note for Bsc. Nursing
Case scenario
The physical exam of a male patient in ED revealed a well-nourished and five days of progressive fatigue and flu-like symptoms.
He also admitted to having produced clay colored stool, dark urine, subjective fevers, and nausea.The patient was alert and oriented.
Further examination revealed prominent bilateral yellow discoloration of the eyes (i.e., scleral icterus) and abdominal examination demonstrated a mildly distended abdomen with mild tenderness in the right upper quadrant.
UNIT-1Medical Disorders Of GI and Hepatobiliary SystemHEPATITIS
Ms. Rina Karki
Lecturer
Medical Surgical Nursing
PRE-TEST
All hepatitis viruses are RNA viruses except
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Which hepatitis virus causes chronic hepatocarcinoma?
Hepatitis C
Hepatitis D
Hepatitis E
Hepatitis G
Review Anatomy and Physiology of Hepatobiliary System
Introduction to Hepatitis
Greek word i.e. "Hepat" means "liver" and "itis" meaning "inflammation".
An inflammatory condition of the liver caused by a variety of infectious and noninfectious agents.
Self-limiting, healing on its own or can progress to scarring of the liver and can be fatal
Causes of Hepatitis
Infectious cause
bacteria, fungi, protozoa
Noninfectious agents
Causes…
Autoimmune cause
Types of Hepatitis
Acute and chronic hepatitis:
Acute: Infection lasts for 6 months. Hepatitis A and E
Chronic: Infection lasts longer than 6 months Hepatitis B
Toxic and drug-induced hepatitis
Obstructive hepatitis
Ischemic hepatitis
Types of Hepatitis…
5. Viral hepatitis
Types of Hepatitis
Types of Hepatitis
Types of Hepatitis…
Hepatitis E
Water borne Virus
Transmitted through Faecal-oral route
IP: 15-65 days.
Hepatitis G
Caused by Hep G virus (HGV)
common in HCV infected patient
Transmitted through blood, needles, body fluids.
IP: Unknown
Types of Hepatitis…
Pathophysiology
Clinical Features of Hepatitis
Acute condition: Low-grade fever is common hepatitis A and E. Hepatitis B is associated with a serum sickness–like syndrome (fever of 39.5° C to 40° C.)
Clinical Features …acute condition…
Clinical Features …chronic condition…
Persistent fatigue
Jaundice
weight loss
gastrointestinal bleeding
Ascitis
Pitting edema
bruisisng
Diagnostic Evaluation
Management of Hepatitis
Medical management and nursing management
Management of Hepatitis…Medical Management
Management of Hepatitis…Medical Management…
Poisoning mamangement example
Management of Hepatitis…Nursing Management
Nursing Management…Nursing Diagnosis
Nursing Management…
Nursing Management…
Management of Hepatitis…Nursing Management
Preventive Measures of Hepatitis
Personal Hygiene
Screening of food handling places and food handlers
screening of blood donors and skin piercing instruments
Preventive Measures…
Use safer sex
Community health education program.
Preventive Measures…
Hep A
Immunization of children (1-18 years of age) consists of 2 or 3 doses of the vaccin
This document discusses Hirschsprung disease, a genetic birth defect where nerve cells are absent from parts of the colon. This causes blockages and requires surgery. The case study involves a 13-month-old boy with chronic constipation concerning for Hirschsprung's. Research shows patients have altered gut microbiomes with more inflammation-linked bacteria. Studies found probiotic supplementation reduced incidence and severity of a common post-surgery complication called enterocolitis. Breastfeeding was also protective through its effects on the microbiome.
The document outlines plans for a Clinical Nutrition Specialist Program in 2025 that will uphold ethical standards, meet competence requirements, contribute to nutrition research, and provide high quality clinical nutrition services. The program aims to be a leading center of excellence and will provide comprehensive clinical training encompassing scientific, medical, and service aspects of nutrition.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Fazlina Binti Mohamed Yusoff, Family Medicine Specialist at Klinik Kesihatan (Health Clinic) Anika, Klang, Selangor, Malaysia.
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
Management of mild covid infection in pregnancy Niranjan Chavan
The document provides guidelines for managing mild COVID-19 infection in pregnancy. It discusses the clinical presentation of mild infection, recommendations for home isolation and monitoring, and guidance on antepartum, intrapartum, postpartum care and breastfeeding. Key points include managing asymptomatic cases through teleconsultation, monitoring for danger signs requiring admission, and making delivery decisions based on obstetric rather than COVID-19 status alone.
Types of hepatitis
HEPATITIS - symptoms
How To Diagnose Hepatitis?
Treatment
Main Prevention Measures for Hepatitis B and C
Hepatitis in Pregnant Women
Oral Manifestations of Hepatitis
Management of patients with hepatitis B and C infection in dental office
Pelvic Inflammatory Disease CDC, 2010 European Guidelines, 2012Aboubakr Elnashar
Pelvic inflammatory disease (PID) is an inflammatory condition of the female upper genital tract that can include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. Diagnosis is difficult as symptoms are often mild and non-specific. Empiric antibiotic treatment is recommended if PID is suspected based on risk factors and pelvic examination findings of cervical motion, uterine, or adnexal tenderness. Common antibiotic regimens include doxycycline with ceftriaxone or clindamycin with gentamicin for inpatient treatment, or azithromycin alone or with metronidazole for outpatient management. Complications can include tubo-
Hepatitis (viral and non viral types) ppt slidesharesonam
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.
This document describes the case of a 96-year-old female patient (L.S.W.) who was given multiple courses of antibiotics, putting her at risk of Clostridium difficile infection. She was later diagnosed with C. difficile diarrhea after developing persistent diarrhea in the hospital. The document then provides details on the epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of C. difficile infection.
This document discusses Hirschsprung disease, a genetic birth defect where nerve cells are absent from parts of the colon. This causes blockages and requires surgery. The case study involves a 13-month-old boy with chronic constipation concerning for Hirschsprung's. Research shows patients have altered gut microbiomes with more inflammation-linked bacteria. Studies found probiotic supplementation reduced incidence and severity of a common post-surgery complication called enterocolitis. Breastfeeding was also protective through its effects on the microbiome.
The document outlines plans for a Clinical Nutrition Specialist Program in 2025 that will uphold ethical standards, meet competence requirements, contribute to nutrition research, and provide high quality clinical nutrition services. The program aims to be a leading center of excellence and will provide comprehensive clinical training encompassing scientific, medical, and service aspects of nutrition.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Fazlina Binti Mohamed Yusoff, Family Medicine Specialist at Klinik Kesihatan (Health Clinic) Anika, Klang, Selangor, Malaysia.
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
Management of mild covid infection in pregnancy Niranjan Chavan
The document provides guidelines for managing mild COVID-19 infection in pregnancy. It discusses the clinical presentation of mild infection, recommendations for home isolation and monitoring, and guidance on antepartum, intrapartum, postpartum care and breastfeeding. Key points include managing asymptomatic cases through teleconsultation, monitoring for danger signs requiring admission, and making delivery decisions based on obstetric rather than COVID-19 status alone.
Types of hepatitis
HEPATITIS - symptoms
How To Diagnose Hepatitis?
Treatment
Main Prevention Measures for Hepatitis B and C
Hepatitis in Pregnant Women
Oral Manifestations of Hepatitis
Management of patients with hepatitis B and C infection in dental office
Pelvic Inflammatory Disease CDC, 2010 European Guidelines, 2012Aboubakr Elnashar
Pelvic inflammatory disease (PID) is an inflammatory condition of the female upper genital tract that can include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. Diagnosis is difficult as symptoms are often mild and non-specific. Empiric antibiotic treatment is recommended if PID is suspected based on risk factors and pelvic examination findings of cervical motion, uterine, or adnexal tenderness. Common antibiotic regimens include doxycycline with ceftriaxone or clindamycin with gentamicin for inpatient treatment, or azithromycin alone or with metronidazole for outpatient management. Complications can include tubo-
Hepatitis (viral and non viral types) ppt slidesharesonam
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.
This document describes the case of a 96-year-old female patient (L.S.W.) who was given multiple courses of antibiotics, putting her at risk of Clostridium difficile infection. She was later diagnosed with C. difficile diarrhea after developing persistent diarrhea in the hospital. The document then provides details on the epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of C. difficile infection.
Napa County Public Health is holding a tabletop exercise on 10/28/13 to discuss the response to an e. Coli outbreak. This is in conjunction with the CA Dept of Public Health and anticipation of the upcoming statewide functional exercise. Slides prepared by The Abaris Group
March 192015talkforresidents final03232015 (1)katejohnpunag
This document provides an update on viral hepatitis and discusses two case studies. It begins by describing a 71-year-old male presenting with jaundice who is diagnosed with acute hepatitis A infection based on a reactive HAV IgM test. It then reviews hepatitis A virus and the diagnosis and management of acute hepatitis A. The second case discusses a 26-year-old male diagnosed with chronic hepatitis B infection based on positive HBsAg, anti-HBc IgM, and HBV DNA tests. The document concludes by discussing chronic hepatitis B infection and approved treatments.
A 45-year-old woman presented with fatigue, weakness, and appetite loss. Laboratory tests found elevated liver enzymes, bilirubin, and HCV RNA. A liver biopsy showed severe inflammation and fibrosis. She was diagnosed with hepatitis C based on her history of blood transfusion and laboratory results. Treatment with antiviral therapy is recommended to prevent further liver damage from the hepatitis C infection.
Health visitor screening and immunisation awareness eventPHEScreening
The document provides an overview of screening and immunisation programs in the UK, including:
1) It describes the roles and responsibilities of the Screening Quality Assurance Service (SQAS) and Screening and Immunisation Team (SIT) in monitoring quality, compliance, and supporting local screening programs.
2) It outlines several screening programs including newborn blood spot screening, newborn hearing screening, newborn physical examination, and infectious disease screening in pregnancy.
3) It discusses immunisation programs and notes the conditions screened for including various metabolic disorders and infectious diseases. Performance monitoring and incident reporting are also addressed.
- LIVER DISORDERS - HEPATITIS helo hi hello hiharvynabatar2
This document discusses various types of liver disorders, focusing on different types of hepatitis. It defines hepatitis as inflammation of the liver cells caused by viral, drug, or bacterial factors. It then proceeds to describe each type of viral hepatitis (A, B, C, D, E) in terms of causative agent, mode of transmission, risk factors, clinical manifestations, diagnosis, prevention, treatment, and prognosis. For each type, it provides a brief overview and comparison. The goal is to help students understand liver functions and dysfunctions, liver tests, manifestations of liver disease, and care approaches for hepatitis and cirrhosis.
The document discusses World AIDS Day which is held annually on December 1st to raise awareness about HIV/AIDS and show support for those living with the disease. It provides information about the themes, transmission, stages of HIV infection, testing, and treatment. The document also outlines the goals of increasing HIV testing and treatment to work towards eliminating HIV/AIDS by 2030.
Program Hepatitis B Di Kalangan Anggota KKMHCY 7102
The document discusses hepatitis B and the hepatitis B immunization program for members of the Malaysian Ministry of Health (KKM). It describes hepatitis B as an infectious liver disease caused by the hepatitis B virus. While some infected people recover within 6 months, children under 6 who become infected are most likely to develop chronic infections. The immunization program aims to ensure KKM members at risk of hepatitis B infection are protected through vaccination. It involves vaccinating those who have not completed the 3-dose hepatitis B vaccine series and testing the immune response of those who already received vaccination.
4. Samir Dervisevic hepatitis b antenatal screening algorithms and reportingPHEScreening
This document discusses hepatitis B screening algorithms and reporting for pregnant women in the UK. It provides background on the national screening program and standards for viral hepatitis B screening during pregnancy. The goals of antenatal hepatitis B screening are early detection of infection to enable treatment for the mother and reduce mother-to-child transmission risk by offering newborn vaccination and prophylaxis. The document reviews epidemiology data on acute hepatitis B cases in Europe and England and outlines the clinical outcome and diagnosis of hepatitis B infection through various serological markers. It presents the hepatitis B testing algorithm and provides clinical comments for reporting screening test results.
Viral hepatitis :- Pathophsiology of Hepatitis BSHIVPAL
This document summarizes the pathophysiology of viral hepatitis. It describes the main hepatitis viruses (A, B, C, D, E), their epidemiology, symptoms, structure, diagnosis and treatment. Over 1.3 million people die each year from hepatitis B and C infections. The viruses are transmitted through bodily fluids and cause inflammation of the liver. Diagnosis involves liver function tests and detecting viral markers in blood. Treatment depends on the virus but may include antiviral drugs and vaccination.
PELVIC INFLAMMATORY DISEASE (PID)
This presentation is prepared as a case based discussion.
References include American Academy of Family Physicians AAFP
I WOULD LIKE TO DEDICATE SPECIAL THANKS TO
DR ALI AL KHALAF FOR REVISING THIS MATERIAL
GASTROINTESTINAL ABDOMINAL ASSESSMENTS AND LABSMeegsEstabillo2
This document provides an overview for a simulation on caring for a patient with hepatitis C. It reviews appropriate infection control measures including standard precautions like hand hygiene and personal protective equipment. It discusses hepatitis C transmission and complications like cirrhosis and ascites. Learning objectives include demonstrating an abdominal assessment, obtaining and handling lab specimens, and communicating effectively. The simulation case involves a 65-year-old male with hepatitis C presenting with abdominal discomfort and weight loss who requires an abdominal assessment and lab collection.
There are several types of viral hepatitis that primarily affect the liver and cause inflammation. The main types are hepatitis A, B, C, D, and E viruses. Hepatitis spreads through fecal-oral or direct contact with infected bodily fluids. Pakistan has a high prevalence of hepatitis B and C, with millions infected. Symptoms include fever, nausea, and jaundice. Complications can include chronic liver damage and liver cancer. Treatment focuses on symptoms and vaccines exist for hepatitis A and B.
JR_Digestive_Kelompok 2_Acute Hepatitis of Unknown Cause.pptrenno5
This document summarizes a case series of 44 children in the UK who presented with acute hepatitis of unknown cause between January and April 2022. The majority (86%) spontaneously improved, while 6 children (14%) experienced acute liver failure requiring transplantation. Human adenovirus was detected via molecular testing in 90% of cases tested. While the exact cause remains unclear, a working hypothesis is an abnormal immune response to a common virus like adenovirus in the context of reduced exposure during pandemic lockdowns. Ongoing investigation is needed to better understand the natural history and immune mechanisms involved.
This document discusses the evaluation and management of fever without a source in children. It defines fever of unknown origin and provides background on the incidence and common causes. Guidelines are presented for evaluation and treatment based on a child's age, appearance, and vital signs. For children who appear well, testing and treatment depends on factors like temperature and white blood cell count. Toxic-appearing children should receive a full evaluation and empiric antibiotics in the hospital. The importance of careful evaluation and follow-up is discussed to avoid potential medical/legal issues.
This case presentation discusses a 30-year old female patient with diabetic foot ulcer on the right foot. She has a history of type 2 diabetes for 9 years and a burn on her right great toe that developed into an ulcer and was later amputated. Her laboratory investigations show hyperglycemia, proteinuria, and pseudomonas infection in the foot ulcer culture. Her treatment includes antibiotics, insulin, oral hypoglycemics, wound dressing, and patient education on foot care and diabetes management to prevent recurrence.
This document discusses HIV-associated wasting and gastrointestinal opportunistic infections. It begins with an index case of a 28-year-old female diagnosed with HIV two weeks prior who presents with weight loss, diarrhea, cough, and oral thrush. The document then reviews the epidemiology, etiology, clinical presentation, diagnosis, and treatment of HIV-associated wasting and common GI opportunistic infections like candidiasis, cytomegalovirus, and Pneumocystis jirovecii pneumonia. Key findings from the patient's history, exam, and labs are also presented, assessing her for conditions like anemia, candidiasis, and likely PJP.
This document provides information about hepatitis. It defines hepatitis as inflammation of the liver and outlines several causes including bacteria, toxins, autoimmune disorders, and viruses. It describes two classifications of hepatitis as acute (lasting 1-4 months) or chronic (for life). The pathophysiology and clinical manifestations of toxic, autoimmune, and viral hepatitis are explained. Management of the different types focuses on identifying and removing toxic agents, using corticosteroids and antiviral drugs, and providing supportive care. Nursing management addresses potential problems like altered nutrition and includes educating patients about their condition. Prevention emphasizes good hygiene, immunizations, and safe sexual practices to avoid contracting viral hepatitis.
Napa County Public Health is holding a tabletop exercise on 10/28/13 to discuss the response to an e. Coli outbreak. This is in conjunction with the CA Dept of Public Health and anticipation of the upcoming statewide functional exercise. Slides prepared by The Abaris Group
March 192015talkforresidents final03232015 (1)katejohnpunag
This document provides an update on viral hepatitis and discusses two case studies. It begins by describing a 71-year-old male presenting with jaundice who is diagnosed with acute hepatitis A infection based on a reactive HAV IgM test. It then reviews hepatitis A virus and the diagnosis and management of acute hepatitis A. The second case discusses a 26-year-old male diagnosed with chronic hepatitis B infection based on positive HBsAg, anti-HBc IgM, and HBV DNA tests. The document concludes by discussing chronic hepatitis B infection and approved treatments.
A 45-year-old woman presented with fatigue, weakness, and appetite loss. Laboratory tests found elevated liver enzymes, bilirubin, and HCV RNA. A liver biopsy showed severe inflammation and fibrosis. She was diagnosed with hepatitis C based on her history of blood transfusion and laboratory results. Treatment with antiviral therapy is recommended to prevent further liver damage from the hepatitis C infection.
Health visitor screening and immunisation awareness eventPHEScreening
The document provides an overview of screening and immunisation programs in the UK, including:
1) It describes the roles and responsibilities of the Screening Quality Assurance Service (SQAS) and Screening and Immunisation Team (SIT) in monitoring quality, compliance, and supporting local screening programs.
2) It outlines several screening programs including newborn blood spot screening, newborn hearing screening, newborn physical examination, and infectious disease screening in pregnancy.
3) It discusses immunisation programs and notes the conditions screened for including various metabolic disorders and infectious diseases. Performance monitoring and incident reporting are also addressed.
- LIVER DISORDERS - HEPATITIS helo hi hello hiharvynabatar2
This document discusses various types of liver disorders, focusing on different types of hepatitis. It defines hepatitis as inflammation of the liver cells caused by viral, drug, or bacterial factors. It then proceeds to describe each type of viral hepatitis (A, B, C, D, E) in terms of causative agent, mode of transmission, risk factors, clinical manifestations, diagnosis, prevention, treatment, and prognosis. For each type, it provides a brief overview and comparison. The goal is to help students understand liver functions and dysfunctions, liver tests, manifestations of liver disease, and care approaches for hepatitis and cirrhosis.
The document discusses World AIDS Day which is held annually on December 1st to raise awareness about HIV/AIDS and show support for those living with the disease. It provides information about the themes, transmission, stages of HIV infection, testing, and treatment. The document also outlines the goals of increasing HIV testing and treatment to work towards eliminating HIV/AIDS by 2030.
Program Hepatitis B Di Kalangan Anggota KKMHCY 7102
The document discusses hepatitis B and the hepatitis B immunization program for members of the Malaysian Ministry of Health (KKM). It describes hepatitis B as an infectious liver disease caused by the hepatitis B virus. While some infected people recover within 6 months, children under 6 who become infected are most likely to develop chronic infections. The immunization program aims to ensure KKM members at risk of hepatitis B infection are protected through vaccination. It involves vaccinating those who have not completed the 3-dose hepatitis B vaccine series and testing the immune response of those who already received vaccination.
4. Samir Dervisevic hepatitis b antenatal screening algorithms and reportingPHEScreening
This document discusses hepatitis B screening algorithms and reporting for pregnant women in the UK. It provides background on the national screening program and standards for viral hepatitis B screening during pregnancy. The goals of antenatal hepatitis B screening are early detection of infection to enable treatment for the mother and reduce mother-to-child transmission risk by offering newborn vaccination and prophylaxis. The document reviews epidemiology data on acute hepatitis B cases in Europe and England and outlines the clinical outcome and diagnosis of hepatitis B infection through various serological markers. It presents the hepatitis B testing algorithm and provides clinical comments for reporting screening test results.
Viral hepatitis :- Pathophsiology of Hepatitis BSHIVPAL
This document summarizes the pathophysiology of viral hepatitis. It describes the main hepatitis viruses (A, B, C, D, E), their epidemiology, symptoms, structure, diagnosis and treatment. Over 1.3 million people die each year from hepatitis B and C infections. The viruses are transmitted through bodily fluids and cause inflammation of the liver. Diagnosis involves liver function tests and detecting viral markers in blood. Treatment depends on the virus but may include antiviral drugs and vaccination.
PELVIC INFLAMMATORY DISEASE (PID)
This presentation is prepared as a case based discussion.
References include American Academy of Family Physicians AAFP
I WOULD LIKE TO DEDICATE SPECIAL THANKS TO
DR ALI AL KHALAF FOR REVISING THIS MATERIAL
GASTROINTESTINAL ABDOMINAL ASSESSMENTS AND LABSMeegsEstabillo2
This document provides an overview for a simulation on caring for a patient with hepatitis C. It reviews appropriate infection control measures including standard precautions like hand hygiene and personal protective equipment. It discusses hepatitis C transmission and complications like cirrhosis and ascites. Learning objectives include demonstrating an abdominal assessment, obtaining and handling lab specimens, and communicating effectively. The simulation case involves a 65-year-old male with hepatitis C presenting with abdominal discomfort and weight loss who requires an abdominal assessment and lab collection.
There are several types of viral hepatitis that primarily affect the liver and cause inflammation. The main types are hepatitis A, B, C, D, and E viruses. Hepatitis spreads through fecal-oral or direct contact with infected bodily fluids. Pakistan has a high prevalence of hepatitis B and C, with millions infected. Symptoms include fever, nausea, and jaundice. Complications can include chronic liver damage and liver cancer. Treatment focuses on symptoms and vaccines exist for hepatitis A and B.
JR_Digestive_Kelompok 2_Acute Hepatitis of Unknown Cause.pptrenno5
This document summarizes a case series of 44 children in the UK who presented with acute hepatitis of unknown cause between January and April 2022. The majority (86%) spontaneously improved, while 6 children (14%) experienced acute liver failure requiring transplantation. Human adenovirus was detected via molecular testing in 90% of cases tested. While the exact cause remains unclear, a working hypothesis is an abnormal immune response to a common virus like adenovirus in the context of reduced exposure during pandemic lockdowns. Ongoing investigation is needed to better understand the natural history and immune mechanisms involved.
This document discusses the evaluation and management of fever without a source in children. It defines fever of unknown origin and provides background on the incidence and common causes. Guidelines are presented for evaluation and treatment based on a child's age, appearance, and vital signs. For children who appear well, testing and treatment depends on factors like temperature and white blood cell count. Toxic-appearing children should receive a full evaluation and empiric antibiotics in the hospital. The importance of careful evaluation and follow-up is discussed to avoid potential medical/legal issues.
This case presentation discusses a 30-year old female patient with diabetic foot ulcer on the right foot. She has a history of type 2 diabetes for 9 years and a burn on her right great toe that developed into an ulcer and was later amputated. Her laboratory investigations show hyperglycemia, proteinuria, and pseudomonas infection in the foot ulcer culture. Her treatment includes antibiotics, insulin, oral hypoglycemics, wound dressing, and patient education on foot care and diabetes management to prevent recurrence.
This document discusses HIV-associated wasting and gastrointestinal opportunistic infections. It begins with an index case of a 28-year-old female diagnosed with HIV two weeks prior who presents with weight loss, diarrhea, cough, and oral thrush. The document then reviews the epidemiology, etiology, clinical presentation, diagnosis, and treatment of HIV-associated wasting and common GI opportunistic infections like candidiasis, cytomegalovirus, and Pneumocystis jirovecii pneumonia. Key findings from the patient's history, exam, and labs are also presented, assessing her for conditions like anemia, candidiasis, and likely PJP.
This document provides information about hepatitis. It defines hepatitis as inflammation of the liver and outlines several causes including bacteria, toxins, autoimmune disorders, and viruses. It describes two classifications of hepatitis as acute (lasting 1-4 months) or chronic (for life). The pathophysiology and clinical manifestations of toxic, autoimmune, and viral hepatitis are explained. Management of the different types focuses on identifying and removing toxic agents, using corticosteroids and antiviral drugs, and providing supportive care. Nursing management addresses potential problems like altered nutrition and includes educating patients about their condition. Prevention emphasizes good hygiene, immunizations, and safe sexual practices to avoid contracting viral hepatitis.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Hepatitis.pptx
1. Case scenario
•The physical exam of a male patient in ED
revealed a well-nourished and five days of
progressive fatigue and flu-like symptoms.
• He also admitted to having produced clay
colored stool, dark urine, subjective fevers, and
nausea.The patient was alert and oriented.
•Further examination revealed prominent bilateral
yellow discoloration of the eyes (i.e., scleral
icterus) and abdominal examination
demonstrated a mildly distended abdomen with
mild tenderness in the right upper quadrant.
9/30/2021 rina karki, medical surgical nursing 1
2. UNIT-1
Medical Disorders Of GI and
Hepatobiliary System
HEPATITIS
Ms. Rina Karki
Lecturer
Medical Surgical Nursing
3. PRE-TEST
• All hepatitis viruses are RNA viruses except
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
• Which hepatitis virus causes chronic hepatocarcinoma?
a. Hepatitis C
b. Hepatitis D
c. Hepatitis E
d. Hepatitis G
9/30/2021 rina karki, medical surgical nursing 3
4. Review Anatomy and Physiology of
Hepatobiliary System
9/30/2021 rina karki, medical surgical nursing 4
6. Introduction to Hepatitis
•Greek word i.e. "Hepat" means "liver" and "itis"
meaning "inflammation".
•An inflammatory condition of the liver caused
by a variety of infectious and noninfectious
agents.
•Self-limiting, healing on its own or can progress
to scarring of the liver and can be fatal
9/30/2021 rina karki, medical surgical nursing 6
7. Causes of Hepatitis
Infectious cause
•bacteria, fungi,
protozoa
Noninfectious agents
9/30/2021 rina karki, medical surgical nursing
Obstruction and ischemia
7
9. Types of Hepatitis
1. Acute and chronic hepatitis:
•Acute: Infection lasts for 6 months. Hepatitis A
and E
•Chronic: Infection lasts longer than 6 months
Hepatitis B
2. Toxic and drug-induced hepatitis
3. Obstructive hepatitis
4. Ischemic hepatitis
9/30/2021 rina karki, medical surgical nursing 9
10. Types of Hepatitis…
5. Viral hepatitis
9/30/2021 rina karki, medical surgical nursing
Hepatitis A,C,D,E,G: RNA virus
Hepatitis B: DNA virus
10
11. Types of Hepatitis
Types Mode of
transmission
Important note
Hepatitis A
IP: 15-50
Days
Avg: 30
days
Faeco-oral
route,
Person to
person contact,
Oro anal sex
Viruses excreted through faeces
for about 2 weeks before the
onset of jaundice and for up to
one week thereafter. (also
excreted in urine)
Hepatitis B
IP: 45-180
days
(Serum
hepatitis)
Avg: 60-
90days
Parenteral,
Sexual contact,
Perinatal
transmission
Risks group
?
9/30/2021 rina karki, medical surgical nursing 11
12. Types of Hepatitis
Types Mode of
transmission
Important note
Hepatitis C
(non A non B
hepatitis)
IP: 2-6
months
Avg: 6-7
weeks
Transfusion of
blood products,
Sexual contact.
Risk group
• Injection drug users
• Shared injection
equipment
• Blood transfusion
• tattoo, piercing
• Mother to child (<5%)
Hepatitis D IP: 21-140 days ;avg:35 days
Transmission, risk factors and precautions:
same as hepatitis B.
9/30/2021 rina karki, medical surgical nursing 12
13. Types of Hepatitis…
Hepatitis E
Water borne Virus
Transmitted through
Faecal-oral route
•IP: 15-65 days.
Hepatitis G
•Caused by Hep G virus
(HGV)
•common in HCV infected
patient
•Transmitted through
blood, needles, body
fluids.
•IP: Unknown
9/30/2021 rina karki, medical surgical nursing 13
14. Types of Hepatitis…
6. Fulminant hepatitis
severe liver failure developing within 8 weeks of
the onset of symptoms usually present with
coagulopathy and hepatic encephalopathy, which
may evolve into a deep coma.
9/30/2021 rina karki, medical surgical nursing 14
15. Pathophysiology
9/30/2021 rina karki, medical surgical nursing
Causative agents: Infection and
inflammation of the liver
Hepatocyte damage; alteration of liver
function
Acute hepatitis
persistence worsening then necrosis of the
liver
Chronic hepatitis leads to liver cirrhosis and
then hepatocellular carcinoma
15
17. Clinical Features of Hepatitis
9/30/2021 rina karki, medical surgical nursing
•Acute condition: Low-grade fever is common hepatitis A
and E. Hepatitis B is associated with a serum sickness–like
syndrome (fever of 39.5° C to 40° C.)
17
22. Management of Hepatitis…
Medical Management
9/30/2021 rina karki, medical surgical nursing
Bed rest
Isolation
• Nausea,vomiting: antiemetics
• Fever: sponging, antipyretics
• Pain: analgesics
• Anorexia-frequent small feeds, IV fluids with glucose
• Antihistamines
• Vitamin K:2.5-10 mg PO/SC
• Poisoning management to remove toxins
• Toxic and alcoholic hepatitis: folic acid, thiamine
Acute conditions require symptomatic management
22
23. Management of Hepatitis…
Medical Management…
9/30/2021 rina karki, medical surgical nursing
Chronic
hepatitis
Alfa-interferon: 180
mcg SC once weekly for
48 weeks
Lamivudine:chronic hep B;
dose: 100 mg orally OD
Adefovir: 10 mg orally
OD
Prednisolone:dose: 40 to
60 mg daily then
maintainance at 10
mg/day
Obstructive
condition
common bile
duct
exploration,
tumor removal
Liver cirrhosis and
hepatocellular
carcinoma
Liver
transplantation
23
25. Management of Hepatitis…
Nursing Management
Assessment :
• vital signs
• intake and output
• symptoms
• Lab values
Nursing diagnosis
-Acute pain related to inflammation
-Imbalanced nutrition less than body
requirements related to insufficient intake
to meet metabolic
demands: anorexia, nausea/vomiting
-Fatigue related to decreased metabolic
energy production
-Risk for deficient fluid volume
9/30/2021 rina karki, medical surgical nursing 25
26. Nursing Management…
Nursing Diagnosis
9/30/2021 rina karki, medical surgical nursing
Acute pain related to inflammation
Imbalanced nutrition less than body requirements
related to insufficient intake to meet metabolic
demands: anorexia, nausea/vomiting
Fatigue related to decreased metabolic energy
production
Risk for deficient fluid volume
Risk for infection
Risk for impaired skin integrity
26
27. Nursing Management…
Imbalanced nutrition less than body requirements related to
insufficient intake to meet metabolic
demands: anorexia, nausea/vomiting
Expected outcome: Initiate behaviors, lifestyle changes to
regain/maintain appropriate weight
• Monitor dietary intake and caloric count. Suggest several
small feedings.
• Encourage mouth care before meals.
• Consult with dietitian, nutritional support team to provide
diet according to patient’s needs, with fat and protein
intake as tolerated.
9/30/2021 rina karki, medical surgical nursing 27
28. Nursing Management…
Fatigue related to decreased metabolic energy
production
Expected outcome: Perform ADLs and participate
in desired activities at level of ability
• Institute bed red or chair rest during toxic state.
Provide quiet environment; limit visitors as
needed
• Increase activity as tolerated, demonstrate
passive or active ROM exercises
9/30/2021 rina karki, medical surgical nursing 28
29. Management of Hepatitis…
Nursing Management
Nursing care :
• Rest and quite activities
• Protect from injury.
• Stimulate appetite
• Standard precautions
• High CHO and protein diet
• Avoid alcohol.
• Low fat diet.
• Vitamin E and A
• Avoid hepatotoxic drugs
9/30/2021 rina karki, medical surgical nursing 29
30. 9/30/2021 rina karki, medical surgical nursing
Increased calorie to meet
the increased energy needs
for disease process, tissue
regeneration (Total: 2500-
3000 calories daily)
30
31. Preventive Measures of Hepatitis
•Personal Hygiene
•Screening of food
handling places and
food handlers
•screening of blood
donors and skin piercing
instruments
9/30/2021 rina karki, medical surgical nursing 31
33. Preventive Measures…
Hep A
• Immunization of children (1-18
years of age) consists of 2 or 3
doses of the vaccine.
• Adults: booster dose 6-12 months
following the initial dose of vaccine.
• Post-exposure : Immune Globulin
given within 2 weeks after
exposure for maximum protection.
9/30/2021 rina karki, medical surgical nursing 33
34. Preventive Measures…
Hep B
•Immunization schedule: 6, 10
and 14 weeks of birth. Adult
dose: 0, 1 month and 6 months
•HBsIg should be given within
24 months of exposure to
hepatitis B or as soon as
possible.
9/30/2021 rina karki, medical surgical nursing 34
36. Prognosis
• Hepatitis A and E: mild and self-limited
• 95% to 99% of otherwise healthy, immunocompetent
patients with acute hepatitis B recover completely.
• Acute hepatitis B and acute hepatitis D do not
necessarily have a more severe disease.
• Chronic hepatitis C follows acute infection in
approximately 85% of cases.
9/30/2021 rina karki, medical surgical nursing 36
38. References
1. Smeltzer SC, Bare B. Hinkle JL. Cheever KH. Brunner
and Suddhath’s-Textbook of Medical surgical Nursing. Vol
II. 12th edition. Philadelphia: Lippincott Williams and
Wilkins; 2010
2. White L, Duncan G and Baumle W. Medical-Surgical
Nursing- an integrated approach. 3rd edition. United
States: Delmar Cengages; 2013
3. W. S. Linda and H. D. Paula . Understanding Medical
Surgical Nursing. 4th edition. New Delhi: Japyee
Brother's Medical Publishers (p) Ltd. 2012
4. Hepatitis [Internet]. World Health Organization. World
Health Organization; [cited 2021Sep29]. Available from:
https://www.who.int/health-topics/hepatitis#tab=tab_1
9/30/2021 rina karki, medical surgical nursing 38
40. POST-TEST
• All hepatitis viruses are RNA viruses except
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
• Which hepatitis virus causes chronic hepatocarcinoma?
a. Hepatitis C
b. Hepatitis D
c. Hepatitis E
d. Hepatitis G
9/30/2021 rina karki, medical surgical nursing 40
41. 9/30/2021 rina karki, medical surgical nursing
1. List out the two potential nursing
diagnosis with interventions while caring
for patient with hepatitis.
41