- Cirrhosis due to altered liver function
- Ascites due to decrease in liver function, increased portal hypertension
- Bleeding from esophageal varices
- Encephalopathy due to diminished liver function
- Bleeding due to clotting disorders
- Enlargement of spleen
Test Results
Serums: Elevated aspartate aminotransferase (AST), alanine aminotrans-
ferase (ALT)
Immunoglobulin (Ig)M anti-HAV: Presence in acute or early convales-
cent stage of hepatitis A
IgG anti-HAV: Presence in later convalescent stage of hepatitis A.
HBeAg: Presence of current viral replication of hepatitis B and infectiv-
ity.
HBsAg: Presence of the surface antigen, either current or past infection
with hepatitis B.
IgM anti-HBc: Presence of acute or recent infection with hepatitis B.
IgG anti-HBc: Presence of past infection with hepatitis B.
HBV DNA: Shows presence of hepatitis B DNA, most sensitive.
Anti-HCV: Presence of hepatitis C infection.
HCV RNA: Presence of hepatitis C infection.
Anti HDV: Presence of hepatitis D infection.
Blood count: Normal to low WBC.
Liver biopsy: Shows hepatocellular necrosis.
Urinalysis: Presence of protein and bilirubin.Treatment
Avoid medications metabolized in the liver.
Avoid alcohol.
Remove or discontinue causative agent if drug induced or toxic hepatitis.
IV hydration if vomiting during acute hepatitis.
Activity as tolerated.
High-calorie diet; breakfast is usually the best tolerated meal.
Administer interferon or lamivudine for chronic hepatitis B.
Administer interferon and ribavirin for hepatitis C.
Administer prednisone in autoimmune hepatitis.
Liver transplantation.Nursing Intervention
Monitor vital signs.
Assess abdomen for bowel sounds, tenderness, ascites.
Plan appropriate rest for patient in acute phase.5CHAPTER 11/ Gastrointestinal Conditions^241