Gerontologic Considerations
The elderly patient who contracts hepatitis B has a serious risk of severe liver
cell necrosis or fulminant hepatic failure, particularly if other illnesses are
present. The patient is seriously ill and the prognosis is poor, so efforts should
be undertaken to eliminate other factors (eg, medications, alcohol) that may
affect liver function.Medical Management
The goals of treatment are to minimize infectivity, normalize liver
inflammation, and decrease symptoms. Alpha interferon offers the most promise. It results in remission in
approximately one third of patients Lamivudine & adefovir are new antiviral agents. Adequate nutrition should be maintained; proteins are restricted when the
liver‘s ability to metabolize protein byproducts is impaired, as demonstrated by
symptoms. If vomiting persists, the patient may require hospitalization and fluid therapy.Nursing Management
Convalescence may be prolonged, with complete symptomatic recovery
sometimes requiring 3 to 4 months or longer. During this stage, gradual resumption of physical activity is encouraged after
the jaundice has resolved. The nurse identifies psychosocial issues and concerns, particularly the effects of
separation from family and friends if the patient is hospitalized during the acute
and infective stages. Even if not hospitalized, the patient will be unable to work
and must avoid sexual contact.C. HEPATITIS C VIRUS (HCV
Formerly referred to as non-A, non-B hepatitis. Blood transfusions and sexual contact accounted for most cases of hepatitis C in
the United States, other parenteral means, such as sharing contaminated needles
by IV/injection drug users and unintentional needle-sticks and other injuries in
health care workers, now account for a significant number of cases.