Adult Nursing Viral Hepatitis Lecture 5 PDF

Adult Nursing Viral Hepatitis Instructor: Karzan M Khursheed Kalar Technical institute Nursing Dept. Lecture : 5 Theory Stage 2nd / semester 1st  Anatomy and Function of the Liver Anatomy:- The liver is located in the upper right part of the abdomen, just below the diaphragm...

Adult Nursing Viral Hepatitis Instructor: Karzan M Khursheed Kalar Technical institute Nursing Dept. Lecture : 5 Theory Stage 2nd / semester 1st  Anatomy and Function of the Liver Anatomy:- The liver is located in the upper right part of the abdomen, just below the diaphragm. It is divided into several lobes and is responsible for a wide range of vital functions. Functions:- The liver plays a crucial role in metabolism, storage, and detoxification, helping to process nutrients, filter out harmful substances, and produce essential proteins. Hepatitis:- refers to the inflammation of the liver, caused by various factors such as viral infections, autoimmune disorders, or excessive alcohol consumption. -Hepatitis refers to an 1. Acute viral hepatitis: symptom last less than 6 month. 2. Chronic viral hepatitis : inflammation of liver at least 6 month.  Types of Hepatitis: A, B, C, D, and E Hepatitis A :- Caused by the hepatitis A virus, usually transmitted through contaminated food or water. Hepatitis B:- Caused by the hepatitis B virus, primarily spread through contact with infected bodily fluids. Hepatitis C:- Caused by the hepatitis C virus, often transmitted through shared needles or unsterile medical equipment. Hepatitis D and E:- Less common types of hepatitis, with different modes of transmission and disease progression. Causes of Hepatitis 1-Infectious hepatitis: Hepatitis Virus type ( A, B, C, D, E) 2-Noninfectious hepatitis: Alcohol and other toxins: Excess alcohol consumption can cause liver damage and inflammation. Autoimmune hepatitis causes the body's immune system to attack the liver, leading to inflammation and liver damage. Primary biliary cirrhosis, also known as primary biliary cholangitis (PBC), causes the bile ducts to become inflamed and collapse, damaging the liver and leading to cirrhosis.  Hepatitis A (HAV) Agent: Hepatitis A virus (HAV), single-stranded RNA (ssRNA), no envelope. Route of Transmission: Fecal-oral (typically through contaminated food or water). Age Affected: Primarily affects children. Carrier State: No carrier state. Incubation Period: 10-50 days, with an average of 25-30 days. Chronic Infection: No chronic infection. Specific Prophylaxis: Immunoglobulin (Ig) and vaccine available.  Hepatitis B (HBV) Agent: Hepatitis B virus (HBV), double-stranded DNA (dsDNA), with an envelope. Route of Transmission: Parenteral (via blood), vertical (mother to child), and sexual contact. Age Affected: Can affect any age group. Carrier State: Common; many individuals can become carriers. Incubation Period: 50-180 days, with an average of 60-90 days. Chronic Infection: Yes, it can become chronic. Specific Prophylaxis: Immunoglobulin (Ig) and vaccine available.  Hepatitis C (HCV) Agent: Hepatitis C virus (HCV), single-stranded RNA (ssRNA), with an envelope. Route of Transmission: Parenteral (via blood, often through shared needles or transfusions). Age Affected: Mostly affects adults. Carrier State: Carrier state is present. Incubation Period: 40-120 days. Chronic Infection: Yes, chronic infection is common. Specific Prophylaxis: No vaccine available.  Hepatitis D (HDV) Agent: Hepatitis D virus (HDV), single-stranded RNA (ssRNA), but its envelope comes from HBV (it requires HBV to infect). Route of Transmission: Parenteral (via blood, similar to HBV). Age Affected: Can affect any age group. Carrier State: No independent carrier state (requires HBV). Incubation Period: 2-12 weeks. Chronic Infection: Yes, chronic infection is possible (only in conjunction with HBV). Specific Prophylaxis: HBV vaccine can help prevent Hepatitis D (since HDV requires HBV to exist).  Hepatitis E (HEV) Agent: Hepatitis E virus (HEV), single-stranded RNA (ssRNA), no envelope. Route of Transmission: Fecal-oral (similar to Hepatitis A, often through contaminated water). Age Affected: Mostly affects young adults. Carrier State: No carrier state. Incubation Period: 2-9 weeks. Chronic Infection: No chronic infection. Specific Prophylaxis: No specific vaccine available. Classification of Virus Hepatitis  Symptoms Symptoms of acute hepatitis B range from mild to severe. They usually appear about 1 to 4 months after infected. 1. Abdominal pain 2. Dark urine 3. Fever 4. Joint pain 5. Loss of appetite 6. Nausea and vomiting 7. Weakness and fatigue 8. Jaundice 9. Hepatomegaly and splenomegaly 10. Enlargement of posterior cervical lymph node. How hepatitis is diagnosed History and physical exam Liver function tests: AST, ALT, ALP & total bilirubin blood tests: viral test Liver biopsy: to determine grade (inflamation) & stage ( fibrosis in chronic hepatitis) Ultrasound Treatment for chronic hepatitis B may include: Antiviral medications. Several antiviral medicines — including entecavir (Baraclude)……….. Interferon injections. Interferon alfa-2b (Intron A) is a man-made version of a substance produced by the body to fight infection. Liver transplant. If the liver has been severely damaged, a liver transplant may be an option Complications of hepatitis Chronic hepatitis B or C can lead to more severe health problems. Because the virus affects the liver, people with chronic hepatitis B or C are at risk of: Chronic liver disease Cirrhosis Liver cancer Nursing intervention 1-Limit client activity (bed rest) in order to promote hepatic healing. 2-Provide dietary education: high-carbohydrate, high-calorie, low- to moderate-fat, and low- to moderate-protein diet and small, frequent meals to promote nutrition and healing. 3-Medications are used sparingly for hepatic rest and regeneration of tissue. 4-Administer interferon (for HBV and HCV). 5-Educate the client and family regarding measures to prevent transmission of disease with others at home Provide comfort measures. 6-Community health educational interventions on transmission and exposure. 7-Hepatitis B vaccination prophylaxis for all healthcare workers. 8-Frequent hand washing traveling. 9-Instruct clients to avoid alcohol. Thank you