LEARNING GUIDE - HEPATITIS AND CIRRHOSIS
1.
2.
Match the following descriptions with the appropriate type of hepatitis:
_____ Transmitted by fecal contamination of water
a. Hepatitis A
in developing areas
_____ Primary worldwide cause of chronic hepatitis
b. Hepatitis B
_____ Rare in the United States, transmitted via water c. Hepatitis C
_____ Only infects people with hepatitis B
d. Hepatitis D
_____ Transmitted by fecal-oral route
e. Hepatitis E
_____ Poses a threat to healthcare workers through
f. Hepatitis G
needle sticks
_____ Typically benign and self-limiting
_____ Known as non-A, non-B hepatitis
_____ Coexists with HBV, HCV and HIV
Describe the progression and clinical manifestations of hepatitis in the following
phases:
a. Acute phase
b. Convalescent phase
c. Chronic phase
3.
4.
5.
6.
Thirty percent of individuals with acute HBV and 80% of those with HCV are
asymptomatic. Explain the problems that this can cause.
Which types of hepatitis virus can lead to chronic hepatitis?
Fulminant hepatitis is a rapidly progressing disease that can result in
___________________.
What can cause toxic hepatitis?
7.
Explain the reason for each of the following alterations in diagnostic findings for a
client with acute hepatitis:
a. Elevated AST and ALT
b. Elevated alkaline phospatase
c. Decreased albumin
d. Prolonged prothrombin time
8.
Describe the nursing interventions related to preparing a client for a liver biopsy.
9.
Vaccines are available for which types of hepatitis?
10.
Describe the post exposure prophylaxis for the following:
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
11.
What are the goals of treatment for:
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
12.
Explain the use of the following medications for the treatment of hepatitis. Include
an explanation about the action and side effects.
a. Interferon alpha
b. lamivudine
c. ribavirin
13.
Describe methods of prevention and protection for:
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
14.
The nurse is providing discharge instructions for a client with Hepatitis A. What
recommendations should she make relative to:
a. Fatigue
b. Nutrition: less than body requirements
c. Alteration in comfort: a) pruritus b) malaise
15.
Describe the pathophysiology of alcoholic cirrhosis. At what stage will discontinuing
drinking allow the liver to heal?
16.
Describe the pathophysiology for each of the following complications of cirrhosis:
a.
Portal hypertension
b.
Esophageal varices
c.
Edema and ascites
d.
Hepatic encephalopathy
e.
Splenomegaly
17.
Place a letter beside each of the following manifestations of cirrhosis indicating
whether it is an early (E) or late (L) manifestation:
_____
_____
_____
_____
_____
_____
_____
_____
_____
constipation
hypertension
weight loss
gynecomastia
anorexia
weakness
anemia
bleeding
ascites
18.
What alterations in CBC would you expect to find in a client with late stage cirrhosis?
Explain your answer.
19.
Describe the treatment for ascites with respect to the following:
a. Diet
b. Medications
c. Paracentesis
d. Peritovenous shunt
20.
Explain the following procedures used to treat esophageal and gastric varices:
a. Beta-blockers
b. Vasopressin and nitroglycerin combination
c. Endoscopic sclerotherapy
d. Balloon tamponade
e. Transjugular intrahepatic portosystemic shunts (TIPS)
21.
Why are Lactulose and Neomycin used to treat clients with cirrhosis?
22.
What instructions would you give to a client with cirrhosis regarding his dietary
intake?
23.
Describe the nursing responsibilities associated with paracentesis.
24.
For each of the following nursing diagnoses commonly associated with cirrhosis,
designate expected outcomes and appropriate nursing interventions:
a. Excess fluid volume related to portal hypertension and hyperaldoseteronism
b. Impaired skin integrity related to edema, ascites, and pruritis
c. Risk for injury: hemorrhage, risk factors include: altered clotting factors and
compromised vascular integrity
d. Altered thought processes related to increased serum levels of ammonia
25.
What are the most common causes of liver cancer?
26.
Describe the manifestations of liver cancer.
27.
Describe the following treatments for liver cancer:
a. Lobectomy
b. Radiofrequency ablation
c. Cryoablation
d. Percutaneous ethanol or acetic acid injection
e. Chemotherapy
28.
Describe the signs and symptoms that would indicate rejection of a liver transplant.
29.
Explain the post operative nursing care for a client with a liver transplant.
30.
Liver transplantation is a practical therapeutic option for many people with end stage
liver disease. However, there is a scarcity of available livers. Discuss practical
solutions and ethical dilemmas related to the lack of resources.
25.
What is the prognosis for most clients with liver cancer?