
May report:
• Distaste for/aversion to cigarettes (smokers)
• Recent flulike URI
SEXUALITY
May report:
• Lifestyle/behaviors increasing risk of exposure (e.g., sexual promiscuity, sexually active homosexual/
bisexual male)
34
35. Pa(ent
assessment
SAFETY
May report:
• Transfusion of blood/blood products in the past
May exhibit:
• Fever
• Urticaria, maculopapular lesions, irregular patches of erythema
• Spider angiomas, palmar erythema, gynecomastia in men (sometimes present in alcoholic hepatitis)
• Splenomegaly, posterior cervical node enlargement
TEACHING/LEARNING
May report:
• History of known/possible exposure to virus, bacteria, or toxins (contaminated food, water, needles,
• surgical equipment or blood); recent surgical procedure with halothane anesthesia; exposure to toxic
chemicals; prescription drug use (e.g., sulfonamides, phenothiazines, isoniazid)
• Travel to/immigration from China, Africa, Southeast Asia, Middle East (hepatitis B [HB] is endemic in these
areas)
• Street injection drug or alcohol use
• Concurrent diabetes, HF, malignancy, or renal disease
35
36. Diagnos(c
studies
for
hepa((s
Liver enzymes:
• Abnormal (4–10 times normal values)
AST/ALT:
• Initially elevated. May rise 1–2 wk before jaundice is apparent, then decline.
• Alkaline phosphatase
Hepatitis A, B, C, D, E panels (antibody/antigen tests):
• Specify type and stage of disease and determine possible carriers.
CBC:
• Red blood cells (RBCs) decreased because of shortened life of RBCs (liver enzyme
alterations) or hemorrhage.
WBC count and differential:
• Leukopenia, leukocytosis, monocytosis, atypical lymphocytes, and plasma cells may be
present.
36
37. Diagnos(c
studies
Serum albumin:
• Decreased.
Blood glucose:
• Transient hyperglycemia/hypoglycemia (altered liver function).
Prothrombin time:
• May be prolonged (liver dysfunction).
Serum bilirubin:
• Above 2.5 mg/100 mL. (If above 200 mg/100 mL, poor prognosis is probable because of increased cellular
• necrosis.)
Liver biopsy:
• Usually not needed, but should be considered if diagnosis is uncertain, of if clinical course is atypical or
unduly
• prolonged
Urinalysis:
• Elevated bilirubin levels; protein/hematuria may occur
37
38. Hepa((s
Nursing
management
NURSING PRIORITIES
• 1.Reduce demands on liver while promoting physical well-being.
• 2.Prevent complications.
• 3.Enhance self-concept, acceptance of situation.
• 4.Provide information about disease process, prognosis, and treatment
needs.
DISCHARGE GOALS
• 1.Meeting basic self-care needs.
• 2.Complications prevented/minimized.
• 3.Dealing with reality of current situation.
• 4.Disease process, prognosis, and therapeutic regimen understood.
• 5.Plan in place to meet needs after discharge
38
39. Self
care
at
home
The
goals
of
self-‐care
are
to
relieve
symptoms
and
prevent
worsening
of
the
disease
•
•
•
•
•
•
Drink
plenty
of
fluids
to
prevent
dehydra(on
Avoid
medicines
and
substances
that
can
cause
harm
to
the
liver,
such
as
acetaminophen
(Tylenol)
Avoid
drinking
alcohol
un(l
your
health
care
provider
OKs
it.
If
your
infec(on
becomes
chronic,
you
should
avoid
alcohol
for
the
rest
of
your
life
Avoid
using
drugs,
even
legal
drugs,
without
consul(ng
your
doctor.
Hepa((s
can
change
the
way
drugs
affect
you.
Do
not
start
any
new
medica(on
without
first
talking
to
your
health
care
provider
Try
to
eat
enough
for
adequate
nutri(on.
Try
to
maintain
a
balanced
diet.
Many
people
with
hepa((s
have
the
greatest
urge
to
eat
early
in
the
day
Take
it
easy.
Your
ac(vity
level
should
match
your
energy
level
39
40. Pa(ent
educa(on
CONTACT A CAREGIVER IF:
• You have a fever.
• You are vomiting (throwing up) and cannot keep food or liquids down
• You have a rash, an itch, or swelling of your abdomen (stomach) or legs
• You are bruising easily
• You have bad abdominal pain
• You have questions or concerns about your disease, medicine, or care
SEEK CARE IMMEDIATELY IF:
• You are too dizzy to stand up
• You feel confused or are very sleepy
• Your stools are red, black, or clay-colored
• Your symptoms are getting worse
• Your vomit (throw up) has blood in it or looks like coffee grounds
40
41. Case
study
45
year
old
female,
who
presented
to
the
ER
41