Medical-surgical Nursing Demystified

(Sean Pound) #1

(^310) Medical-Surgical Nursing Demystified



  • IgM anti-HAV in acute or early convalescent stage of hepatitis A.

  • IgG anti-HAV in later convalescent stage of hepatitis A.

  • HBeAg indicates current viral replication of hepatitis B and infectivity.

  • HBsAg shows presence of the hepatitis B surface antigen which is indicative
    of either current or past infection with hepatitis B.

  • IgM anti-HBc shows acute or recent infection with hepatitis B.

  • IgG anti-HBc shows convalescent or past infection with hepatitis B.

  • HBV DNA shows presence of hepatitis B DNA, most sensitive.

  • Anti-HCV present with hepatitis C infection.

  • HCV RNA present with hepatitis C infection.

  • Anti-HDV present with hepatitis D infection.

  • WBC count normal to low.

  • Liver biopsy shows hepatocellular necrosis.

  • Urinalysis shows protein and bilirubin.


TREATMENT



  • Avoid medications metabolized in the liver.

  • Avoid alcohol.

  • Remove or discontinue causative agent if drug-induced or toxic hepatitis.

  • Intravenous 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 DIAGNOSES



  • Fatigue

  • Risk for injury

  • Impaired tissue integrity

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