Hepatitis B

Infectious Ward
BSN III
Introduction

 Hepatitis B is
considered a
dangerous
communicable
disease due to
possibility of severe
complications such as
massive liver
damage.
Objectives of the Study

To enhance the ability,

efficiency and effectivity of care
in the presented disease
condition
Patients Profile
Name:
Mr. Chickboy

Age:
30 years old

Rank:
PFC

Status:
Single

Date Admitted
February 3, 2009

Initial Diagnosis:
Acute Viral Hepatitis B
 Theoretical Framework
Lydia Hall’s
Three
Interlocking
Circles
CORE

CARE CURE
Medical History
HISTORY OF PRESENT ILLNESS
- Condition started 1 week prior to admission,
patient was noted to have yellowish / icteric
sclera accompanied by darkening of urine
(dark yellow).

Past Medical History

PHX:
( + ) Alcoholic Drinker (occasionally 2-3x a week,
brandy, beer)
( + ) Multiple Sexual Partners
( + ) Smoker (20 sticks per day)
( + ) SIP ACL Repair (2006)
( - ) Diabetes Milletus
( - ) Hypertension

FHX:
( - ) Diabetes Milletus
( - ) Hypertension
Physical Assessment
Relevant Findings
-General Appearance and
Health Status
Weak in appearance

-Skin
Jaundice, with lesions
Scars in R lower extremities

-Eyes
Icteric sclera

-Mouth
Jaundice discoloration
Hepatitis B
 Etiologic Agent
-The disease is caused
by Hepatitis B virus.
 Incubation Period
- 2-6 Months
 Period of
Communicability
- During the latter part
of the incubation period
and during the acute
phase.
 Laboratory Exam Results
CBC (February 03, 2009) March 3, 2009
 WBC Count  ALT

12.8 x 109/ L) 113.3 U/L

CBC (March 18, 2009)
 Hemoglobin  AST
110 90..8 U/L
 WBC Count
 ALP
132.0
11.2
HEPA PROFILE  Bilirubin
(February 05, 2009) 425 µmol/ l
 HBSAg
1996  Total Bilirubin
 HBeAg
430
780.7
 Anti-HBe IgM
9.11
Drug Study

 CHLORPHENAMINE  HYDROXYZINE
MALAETE (Iterax)

 Classification:  Classification:
Anti-histamine Anti-allergics
 Risk Factor
Multiple Sex Partners

Virus Enters the Body and Circulating Immune Complex

reaches the Liver

Cell Death Inflammation of the Activated Complement

Liver System

Damaged Cells Release Bile Flow Disrupted

Enzymes
Fever, Malaise, Loss of
Appetite
Bilirubin Stays In the Blood

AST, ALT Elevated

Bilirubin Diffuses Into Tissues Excess Bilirubin Excreted by

the Kidneys

Jaundice Bile Salt Under the Skin Dark Yellow Urine

Irritates Nerve Ending

Pruritus PATHOPHYSIOLOGY
Nursing Care Plans
Nursing Diagnosis:
Impaired skin integrity related to
generalized itching
Knowledge deficit related to disease
and treatment
Disturbed body image related to
unsightly skin appearance
Sleep pattern disturbance related to
generalized pruritus
Discharge Planning
Medicine
Exercise
Treatment
Health Teaching
OPD
Diet
Sex/Spiritual
Nursing Implications
A. Nursing Research

B. Nursing Practice

C. Health Education
End
 Risk Factor
Multiple Sex Partners

Immune System Virus Enters the Body and Circulating Immune Complex
Inititates reaches the Liver
Destruction of
Infectred
Hepatitis Activated Complement
Hepatocytes
System

Damaged Cells Release Cholestasis

Enzymes
Fever, Malaise, Loss of
Appetite
Hyperbilirubinemia

AST, ALT Elevated

Bilirubin Diffuses Into Tissues Excess Conjugatd Bilirubin

Excreted by the Kidneys

Jaundice Accumulated Bile Salt Dark Yellow Urine

Under the Skin Irritates
Nerve Ending

Pruritus
PATHOPHYSIOLOGY