Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months.
It include the definition , signs and symptoms, types, diagnosis, medical management, Nursing management, preventive measures, complication, Post exposure prophylaxis of Hepatitis.
HEPATITIS IS THE INFLAMMATION OF THE LIVER, CAUSED BY VIRUSES, TOXINS, OR CHEMICALS (INCLUDING DRUGS).
1.
VIRAL HEPATITIS
2.
TOXIC HEPATITIS
3.
CHRONIC HEPATITIS
4.
ALCOHOLIC HEPATITIS
It include the definition , signs and symptoms, types, diagnosis, medical management, Nursing management, preventive measures, complication, Post exposure prophylaxis of Hepatitis.
HEPATITIS IS THE INFLAMMATION OF THE LIVER, CAUSED BY VIRUSES, TOXINS, OR CHEMICALS (INCLUDING DRUGS).
1.
VIRAL HEPATITIS
2.
TOXIC HEPATITIS
3.
CHRONIC HEPATITIS
4.
ALCOHOLIC HEPATITIS
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Megaloblastic anaemia is a red blood cell disorder due to the inhibition of DNA synthesis during erythropioesis.
Mitotically, the inhibition of the DNA synthesis impaires the progression of the cell cycle development from G2 to (M) stage.
In this video, you can learn about the basics of Typhoid fever and also the symptoms and treatment of this disease in a very simple way. We describe to you here all about,
1. Typhoid fever
2. Symptoms of Typhoid
3. Causes of Typhoid
4. Diagnosis of Typhoid
5. Prevention of Typhoid
6. Treatment of Typhoid
7. Diet for Typhoid fever
You can download the PowerPoint file from below link:
https://docs.google.com/presentation/d/1s8Ix3t8t3O-KYWVze2C8nm4QYIWJdFSXg_sTR78htiQ/edit?usp=sharing
You can learn from video by the below link:
https://youtu.be/PDhr_UmTWuc
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Megaloblastic anaemia is a red blood cell disorder due to the inhibition of DNA synthesis during erythropioesis.
Mitotically, the inhibition of the DNA synthesis impaires the progression of the cell cycle development from G2 to (M) stage.
In this video, you can learn about the basics of Typhoid fever and also the symptoms and treatment of this disease in a very simple way. We describe to you here all about,
1. Typhoid fever
2. Symptoms of Typhoid
3. Causes of Typhoid
4. Diagnosis of Typhoid
5. Prevention of Typhoid
6. Treatment of Typhoid
7. Diet for Typhoid fever
You can download the PowerPoint file from below link:
https://docs.google.com/presentation/d/1s8Ix3t8t3O-KYWVze2C8nm4QYIWJdFSXg_sTR78htiQ/edit?usp=sharing
You can learn from video by the below link:
https://youtu.be/PDhr_UmTWuc
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Peplau's theory explains the phases of interpersonal process, roles in nursing situations and methods for studying nursing as an interpersonal process. Nursing is therapeutic in that it is a healing art, assisting an individual who is sick or in need of health care.
Interstitial lung diseases (ILDs) are a group of more than 200 different disorders that cause scarring in the lungs. Scar tissue in the lungs can make it harder for you to breathe normally. In ILDs, scarring damages tissues in or around the lungs’ air sacs and airways.
Pulmonary tuberculosis
The bacterium Mycobacterium tuberculosis causes tuberculosis (TB), a contagious, airborne infection that destroys body tissue. Pulmonary TB occurs when M. tuberculosis primarily attacks the lungs. However, it can spread from there to other organs.
New treatment regimen is mentioned here.
chronic obstructive pulmonary disease and its management
chronic obstructive pulmonary disease is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
COPD typically has a clear cause and a clear path of prevention, and there are ways to slow the progression of the disease.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
6. HEPATITIS
■ Hepatitis is defined as the
inflammation of the liver.
■ According to WHO, 325 million
people globally live with a hepatitis
infection.
■ Viral hepatitis B infection in the
world is among 257 million people.
■ Hepatitis C infection is among 71
million people globally.
11-06-2021 6
7. .
■ Nearly 96,000 people die annually in India due to Hepatitis C, which has
become a hidden epidemic according to WHO report.
■ India has an estimated number of 40 million chronic Hepatitis B Virus
(HBV) infected people throughout the country, constituting about 11
percent of the estimated global Hepatitis-B burden.
■ The prevalence rate of Chronic Hepatitis B Virus (HBV) infection in India
is around 3 to 4 percent.
■ The prevalence of HCV infection in India is 1 per cent.
■ Men are more prone as compared to women.
EPIDEMIOLOGY
11-06-2021 7
8. Types Of Hepatitis (Based On Duration)
ACUTE HEPATITIS
Duration more than 6 months
Duration less than 6 months
CHRONIC HEPATITIS
11-06-2021 8
9. TYPES OF HEPATITIS (cause based)
VIRAL HEPATITIS NON VIRAL
HEPATITIS
Drug Induced Hepatitis
Toxic Hepatitis
OTHER TYPES
11-06-2021 9
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E
Autoimmune Hepatitis
Alcoholic Hepatitis
Non Alcoholic
Steatohepatitis (NASH)
11. 11-06-2021 11
HEPATITIS A HEPATITIS B HEPATITIS C HEPATITIS E
TYPE OF VIRUS RNA DNA RNA RNA
ROUTE OF
TRANSMISSION
Feaco-oral route Parenteral Parenteral Feaco-oral route
SEVERITY OF
ILLNESS
Mild Severe Mild Mild
CHRONICITY
OF DISEASE
None 10% 50-60% None
13. .
■ Formerly as Infectious hepatitis.
■ Accounts for 20-25% of cases of clinical hepatitis.
Hepatitis A
Causative organism:
Hepatitis A virus
Incubation period:
15- 50 days
(average: 28 days)
Mode of transmission:
Fecal oral route
11-06-2021 13
14. 11-06-2021 14
Etiological factors
Invasion of virus into liver cells and
replication
Cytotoxic cytokines and NK cells
release to attack virus
Lysis of infected hepatocytes
Scar tissue forms around dead and
infected liver cells
Liver damage and improper function
cirrhosis
Reduces blood flow to the liver
Permanent Shrinking and hardening of
liver
Chronic infection
Dormant and reactivation
PATHOPHYSIOLOGY
19. Assessment and Diagnostic findings
The liver and spleen are often moderately enlarged for a few days after
onset; otherwise, apart from jaundice, there are few physical signs.
Hepatitis A antigen may be found in the stool a week to 10 days before
illness and for 2 to 3 weeks after symptoms appear.
■ HAV antibodies are detectable in the serum, but usually not until
symptoms appear: done through ELISA.
Biochemical test may reveal abnormal levels of bilirubin, alanine
aminotransferase, and protein.
Blood tests: 2 kind of antibodies – IgM (shows acute infection) and IgG
(previous infection).
11-06-2021 19
20. 11-06-2021 20
• To diagnose jaundice and assess the severity of jaundice
Bilirubin
• To assess for hemolysis
Unconjugated bilirubin
• To diagnose cholestasis
Alkaline phosphatase
• To diagnose hepatocellular carcinoma and to assess disease progression
SGOT/AST
• ALT lower than AST is found in person’s with alcoholism
SGPT/ALT
• To diagnose autoimmune hepatitis
Gamma globulin
21. Two-dose vaccine be given to adults
18 years of age or older, with the
second dose 6 to 12 months after the
first.
PREVENTION
Children and adolescents 2 to 18 years
of age receive three doses, with the
second dose 1 month after the first and
the third dose 6 to 12 months later.
Vaccination: Havrix & Vaqta
11-06-2021 21
22. Travelers to developing countries
Settings with poor or uncertain sanitation conditions
Recommended for:
Other high-risk groups (homosexual men, injection/intravenous drug
users, staff of day care centers, and health care personnel).
Immune globulin: for household members and sexual contacts of people with hep. A,
Day care center and restaurant workers with exposure to or infected with hepatitis A
11-06-2021 22
23. Good personal hygiene and
proper sanitation
Twinrix (combined
Hep. A and B vaccine )
is available for
vaccination of people 18
years of age and older
with indications for hep.
A and B vaccination. (3
doses-0,1,6 months)
11-06-2021 23
25. Medical Management
Supportive treatment
Bed rest during the acute stage.
During the period of anorexia, the patient should receive frequent small
feedings, supplemented, if necessary, by IV fluids with glucose.
Optimal food and fluid levels are necessary to counteract weight loss and
slow recovery.
Gradual but progressive ambulation seems to hasten recovery, provided
the patient rests after activity and does not participate in activities to the
point of fatigue.
11-06-2021 25
26. Nursing Management
■ Assist the patient and family in coping with the temporary disability
and fatigue that are common in hepatitis.
■ Specific guidelines about diet, rest, follow-up blood work.
■ The importance of avoiding alcohol.
■ Sanitation and hygiene measures (particularly hand washing) to prevent
spread of the disease.
11-06-2021 26
27. .
Hepatitis B
Causative organism:
Hepatitis B virus
Incubation period:
60-150 days
(average 90 days)
Mode of transmission:
percutaneous and per
mucosal routes
11-06-2021 27
31. Assessment And Diagnostic Finding
Hepatitis B virus is a DNA virus composed
of the following antigenic particles:
HBcAg- hepatitis B core antigen
HBsAg- hepatitis B surface antigen
(antigenic material on the viral surface, a
marker of active replication and infection)
HBeAg- an independent protein
circulating in the blood.
HBxAg- gene product of X gene of HBV
DNA
11-06-2021 31
32. .
Anti-HBc-antibody, persists during the active phase
of illness, may indicated continuing HBV in the liver.
Anti-HBs-antibody, detected during late
convalescence, usually indicates recovery and
development of immunity.
Anti-HBe-antibody, signifies reduced infectivity.
Anti-HBxAg-antibody, may indicate ongoing
replication of HBV.
■ HBsAg appears in the circulation in 80-90% of
infected patients 1 to 10 weeks after exposure to HBV
and 2 to 8 weeks before the onset of symptoms or an
increase in transferase levels.
■ Liver ultrasound or transient elastography can show
the amount of liver damage.
■ liver biopsy, and fibro tests
11-06-2021 32
33. Continued screening of
blood donors
Wearing Gloves while handling
blood, body fluids and sample
of HBsAg positive specimen
Maintaining good
personal hygiene
Use of disposable syringe, needle
and lancets
11-06-2021 33
Prevention
34. .
A yeast-recombinant hepatitis B vaccine is
used to provide active immunity and has
shown rates of protection greater than 90%
in healthy people
Active Immunization
Nurses and health care professionals exposed
to blood and blood products
All unvaccinated people being evaluated for
a STI, history of STI, people with multiple
sex partners, people who have sex with IV or
injection drug users, or sexually active men
with other men.
11-06-2021 34
35. Passive Immunity: Hepatitis B Immune Globulin
Hepatitis B immune globulin (HBIG) provides
passive immunity to hepatitis B and is indicated for
people exposed to HBV who have never had hepatitis
B and have never received hepatitis B vaccine.
Specific indications for postexposure vaccine with
HBIG include:
(1) Inadvertent exposure to HBAg-positive blood
through percutaneous (needlestick) or transmucosal
(splashes in contact with mucous membrane) routes
(2) sexual contact with people positive for HBAg
(3) Perinatal exposure.
11-06-2021 35
36. Medical Management
Treatment of acute hepatitis B is indicated only in patients with severe
hepatitis and liver failure.
Nucleoside and nucleotide analog such as tenofovir, adenofovir, lamivudine.
Interferon: standard interferon (intron A), pegylated interferon (peglntron):
Alpha interferon as the single modality of therapy: regimen of 5 million units
daily or 10 million units three times weekly for 4 to 6 months.
Liver transplant
11-06-2021 36
37. Dietary management
Recommend small, frequent meals, minimize periods without food intake.
Provide intake of 25-30 kcal/day.
Provide protein intake of 1-1.5 g/kg/day.
Carefully monitor fluid balance.
Be aware that that enteral feedings may be necessary if anorexia, nausea,
and vomiting persist.
Instruct patient to abstain from alcohol during acute illness and for at least
6 months after recovery.
■ Advise patients to avoid substances (medications, herbs, illicit drugs, and
toxins) that may affect liver function.
11-06-2021 37
38. 11-06-2021 38
Types of hepatitis on the basis of duration?
Types of hepatitis on the basis of cause?
Name of the vaccine for hepatitis A prevention?
Stages of symptoms development in hepatitis?
What are the four antigenic particles of hepatitis B DNA virus?
Dose, route and frequency of hepatitis B vaccine?
Route of transmission for hepatitis A and hepatitis C?
39. Hepatitis C
Incubation period:
14-182 days
(average: 14-84 days)
Mode of transmission:
Direct percutaneous or
mucous membrane
exposure
Causative organism
Hepatitis C virus
Non-A, Non-B hepatitis,
or NANB hepatitis
11-06-2021 39
41. Assessment and diagnostic findings
■ HCV antibody: ELISA: It takes at least 4 weeks after infection before
antibody appears.
■ HCV-RNA: PCR is done to diagnose HCV infection in acute phase,
however its main use is in monitoring the response to antiviral therapy.
■ Liver ultrasound
■ Biochemical studies
11-06-2021 41
42. Management:
Combination of two antiviral agents, peginterferon and ribavirin (Rebetol),
is effective in producing improvement in patients with Hepatitis C and in
treating relapse.
Peginterferon (pegasys)
Ribavirin must be used cautiously in women of
childbearing age.
The triple therapy of protease inhibitor, peginterferon,
and ribavirin is recommended as standard of treatment for Hepatitis C by
American Association for the study of liver disease.
11-06-2021 42
43. Prevention
Advise avoidance of high-risk behaviors such as IV drug use.
■ Use needless IV and injection systems in health care
Use barrier precautions in situation of contact with blood or body fluids.
Monitor cleaning, disinfection and sterilization of reusable devices in
patient care settings.
Avoid multidose vials in patient care settings.
Use standard precautions in clinical care.
11-06-2021 43
44. Hepatitis D
The virus requires hepatitis
B surface antigen for its
replication, only
individuals with hepatitis B
are at risk for hepatitis D.
Incubation period:
21-140 days
Causative organism
Hepatitis D virus
Mode of
transmission:
Same as hepatitis B
11-06-2021 44
Coinfection &
superinfection
45. .
Diagnosis
■ Anti-delta antibodies on testing confirm the diagnosis.
■ Sexual contact with those having hepatitis B is considered to be an
important mode of transmission B and D.
Management
■ Treatment is similar to that of other forms of hepatitis.
■ Interferon alpha is the only licensed drug for the treatment of hepatitis
D.
11-06-2021 45
46. Hepatitis E
Incubation period:
15 to 65 days
Causative organism
Hepatitis E virus
Mode of
transmission:
Fecal oral route
11-06-2021 46
Resembles
Hepatitis A
Jaundice is nearly
always present
Diagnosis:
Anti HEV
IgM and Ig G
HEV RNA quantification
48. 11-06-2021 48
Hepatitis G or GB virus-C
NA NB NC
Hepatitis
Incubation period:
14 to 145 days
Causative organism
Hepatitis G virus &
GB virus-C
Strong significance in
HIV coinfection.
Mode of
transmission:
Parenteral or sexual
52. Carbon tetrachloride,
Vinyl chloride,
Herbicides,
phosphorus,
chloroform,
gold compounds, and
Industrial chemicals known as polychlorinated biphenyls.
Toxic hepatitis resembles viral hepatitis in onset.
Obtaining a history of exposure to hepatotoxic chemicals, medications, or other
agents assists in early treatment and removal of the offending agent.
TOXIC HEPATITIS
11-06-2021 52
53. . Symptoms:
Anorexia, nausea, and vomiting, jaundice and hepatomegaly.
Symptoms are more intense for the more severely toxic patient.
Recovery from acute toxic hepatitis is rapid if the hepatotoxin is identified
early and removed.
• Recovery is unlikely if there is a prolonged period between exposure and
onset of symptoms. There are no effective antidotes.
• Vomiting may be persistent, with the emesis containing blood. Clotting
abnormalities may be severe, and hemorrhages may appear under the skin.
• Delirium, coma, and seizures develop, and within a few days the patient
may die of fulminant hepatic failure.
• Therapy is directed toward restoring and maintaining fluid and electrolyte
balance, blood replacement, and comfort and supportive measures.
11-06-2021 53
54. .
Acetaminophen,
Isoniazid,
Halothane,
Certain antibiotics,
Antimetabolites,
Medications used to treat rheumatic and musculoskeletal disease,
Antidepressants, psychotropic medications, anticonvulsants, and
Inhalational agents of the halothane family are metabolized by the liver and excreted in
bile. These volatile anaesthetics may also decrease hepatic blood flow. Halothane
hepatitis is a dreaded but rare complication of halothane administration
Isoflurane is considered the anaesthetic agent of choice in patients with liver disease.
DRUG INDUCED HEPATITIS
11-06-2021 54
More than 900
drugs, toxins and
herbs
55. .
Risk factors:
■ Females
■ Old Age
■ Alcoholic or Liver disease
■ Comorbidities such as AIDS, TB, ARF, DM, etc.
Symptoms:
Usually the onset is abrupt, with chills, fever, rash, pruritus, arthralgia, anorexia, and nausea.
Later, there may be jaundice and dark urine and an enlarged and tender liver.
When the offending medication is withdrawn, symptoms may gradually subside.
However, reactions may be severe and even fatal, even though the medication is stopped.
If fever, rash, or pruritus occurs from any medication, its use should be stopped immediately.
A short course of high-dose corticosteroids may be used in patients with severe hypersensitivity.
Liver transplantation
11-06-2021 55
56. AUTOIMMUNE HEPATITIS
.
■ It is a chronic inflammation of the liver of unknown cause
■ Majority of patients are women.
■ It is characterized by the presence of autoantibodies.
■ There is an autoimmune reaction against normal hepatocytes.
■ Type 1 and type 2 are the two types of autoimmune hepatitis.
Diagnosis:
■ serological markers such as antinuclear antibodies, anti-DNA antibodies.
Treatment:
■ Prednisone, and azathioprine
■ Patient who does not respond to prednisone and azathioprine, cyclosporine,
budesonide, methotrexate are used.
11-06-2021 56
57. .
■ Alcoholic hepatitis is a disease, inflammatory condition of the liver caused
by heavy alcohol consumption over an extended period of time.
Diagnosis:
■ CBC, LFT, USG, CT scan, blood clotting test, liver biopsy.
Treatment:
■ Patients needs to stop drinking.
ALCOHOLIC HEPATITIS
11-06-2021 57
58. .
■ It is a part of non-alcoholic fatty liver disease (NAFLD)
■ It is a condition where fat builds up in the liver not due to alcohol
consumption.
■ It is the inflammation and liver cell damage along with fat in liver.
■ It is a serious condition that results in cirrhosis, hepatocellular cancer, liver
failure.
Risk factors
Obesity
DM
HTN
Hyperlipidemia
NON ALCOHOLIC STEATOHEPATITIS (NASH)
11-06-2021 58
59. .
Clinical findings
Elevated liver enzymes, Liver biopsy, liver scan, CT scan, and USG.
Treatment :
There is no definitive treatment and therapy is directed at reduction of risk
factors
Treat diabetes, weight reduction and management of hyperlipidemia.
11-06-2021 59
62. Nursing assessment
Assess for systemic and liver related symptoms
Obtain history such as IV drug use, sexual activity, travel and ingestion of
possible contaminated food or water to assess for any mode of transmission
of the virus
Assess size and texture of liver to detect enlargement or characteristics of
cirrhosis
Obtain vital signs.
11-06-2021 62
63. 1. Imbalanced nutrition less than body requirements related
to the effects of liver dysfunction
Encourage small frequent feedings of high calorie, low fat diet.
Avoid large quantities of protein during acute phase of illness
Encourage taking pleasing meals in an environment with minimal noxious
stimuli
Administer or teach self-administration of antiemetics as prescribed.
Encourage eating meals in a sitting position to decrease pressure on the
liver.
11-06-2021 63
64. 2. Deficient fluid volume related to nausea and vomiting
Monitor intake and output
Provide frequent oral fluids as tolerated.
Administer IV fluids for patients with inability to maintain oral fluids
11-06-2021 64
65. 3. Activity intolerance related to anorexia and liver
dysfunction
Promotes periods of rest during symptom producing phase
provide emotional support and diversional activities
encourage gradual resumption of activities and mild exercise during
convalescent period
promote comfort by administering analgesics and prescribed.
11-06-2021 65
66. 4. risk for injury related to coagulopathy because of impaired
liver function
Monitor and teach patient to monitor and report sign of bleeding
Monitor PT and administer Vitamin K as ordered.
Avoid trauma that may cause bruising.
11-06-2021 66
67. 5. Risk of disease transmission related to unhygienic
practices
Stress importance of proper public and home sanitation and proper
preparation of foods
Encourage specific protection for close contacts such as immune globulin
as soon as possible to household contact of HAV
HBIG as soon as possible to blood or body fluids contact of HBV patients,
followed by HBV vaccine series
Explain precautions to patient and family about transmission and
prevention of transmission
11-06-2021 67
68. 6. Disturbed thought process related to complication such as
hepatic encephalopathy
Monitor for signs of encephalopathy
Monitor for worsening of condition from stupor to coma
Maintain calm, quite environment and reorient patient as needed.
11-06-2021 68
70. .
■ As discussed throughout the presentation, hepatitis is defined as the
inflammation of liver. Hepatitis can be further classified as viral and
non-viral hepatitis. Viral hepatitis includes hepatitis A, B, C, D, E and G
and non-viral hepatitis that are caused due to medications include toxic
hepatitis and drug induced hepatitis.
■ Nurses can also counsel the patients and their family for various options
available in treatment for hepatitis.
11-06-2021 70
CONCLUSION
71.
72. .
Brunner & Suddarth’s. Textbook of Medical Surgical. 13th edition Volume-2. New
Delhi: Wolters Kluwer;2015; Page no. 1349-1353
Lewis’s. Textbook of Medical-SurgicalNursing.11thEditionVolum 2. Chintamani
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