1. Hepatitis is inflammation of the liver that is commonly caused by viral infections such as hepatitis A, B, C, D, and E. It can also be caused by alcohol, toxins, and certain drugs or medical conditions. 2. The symptoms of hepatitis include fever, jaundice, nausea, abdominal pain, and fatigue. Complications can include liver cancer, cirrhosis, and liver failure if left untreated. 3. Hepatitis is diagnosed through clinical features, blood tests, and liver function tests. Nursing care focuses on rest, nutrition, hygiene, medication administration, and health teaching to prevent further transmission.

2. INTRODUCTION.
• Hepatitis is the inflammation of the liver.
• The liver is a vital organ that processes nutrients, filters the
blood and fight infection. When the liver is inflamed its function
can be affected.
• Alcoholism, toxins, some medications and certain medical
conditions can cause hepatitis.
• Hepatitis is mainly caused by a virus either A,B,C,D and E
• Hepatitis A and E are caused by the faeco-oral route, while B,C
and D are blood borne.

3. CAUSES OF HEPATITIS.
• Viral infections (yellow fever and hepatitis viruses.)
• Alcoholism
• Certain medications e.g. Rifampicin, Largactil etc.

4. DIAGNOSIS.
• Clinical features
• Full blood count
• Liver function test

5. CLINICAL FEATURES.
• Fever
• Headache
• Jaundice
• Nausea
• Vomiting
• Loss of appetite
• Loss of weight
• hepatomegally
• Abdominal pains
• Joint pains
• Dark coloured urine
• General body itching (pruritus)
• Fatigue
• Ascites.

6. COMPLICATIONS.
• Liver cancer
• Liver cirrhosis
• Hepatic coma
• Hepatic failure.

7. TYPES OF HEPATITIS.

8. HEPATITIS A.
• It is the inflammation of the liver caused by the Hepatitis A virus.
• It is also known as the infectious Hepatitis and its more common
in children than adults.
• It is primarily transmitted through food and water contaminated
with the virus.
• It can also be transmitted by flies when it steps on a stool
infected with the virus and then settle on a food.
• In most cases the infection goes away on its own and does not
lead to long term liver problem. The incubation between 15 – 50
days.

9. MODE OF TRANSMISSION.
• Ingestion of food or water contaminated with the HAV.
• Ingestion of food prepared by a person with the HAV.
• Contact with faecal substance while changing a diaper or
while on a public toilet.
• Consuming shell fish from sewage contaminated water.
• Having sex with a person with HAV.

10. RISK FACTORS.
• Leaving with someone with the HAV.
• Eaten from restaurant where food handlers were found to
be having the HAV.
• Being an illegal drug addict.

11. PREVENTION.
• Practice proper hand washing before and after visiting the
toilet.
• Avoid eating raw or uncooked foods in places with poor
sanitation.
• Cover food to prevent flies from stepping on it with the virus.
• Foods must be cooked to the right temperature before eating.
• Avoid eating or drinking contaminated food.
• Get vaccinated against the HAV.

12. HEPATITIS B.
• It is the inflammation of the liver caused by the Hepatitis B virus.
• It is also called the serum hepatitis.
• It becomes chronic leading to liver failure, liver cancer or liver
cirrhosis.
• The HBV has been found in blood, urine, saliva, semen and
vaginal secretions and can be transmitted through mucus
membrane and break/cut in the skin.

13. MODE OF TRANSMISSION.
• Transfusion of infected blood /blood products.
• Unsafe injection practice among drug users.
• Unprotected sexual intercourse with an infected person.
• Perinatal (from mother to baby at birth.)
• Direct contact with blood and other body secretion in health
care settings.
• Sharing of articles like blade, spoon, sponge, pins, toothbrush
etc.

14. RISK FACTORS.
• Being a medical staff e.g. surgeon, nurses, clinical
laboratory workers etc.
• Having multiple sex partners (prostitutes and
homosexuals)
• Being infected with HIV.
• Being born to parents with the HBV.
• Leaving with someone with the HBV.

15. PREVENTION.
• Avoid sexual contact with a person with acute or chronic HBV.
• Avoid sharing personal articles like spoon, toothbrush, razor blade
etc.
• Avoid sharing needles during drug use.
• Clean blood spills with bleach solution.
• Screening of blood before transfusion.
• Get vaccinated against the HBV including infants.

16. HEPATITIS C.
• It is the inflammation of the liver caused by the Hepatitis C virus.
• It becomes chronic leading to liver failure, liver cancer or liver
cirrhosis.
• The HCV has been found in blood and can be transmitted
through mucus membrane and break/cut in the skin.
• HCV cannot be spread by sharing eating utensils,
breastfeeding, hugging, kissing and holding hands

17. MODE OF TRANSMISSION.
• Transfusion of infected blood /blood products.
• Unsafe injection practice among drug users.
• Direct contact with blood in health care settings.

18. RISK FACTORS.
• Being a medical staff e.g. surgeon, nurses, clinical
laboratory workers etc.
• Being infected with HIV.
• Being born to parents with the HCV.
• Leaving with someone with the HCV.
• Having acupuncture or tattoo with an infected instrument.

19. PREVENTION.
• Avoid sharing needles during drug use.
• Clean blood spills with bleach solution.
• Screening of blood before transfusion.
• Get vaccinated against the HCV including infants.
• Using sterile instrument during acupuncture and tatooning.

20. HEPATITIS D.
• It is the inflammation of the liver caused by the Hepatitis D virus.
• It is also known as the Delta hepatitis.
• The HDV only occur in people who are infected with the HBV
because HDV is an incomplete virus that requires the helper
function of HBV to replicate or multiply.
• The HDV has been found in blood, urine, saliva, semen and
vaginal secretions and can be transmitted through mucus
membrane and break/cut in the skin.

21. MODE OF TRANSMISSION.
• Transfusion of infected blood /blood products.
• Unsafe injection practice among drug users.
• Unprotected sexual intercourse with an infected person.
• Perinatal (from mother to baby at birth.)
• Direct contact with blood and other body secretion in health
care settings.
• Sharing of articles like blade, spoon, sponge, pins,
toothbrush etc.

22. RISK FACTORS.
• Being a medical staff e.g. surgeon, nurses, clinical
laboratory workers etc.
• Having multiple sex partners (prostitutes and
homosexuals)
• Being infected with HIV.
• Being born to parents with the HBV.
• Leaving with someone with the HBV.

23. PREVENTION.
• Avoid sexual contact with a person with acute or chronic HBV.
• Avoid sharing personal articles like spoon, toothbrush, razor blade
etc.
• Avoid sharing needles during drug use.
• Clean blood spills with bleach solution.
• Screening of blood before transfusion.
• Getting vaccinated against the HBV can protect the individual.

24. HEPATITIS E.
• It is the inflammation of the liver caused by the Hepatitis E virus.
• It is primarily transmitted through food and water contaminated
with the virus.
• It can also be transmitted by flies when it steps on a stool
infected with the virus and then settle on a food.
• It resembles the HAV.
• It does not cause any chronic liver infections.

25. MODE OF TRANSMISSION.
• Ingestion of food or water contaminated with the HEV.
• Ingestion of food prepared by a person with the HEV.
• Contact with faecal substance while changing a diaper or
while on a public toilet.
• Consuming shell fish from sewage contaminated water.
• Consuming pork, beef ,mutton etc.

26. RISK FACTORS.
• Leaving with someone with the HEV.
• Eaten from restaurant where food handlers were found to
be having the HEV.
• Consuming pork, beef ,mutton etc.

27. PREVENTION.
• Practice proper hand washing before and after visiting the toilet.
• Avoid eating raw or uncooked foods in places with poor sanitation.
• Cover food to prevent flies from stepping on it with the virus.
• Foods must be cooked to the right temperature before eating.
• Avoid eating or drinking contaminated food.
• Get vaccinated against the HEV.

28. NURSING MANAGEMENT.
• Psychological care.
• Rest and sleep.
• Observation.
• Nutrition.
• Exercise.
• Personal hygiene.
• Elimination.
• Medication.

29. PSYCHOLOGICAL CARE.
• Reassure patient to allay fear and anxiety.
• Explain disease condition to patient and relatives and allow
them to ask questions and answer tactfully.
• Explain all procedures to be carried on patient to the patient
and family.

30. REST AND SLEEP.
• Nurse patient in a serene and a well ventilated room.
• Restrict visitors during sleeping hours.
• Provide low bed with side rails to prevent patient from falls.
• All procedures to be carried out on patient must be grouped to avoid
disturbing the patient whiles sleeping.
• Provide a comfortable bed free off creases and crumps.
• Perform sleeping rituals for patient if he/she has. like serving warm drinks
or playing cool music.

31. OBSERVATION.
• Observe vital signs, record and report any abnormalities. If temperature is
high, tepid sponge and serve prescribed anti pyretic medications.
• Observe vomitus for amount, odour, blood and colour.
• Observe bowl movement for constipation or diarrhoea.
• Observe for side effects of medications served.
• Observe stool for amount, odour and colour.
• Monitor input and output by maintaining the input and out put chart to check
for dehydration or over hydration.

32. NUTRITION.
• Serve a well balanced diet rich in protein, vitamin, iron and carbohydrate to
promote energy.
• Serve food in bits but at frequent intervals.
• Serve food attractively and reduce fats and oil in diet.
• Encourage patient to brush his/her teeth to boost appetite.
• Remove bed pans and all unattractive articles out of patients sight.
• Encourage patient to drink more fluids to prevent dehydration due to profuse
sweating and vomiting.

33. PERSONAL HYGIENE.
• Encourage patient to bath at least twice daily.
• Encourage patient to brush his/her teeth at least twice daily.
• Encourage patient to wash hands before eating and after visiting the
toilet.
• Encourage patient to change cloth and bed linen daily due to sweating.
• Treat pressure sores if any.

34. ELIMINATION.
• Serve bed pans and urinals to help patient pass urine or faeces.
• Apply warm compress to patient lower abdomen to help him
pass urine or open nearby taps to have psychological influence
on him/her to pass urine.
• Give enema to enable patient pass faeces.

35. EXERCISE.
Encourage patient to do mild to moderate exercises to
promote circulation and prevent embolism.

36. MEDICATION.
Serve prescribe medication by observing the rights in
serving medication.