HEPATITIS A

(Infectious Hepatitis)
Submitted by:

Gilbert Lafuente
Submitted to:

Dario Sumande, RN MAN

DEFINITION Liver disease caused by the hepatitis A virus Inflammation of the liver which is not severe Runs an acute onset

INCUBATION PERIOD 15-60 days PERIOD OF COMMUNICABILITY Week before and week after the symptoms MODE OF TRANSMISSION Ingestion Fecal-oral Infected food handler SIGNS AND SYMPTOMS Flu-like illness with chills and fever Diarrhea, fatigue and abdominal pain Loss of appetite Jaundice and dark colored urine Young children asymptomatic/mild

DIAGNOSTIC PROCEDURES HAV and HBV complement fixation rate Liver function test Bile examination in stool and urine SGOT, SGPT, ALT IgM Level

TREATMENT High CHO, Decrease CHON and Decrease Fat Increase vitamin supplements (B-complex) Isoprinosine (methisoprenol) Alkalies, Belladona and Anti-emetics

NURSING INTERVENTIONS Enteric isolation Rest during symptomatic phase Improve nutritional status Observe for melena Provide skin and oral care Increase ability to carry out activities

PREVENTION 1. 2. 3. 4. 5. Hands should be washed thoroughly every after use of toilet. Travelers should avoid water and ice if unsure of their purity. Food handler should carefully be screened. Safe preparation and serving of food must be practiced. Public education.

PATHOPHYSIOLOGY Entry of hepatitis A virus through fecal-oral route

Enters and infects liver

Interlobular infiltration with mononuclear cell

Necrosis

Cell ballooning Hyperplasia of kuffer cell Degeneration of hepatocytes

Obstructive jaundice

Collapse of reticulin framework

Pale feces

Itchiness Destroyed liver parenchyma

Liver shutdown

Death

HEPATITIS B
(Infectious Hepatitis)
Submitted by:

Gilbert Lafuente
Submitted to:

Dario Sumande, RN MAN

DEFINITION The inflammation of the liver caused by hepatitis B virus. More serious than hepatitis A due to possibility of severe complications such as massive damage and hepatocarcinoma of the liver. ETIOLOGIC AGENT Hepatitis B virus Has very limited tissue tropism. HBV infects the liver and pancreas

 HbsAg appears in the blood 30-60 days after exposure and persists for variable periods of time. INCUBATION PERIOD 50-189 or 2-5 months PERIOD OF COMMUNICABILITY During the latter part of incubation period and during the acute phase. Virus persist in the blood for many years MODE OF TRANSMISSION Person to person contact via infected body fluids Contaminated needles and syringes Infected blood or body fluids introduced at birth Sexual contact

HBV transmission does not occur Fecal oral route Food or water borne Mosquito SIGNS AND SYMPTOMS 1. Prodromal Periods Fever, abdominal discomfort, chills Malaise Anorexia N/V Jaundice, dark urine and pale stool 1. Fulminant Hepatitis Ascitis Bleeding DIAGNOSTIC PROCEDURES Compliment fixation test Liver function test Bile examination in blood and urine Serum transaminase SGOT, SGPT, ALT HbsAg

NURSING INTERVENTIONS Rest during symptomatic phase Improve nutritional status Observe for melena Provide skin and oral care Increase ability to carry out activities

PREVENTION 1. HbIg should be administered within 72 hours 2. Hepa B vaccines for pre-exposure

3. 4. 5. 6. 7. 8. 9.

Avoid sharing of toothbrush, razor and other instruments Avoid injury with sharp objects or instruments Use diposable needles and syringes only once and discard properly Hands and other skin areas must be wash immediately Blood donors must be screened to exclude carriers Observe safe sex. Have adequate rest, sleep, exercise and eat nutritious foods

PATHOPHYSIOLOGY Entry of virus via MOT

Invasion of the liver

Hepatic proliferation of virus

Release of HbsAg in the blood

Degenerative changes in parenchyma

Cellular swelling

necrosis

Jaundice, dark urine, pale stool Decrease vitamin k and clothing factors Extravasation of capillary

Bleeding

Escape of albumin

Ascitis