Hepatitis for Certified Emergency Nursing (CEN)

Hepatitis

Definition/Etiology:

Hepatitis – Inflammation of the liver

Hep A – fecal/oral route

• Contaminated food/water

Hep B – transmitted through mucus membranes/body fluids

• IVDA
• Sexually transmitted
• Needle sticks
• Blood transfusions

Hep C-

• IVDA
• Sexually transmitted
• Needle sticks
• Blood transfusions
• Baby boomers (1945-1966) due to lifestyle and medical treatments

Hep D-

• Usually, a co-infection with Hep B

Pathophysiology:

Liver works to:

• Metabolize toxins from the blood
• Clears old red blood cells
• Produces factors to help blood clot
• Stores glycogen and vitamins
• Makes bile to break down food

Inflammation damages the liver and impacts its function. It can also lead to long-term liver impairment, cancer, and hardening (cirrhosis)

Clinical Presentation:

• Fatigue
• N/V
• Fever
• Anorexia
• Jaundice
• Dark urine
• RUQ tenderness
• Hepatomegaly
• Skin itching
• Confusion
• AMS
• Easy bruising

Collaborative Management:

• Labs
• Elevated AST/ALT
• Possible dehydration
• Hepatitis panel
• Ammonia Level
• PT/INR
• Liver US

Evaluation | Patient Monitoring | Education:

Best treatment is prevention

• Hep A (acute)– vaccine. Offered to endemic areas, those who use illicit drugs, patient with chronic liver disease, men who have sex with men
• Hep B – Vaccines! Part of the routine immunization schedule.
• Hep C (chronic)– no vaccine. May be placed on antivirals

Linchpins: (Key Points)

• Hep A (Acute) (Anal/Oral route) (Adventurous travelers get vaccines)
• Hep B (Babies get vaccines) (Blood/Body fluid)
• Hep C (chronic) – (Can’t get a vaccine) (Contaminated body fluids)
• Hep D (Doubles up with Hep B)