Pathophysiology
Inflammation of the liver caused by direct cellular injury and secondary injury by the immune
response; those with a lesser immune response may become carriers rather than infected.
Hepatitis A (HAV): Spread by the oral-fecal route.
Hepatitis B (HBV; often coexistent with hepatitis D [HDV]): Spread by blood and body fluids.
Hepatitis C (HCV): Spread by contact with contaminated blood, IV drug use, unprotected sex.
Hepatitis E (HEV): Spread by contaminated water.
Assessment and Diagnostic Findings
Preicteric phase: Weeks to months depending on type; characterized by malaise, lethargy, nausea,
vomiting.
Icteric phase: Characterized by jaundice, pale stools, dark tea-colored urine, and rashes.
↑ ALT and AST, ↑ bilirubin, presence of virusspecific antigen, prothrombin time >11.6 seconds, ↑ ESR, ↑ serum ammonia levels, abnormal hepatocytes revealed through liver biopsy.
Complications
Acute or chronic liver failure and encephalopathy.
Hemorrhage; liver cancer.
Medical Care and Surgical Treatment
Avoid hepatotoxic medications like acetaminophen.
Bedrest; avoid injections to prevent hemorrhage.
Small, frequent meals that contain high calories,
high protein (titrate protein to ammonia levels),
low sodium, and moderate fluid intake.
Immunoglobulin therapy on exposure; hepatitis A and B vaccination for prevention.
Keep in Mind
Teach client dietary regimen, to rest, and avoid hepatotoxic substances.
Report confusion, asterixis, abdominal distention, or edema of legs/feet.
Inflammation of the liver caused by direct cellular injury and secondary injury by the immune
response; those with a lesser immune response may become carriers rather than infected.
Hepatitis A (HAV): Spread by the oral-fecal route.
Hepatitis B (HBV; often coexistent with hepatitis D [HDV]): Spread by blood and body fluids.
Hepatitis C (HCV): Spread by contact with contaminated blood, IV drug use, unprotected sex.
Hepatitis E (HEV): Spread by contaminated water.
Assessment and Diagnostic Findings
Preicteric phase: Weeks to months depending on type; characterized by malaise, lethargy, nausea,
vomiting.
Icteric phase: Characterized by jaundice, pale stools, dark tea-colored urine, and rashes.
↑ ALT and AST, ↑ bilirubin, presence of virusspecific antigen, prothrombin time >11.6 seconds, ↑ ESR, ↑ serum ammonia levels, abnormal hepatocytes revealed through liver biopsy.
Complications
Acute or chronic liver failure and encephalopathy.
Hemorrhage; liver cancer.
Medical Care and Surgical Treatment
Avoid hepatotoxic medications like acetaminophen.
Bedrest; avoid injections to prevent hemorrhage.
Small, frequent meals that contain high calories,
high protein (titrate protein to ammonia levels),
low sodium, and moderate fluid intake.
Immunoglobulin therapy on exposure; hepatitis A and B vaccination for prevention.
Keep in Mind
Teach client dietary regimen, to rest, and avoid hepatotoxic substances.
Report confusion, asterixis, abdominal distention, or edema of legs/feet.