The client with Viral Hepatitis for your nursing review.
The nurse is evaluating a client who is taking Lamivudine for chronic hepatitis B. (Epivir). What is the most critical information to convey to the physician?
A. The client’s daily report shows a 3 kg weight gain in two days.
B. The customer is experiencing nausea.
C. The client has an oral temperature of 99 degrees Fahrenheit.
D. The client is exhausted.
The correct answer is A. Fluid weight increase is a cause for worry, as the medicine should be administered with caution in patients with compromised renal function. Because the medicine is eliminated in the urine, dosage adjustments may be required in patients with renal insufficiency. Nausea, slight temperature increase, and exhaustion are all signs to keep an eye on if you have hepatitis.
Results
#1. While assessing a hepatitis patient, the nurse notices that the AST and ALT lab results have increased. Which of the following remarks by the client requires the nurse to provide additional instruction?
Acetaminophen is harmful to the liver and should be avoided by anyone who has liver problems. Resting for longer periods of time allows the liver to regenerate. To treat nausea, a low-fat, high-carbohydrate diet and dry toast are recommended.
#2. A study abroad program is being undertaken by a group of college freshmen. The nurse should instruct the pupils on the following topics when teaching them about hepatitis B:
Because hepatitis B is a sexually transmitted disease, students should follow safe sexual practices. Hepatitis A and E are spread due to poor hygienic conditions in developing countries. Hepatitis can be prevented by focusing on the channels of transmission and avoiding infection; isolation in single rooms is not required. Hepatitis D does not have a vaccination.
#3. During the icteric phase of viral hepatitis, which of the following is normal for a client?
Liver inflammation and blockage prevent bile from flowing normally. Excess bilirubin causes the skin and sclera to appear yellow, as well as the urine to become black and frothy. Anorexia nervosa is also frequent. Tarry stools are a sign of gastrointestinal bleeding and are not common in people with hepatitis. Hepatitis can cause light or clay-colored feces due to bile duct blockage. It would be uncommon to experience shortness of breath.
#4. The nurse is preparing a home visit for a hepatitis client. To prevent transmission, the nurse should emphasize the following:
The oral-fecal route is the most common route of infection for hepatitis A, with parenteral transmission being rare. Before eating or preparing food, wash your hands thoroughly. Hepatitis B, C, and D can all be transmitted through the skin. Chronic hepatitis B and C are treated with alpha-interferon.
CL: Synthesize; CN: Safety and infection control
#5. The nurse is putting together a care plan for a client who has viral hepatitis. The nurse should tell the client to do the following:
Hepatitis treatment consists mostly of bed rest with limited access to the restroom. During the acute period, bed rest is maintained to minimize metabolic demands on the liver, improving blood flow and supporting liver cell regeneration. When activity is progressively resumed, the client should be trained to take a break before becoming too exhausted. Although appropriate fluid intake is crucial, forcing fluids to treat hepatitis is not necessary. Hepatitis is not treated with antibiotics. Hepatitis does not cause electrolyte imbalances.
CL: Synthesize; CN: Basic care and comfort
#6. The nurse should check laboratory findings for which of the following abnormal laboratory values while planning care for a client with viral hepatitis?
Because of decreased absorption of vitamin K and decreased liver generation of prothrombin, the prothrombin time may be prolonged. The client’s bleeding tendencies should be properly examined. Hepatitis has no effect on blood glucose, potassium, or calcium levels in the blood.
CL: Analyze; CN: Reduction of danger possibility
#7. The client with viral hepatitis should be taught to
To promote liver rejuvenation, a client with hepatitis is advised to eat a low-fat, high-protein, high-carbohydrate diet. Because customers may be anorexic and lose weight, proper nutrition is essential. To increase hepatocyte growth, activity should be reduced and appropriate rest should be provided. It is important to avoid social isolation and to provide knowledge on how to prevent transmission.
CL: Synthesize; CN: Health Promotion and Maintenance
#8. The nurse creates a teaching plan for the client on how to prevent hepatitis A transmission. Which of the following discharge instructions do you think the client should follow?
The hepatitis A virus is spread by the feces-oral pathway. It spreads through contaminated hands, water, and food, with shellfish growing in contaminated water being the most common source. Hepatitis A is a concern for certain animal workers, notably those who work with monkeys. Hand washing on a regular basis is arguably the single most important preventive measure. Hepatitis A is not transmitted by insects. Family members are not required to remain away from the hepatitis patient. Food and clothing do not need to be disinfected.
CL: Synthesize; CN: Safety and infection control
#9. The nurse determines that the hepatitis patient is fatigued, weak, and has an overall feeling of malaise. During morning care, the client quickly becomes exhausted. Which of the following nursing diagnoses would be appropriate based on this information?
Activity intolerance with fatigue is the most accurate diagnosis for this client. The primary goal of hepatitis treatment is to gradually increase activity as tolerated. The plan of care should include periods of rest and activity that alternate. There is no evidence that the client is physically immobile, unable of self-care, or incapable of coping adequately.
CL: Analyze; CN: Basic care and comfort
#10. What is the best way for the nurse to respond to the client's acknowledged sentiments of isolation as a result of hepatitis?
The nurse should urge the client to express their feelings of isolation in more detail. Rather than dismissing these thoughts or making assumptions about the source of isolation, the nurse should encourage clients to express their concerns and educate them on how to avoid illness transmission.
CL: Synthesize; CN: Psychosocial adaptation