Hepatitis Practice Questions with Answers and NCLEX® Review

Introduction to Hepatitis

Hepatitis is a medical condition characterized by liver inflammation, resulting from various causes, including heavy alcohol use, autoimmune disorders, drugs, or exposure to toxins. However, the most common cause of hepatitis is a viral infection, referred to as viral hepatitis. 

The most frequently encountered types of viral hepatitis are Hepatitis A, Hepatitis B, and Hepatitis C. The other types of viral hepatitis, such as Hepatitis D and E, are less common. 

The severity of hepatitis can vary from mild and self-limiting to severe illness requiring liver transplantation, depending on the etiology. Hepatitis is classified as acute or chronic, depending on the duration of the inflammation or insult to the liver. 

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Acute hepatitis is typically self-resolving but can result in fulminant liver failure, depending on the cause. 

Chronic hepatitis, on the other hand, can lead to liver damage, including liver fibrosis, cirrhosis, hepatocellular carcinoma, and portal hypertension, resulting in significant morbidity and mortality.

Pathophysiology of Hepatitis

Hepatitis is a medical condition that involves liver inflammation and can arise from various factors, such as alcohol abuse, autoimmune disorders, drug-induced injury, or exposure to hepatotoxic substances. 

The most frequently observed etiology of hepatitis is viral hepatitis, a condition caused by different types of viruses that can lead to liver inflammation. 

Non-viral causes include: alcohol and autoimmune diseases.

Viral hepatitis has various routes of transmission and several different forms, including Hepatitis A, B, C, D, and E. It can be caused by various microorganisms, including cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Herpes Simplex virus (HSV). 

Once the viruses enter the bloodstream, they spread to the liver, infecting the hepatocytes and replicating. And as they replicate, they change the antigenic structure on their surface, leading to an immune response from the body. The immune system attacks the hepatocytes in an attempt to clear the virus. 

However, in cases of Hepatitis B and C, this process can continue for years, leading to chronic liver disease.

Risk Factors & Causes of Hepatitis

• IV drug use
• Tattoos and body piercings with dirty needles
• Sharing razors
• Unprotected sex

Signs and Symptoms of Hepatitis

• Headache
• Fever
• Fatigue (malaise)
• Nausea and vomiting
• Loss of appetite
• Abdominal pain

Complications of Hepatitis

• Acute liver failure
• Cirrhosis
• Liver cancer
• Gallbladder issues

Nursing Interventions for Hepatitis

• Practice proper hand hygiene, isolation precautions, and appropriate use of personal protective equipment (PPE) can help prevent the spread of hepatitis to others.
• Encourage rest, adequate fluid intake, and eating small frequent meals to prevent nausea (low protein and fat).
• Administer Antiviral medications, as well as other medications for symptom management, may be prescribed by the healthcare provider. 
• Monitor the patient for potential side effects and ensure that medications are taken as prescribed.
• Provide a well-balanced diet, including adequate protein and calories, can help support liver function and promote healing.

Educate the patient on infection control measures, medication management, nutritional support, and signs and symptoms of complications – including protected sex, avoiding sharing razors and toothbrushes, and avoiding alcohol.

Sources

https://u.osu.edu/viralhepatitis2019/viral-hepatitis-pathophysiology/ 

https://www.ncbi.nlm.nih.gov/books/NBK554549/