LEARNING GUIDE
Module 14: Gastrointestinal Disorders: Liver- Hepatitis and Cirrhosis
Marnie Quick RN, MSN, CNRN
Hepatitis
1.
2.
Match the following with the appropriate type of Hepatitis:
___ Only infects people with hepatitis B
A.
___ Transmitted by fecal-oral route
B.
___ Known as non-A, non B hepatitis
C.
___ Primary worldwide cause of chronic hepatitis
D.
___ Rare in the United States
E.
___ A threat to healthcare workers- needle sticks
___ Typically benign and self-limiting
__(2)Primary risk for liver cancer
___ Notify the Health Department if food handler has
Hepatitis
Hepatitis
Hepatitis
Hepatitis
Hepatitis
A
B
C
D
E
Fill out the following:
Mode transmission
Who at risk
Incubation
Usual course
Hepatitis A
Hepatitis B
3.
What is the best way to prevent spread of Hepatitis A from an infected person?
4.
Which hepatitis has few long-term consequences, where the individual can
return to ‘normal’ life style after having?
5.
Describe the symptoms in each phase of hepatitis. What role does bilirubin play
in causing the symptoms?
a. Preicteric Phase:
b. Icteric Phase:
c. Convalescent Phase:
6.
Check which type of hepatitis can lead to chronic hepatitis?
__ Hepatitis A
__ Hepatitis D
__ Hepatitis B
__ Hepatitis E
__ Hepatitis C
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7.
What is a complication of chronic Hepatitis?
8.
A rapidly progressive disease, with liver failure developing with 2-3 weeks after
the onset of symptoms is called _________ and it is caused by which type of
viral hepatitis _______.
9.
What causes toxic hepatitis?
10.
Why would ALT and AST be elevated in patients with hepatitis? What nursing
interventions should be done if they are elevated?
11.
What effect does viral hepatitis have on serum bilirubin? Why is an elevated
bilirubin significant?
12.
Are there lab tests for specific viral antibodies causing hepatitis?
13.
Describe the nursing interventions related to preparing a patient for a liver
biopsy.
14.
What should the nurse teach someone prior to having a liver biopsy?
15.
Describe the postexposure prophylaxis for:
a. Hepatitis A:
b. Hepatitis B:
16.
When discharging a patient with Hepatitis, what recommendations should be
made relative to:
a. Fatigueb. Nutrition-
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Cirrhosis of the Liver
17.
Describe the pathophysiology of alcoholic cirrhosis (Laennec’s cirrhosis).What
stage will discontinuing drinking allow the liver to heal?
18. Describe the following complications of cirrhosis in relation to:
Complication
Pathophysiology
Manifestations
Treatment
Portal
Hypertension
Splenomegaly
Ascites &
Peripheral
Edema
Esophageal
Varices
Hepatic
Encephalopathy
19.
Draw a picture of the upper GI with a Stegstaken-Blakmore in place. How does
it work to control esophageal bleeding? Is tension (traction) needed to keep the
tube in place?
20.
What changes in CBC and blood coagulation studies would you expect to find in
a client with late stage cirrhosis? Why? Other lab studies?
21.
What drugs are toxic to the liver? What happens if given to an individual with
liver problems?
22.
What is the major cause of the symptoms seen in hepatic encephalopathy?
What can be done to decrease this ‘cause’?
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23.
What is the drug of choice to treat ascites? Describe its action.
24.
Why are Lactulose and Neomycin used to treat patients with cirrhosis?
25.
How does the diet for a patient with hepatic encephalopathy differ from a
patient with cirrhosis without encephalopathy?
26.
What is hepatic coma?
27.
What instructions would you give to a patient with cirrhosis regarding his
sodium and fluid intake?
28.
State the nursing responsibilities for a patient undergoing paracentesis?
29.
Why might IV salt-poor albumin be given post paracentesis?
30.
What is the major concern with a patient with esophageal varices?
31.
Draw a picture of a liver, label the hepatic and the portal veins. Show where the
stent is placed in a Transjugular Intrahepatic Portosystemic shunt (TIPS)
procedure. What is the result of this procedure?
32.
Is TIPS a permanent solution for treating portal hypertension?
33.
You have determined that your patient has fluid volume excess related to portal
hypertension, hypoalbuminemia, and hyperaldosteronism. What measures
would you take to monitor this patient for changes in status?
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