Definition of Hepatitis
Hepatitis is a widespread inflammation of the liver that results in degeneration and necrosis of liver cells. Inflammation of the liver can be due to bacterial invasion, injury by physical or toxic chemical agents (e.g., drugs, alcohol, industrial chemicals), viral infections (hepatitis A, B, C, D, E, G), or autoimmune response.
Although most hepatitis is self-limiting, approximately 20% of acute hepatitis B and 50% of hepatitis C cases progress to a chronic state or cirrhosis and can be fatal.
Nursing Care Plan for Hepatitis
Nursing Care Plan for Hepatitis: Nursing Priorities & Discharge Goals
Nursing Priorities| Nursing Care Plan for Hepatitis
- Reduce demands on liver while promoting physical well-being.
- Prevent complications.
- Enhance self-concept, acceptance of situation.
- Provide information about disease process, prognosis, and treatment needs.
Discharge Goals | Nursing Care Plan for Hepatitis
- Meeting basic self-care needs.
- Complications prevented/minimized.
- Dealing with reality of current situation.
- Disease process, prognosis, and therapeutic regimen understood.
- Plan in place to meet needs after discharge.
Nursing Care Plan for Hepatitis: Nursing Diagnosis
Nursing Care Plan for Hepatitis: Nursing Diagnosis of Hepatitis
- Fatigue May be related to Decreased metabolic energy production; States of discomfort; Altered body chemistry (e.g., changes in liver function, effect on target organs).
Nursing Care Plan for Hepatitis: Nursing Intervention for Hepatitis with Rationale
Energy Management (NIC)
Nursing Intervention for Hepatitis: Independent
- Promote bedrest/chair (recliner) rest during toxic state. Provide quiet environment; limit visitors as needed. Rationale: Promotes rest and relaxation. Available energy is used for healing. Activity and an upright position are believed to decrease hepatic blood flow, which prevents optimal circulation to the liver cells.
- Recommend changing position frequently. Provide/instruct caregiver in good skin care. Rationale: Promotes optimal respiratory function and minimizes pressure areas to reduce risk of tissue breakdown.
- Do necessary tasks quickly and at one time as tolerated. Rationale: Allows for extended periods of uninterrupted rest.
- Determine and prioritize role responsibilities and alternative providers/possible community resources available, e.g., Meals and Wheels, homemaker/housekeeper services. Rationale: Promotes problem solving of most pressing needs of individual/family.
- Identify energy-conserving techniques, e.g., sitting to shower and brush teeth, planning steps of activity so that all needed materials are at hand, scheduling rest periods. Rationale: Helps minimize fatigue, allowing patient to accomplish more and feel better about self.
- Increase activity as tolerated, demonstrate passive/active ROM exercises. Rationale: Prolonged bedrest can be debilitating. This can be offset by limited activity alternating with rest periods.
- Encourage use of stress management techniques, e.g., progressive relaxation, visualization, guided imagery. Discuss appropriate diversional activities, e.g., radio, TV, reading. Rationale: Promotes relaxation and conserves energy, redirects attention, and may enhance coping.
- Monitor for recurrence of anorexia and liver tenderness/ enlargement. Rationale: Indicates lack of resolution/exacarbation of the disease, requiring further rest, change in therapeutic regimen.
Nursing Care Plan for Hepatitis: Nursing Intervention with Rationale.
Energy Management (NIC)
Nursing Intervention for Hepatitis: Collaborative
- Administer medications as indicated: sedatives, antianxiety agents, e.g., diazepam (Valium), lorazepam (Ativan). Rationale: Assists in managing required rest. Note: Use of barbiturates and antianxiety agents, such as prochlorperazine (Compazine) and chlorpromazine (Thorazine), is contraindicated because of hepatotoxic effects.
- Monitor serial liver enzyme levels. Rationale: Aids in determining appropriate levels of activity because premature increase in activity potentiates risk of relapse.
- Administer antidote or assist with inpatient procedures as indicated (e.g., lavage, catharsis, hyperventilation) depending on route of exposure. Rationale: Removal of causative agent in toxic hepatitis may limit degree of tissue involvement/damage.
Nursing Care Plan for Hepatitis: Overview; Nursing Care Plan for Hepatitis: Nursing Priorities & Discharge Goals; Nursing Care Plan for Hepatitis: Nursing Diagnosis; Nursing Care Plan for Hepatitis: Nursing Intervention with Rationale. Nursing Care Plan for Hepatitis
