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KETAN THUMMAR
    2nd BSc.Nursing
             RN:40
 Hepatitis   is an inflamation of the
  liver.
 This inflammation may be
  caused by viruses,toxins or
  chemicals.
 There are several types of
  hepatitis such as
  viral,toxic,chronic and alcoholic.
   It is the most common blood-borne
    infection.
   The most common of type of hepatitis
    are:
   Hepatitis A virus [HAV]
   Hepatitis B virus [HBV]
   Hepatitis C virus [HCV]
   Hepatitis D virus [Delta agent]
   Hepatitis E virus
 Other  agents which may cause
  hepatitis;
 Rubella virus,varicella virus,retro
  viruses,yellow fever virus,adeno
  viruses and marbug virus.
 Epstein-barr virus,cytomegalo
  virus,herpes simplex are other
  possible causes of viral hepatitis.
 Hepatitis   A
 Hepatitis   B
 Hepatitis   C
 Hepatitis   D
 Hepatitis   E
 Hepatitis   F
 Hepatitis   G
OCCURENCE
Poor sanitation
fall
Early winter
 INCUBATION      PERIOD:


  It   is about 30 days.
RISK FACTORS/HIGH RISK GROUPS
        Close personal contact
Handling faces contaminated wastes
Poor sanitation
Peaple who work with animals from HAV
                        endemic areas
Peaple who eat raw or steamed
                     shell fish
 Infected feces,fecal oral
  route,may be airborne if
  copious secretion,shellfishes
  from contaminated water.
 No carrier state
 Mortality low
 Rarely causes fulminating
  hepatic failure
 Anti HAV-IgM Positive in acute
  hepatitis
 IgG positive after infection
 Hygiene
 Immune   globulin(possive)
 Inactivated hepatitis A
  vaccine-havrix & vaqta(active)
 Adult1st dose 1ml IM
         2nd dose 1ml IM after 6
                   to 12 months.
 Hepatocytes undergo pathologic changes
     induced by the body’s immune response to
                     the virus.

        Inflammation of the liver with areas of
        necrosis occurs,and the resultant damage
            leads to impairment of function.

   The degree of functional impairment depends
      on the amount of hepatocellular damage.
   The endoplamic reticulamis the first
        cellular organelle to undergo change
        and liver functions thats depends on
              these processes are alters.

       Kuffer cells increase In both size and
                       number.

   Vascular and ductular tissues undergo
           inflammatory changes.
OCCURRENCE:
World-wide,especiallyin drug
 addicts,homosexuals,people
 exposed to blood and blood
 product.
Occurs all year.
6
 weeks to 6 months;mean
12-14 weeks
Risk factors /high risk groups
Health workers in contact with body secretions
Hemodialysis and post
   transfusion clients
Blood and blood products
Homosexually active males
Drug abusers
 Heterosexual  transmission
 Contact with blood and body
  fluids
 Carrier state
 More serious
 May be fatal
 HBsAg
 HBV-DNA
 Anti-HBc-IgM
 HbeAg
 Anti-HBsAg
 Hygiene
 Avoidance   of risks
 HBIG(Passive)
 Recombinant hepatitis B
  vaccine(active)
 Hepatitis B vaccine(passive)
 3 IM injection(deltoid) 0,1,6
  months
 The HBV is a DNA virus that has an
  inner core and a surface envelope.
 The body forms antibodies to the viral
  antigens HBsAg.
 The presence of resolving infection
    blood denotes:
1. A previous or resolving infection with
    hepatitisB
2. A Continuing,chronic infection,
3. Immunization with immunoglobulin
    or HBV vaccine.
   IV drug use accounts for 60% of HCV
    transmission.
   The risk ralated to injecting drug use is that
    shared drug paraphenalia used to prepare or
    inject the drug may have contaminated with HCV
    infection.
   Tattooing and body piercing tools contaminated
    with small amount of blood may also contribute
    to HCV infection.
   The tattoo artist or piercer must use good health
    practices such as hand-washing,sterized or
    disposable tattoing needles,disposable gloves.
OCCURRENCE:
 Post-transfusion
 Those  working around blood and
  blood products.
 IV drug users
 Occurs all year

INCUBATION     PERIOD:
 6-7   weeks
 Similar to that
  for hepatitis B
 IV drug use
 Intranasal
  cocaine use
 Body piercing
 Multiple sex
  partners
TRANSMISSION       SEVERITY
 Contact  with     Canlead to
  blood and body    chronic
  fluids.
                    hepatitis.
 Source of
  infection
  uncertain in
  many clients.
 Carrier state.
Anti-HCV Or anti-HDV   HCV RNA
Anti-HCV interferon
          alfa-2b in combination
Hygiene   with ribavirin(Rebetol)
 Itis also known as delta hepatitis.
 Hepatitis D is transmitted only
  through blood contact and thus
  seen most commonly in clients
  exposed to blood and blood
  products,such as IV drug users
  and people with hemophilia.
 Hepatitis D virus
  requires the helper
  function of HBV for its
  replication and
  expression.
 Hepatitis D virus can
  either infect a person
  stimultaneously with
  HBV(co-infection) or
  infect a person already
  infected with
  HBV(superinfection)
OCCURRENCE             INCUBATION
   Hepatitis D virus     PERIOD AND
    causes hepatitis      RISK
    only in               FACTORS/HIGH
    association with      RISK GROUPS
    hepatitis B virus
                         Same as for
    and only in
    presence of           hepatitis B
    HBsAg
 Co infect with hepatitis B
 Close personal contact
 Carrier state
 Similar to
  hepatitis B
 More severe if
  occurs with
  chronic hepatitis
  B
 Increased risk of
  hepatocellular
  carcinoma.
HDAg-possitive(anti-
                       HDV RNA serum
HDV)
HEPATITIS B
HYGIENE
          VACCINE(ACTIVE)
 This form of hepatitis primarily affect
  young adults.
 It has a short incubation and there is
  no evidence that it becomes chronic.
 The hepatitis E virus alters
  hepatocellular function in almost the
  other types of hepatitis viruses.
 It causes necrosis and liver cell
  damage.
OCCURRENCE               INCUBATION
   Parts of              PERIOD
    Asia,Africa,India,    14-60
    Maxico,Philipines     days;mean 40
    where there is
                          days
    poor sanitation.
 RISK              TRANSMISSION
 FACTORS/HIG          Fecal-oral
                       route,food-or
 H RISK                water-borne.
 GROUPS               No carrier state
 Travelling or
 living in areas
 where
 incidence is
 high.
 Illness self-
  limiting
 Mortality rate
  in pregnant
  women 10%-
  20%
 DIAGNOSTIC    PROPHYLAXIS

  TESTS          AND ACTIVE
 Anti-HEV
                 OR PASSIVE
                 IMMUNITY
                Hygiene
                Sanitation
                No immunity
   Hepatits f seems to be
    similar to hepatitis A
    and E in its mode of
    transmission.
   There is no serologic
    test for hepatitis F, and
    diagnosis is by
    electron microscopic
    identification of the
    virus.
   Hepatitis G is spread through contact with
    blood,blood product, and body fluids.
   Most clients are asymptomatic, and chronic
    infection develops in 90% to 100% of infected
    individuals.
   Hepatitis G virus, like HCV,is a blood borne
    RNA virus.
   Current data indicate that a large portion of
    client infected with hepatitis G are also
    infected with HCV.
   Hepatitis G virus
    does not alter
    the severity of
    hepatitis C, nor
    is it associated
    with acute or
    chronic liver
    injury,although
    the latter finding
    requires
    continused
    study.
 Associated  with
  chronic viremia
  lasting 10
  years.
 Rarely causes
  frank hepatitis.
 Health care workers in
  hemodialysis.
 IV drug users.
 Hemodialysis clients.
 Chronic hepatitis B or C clients.
   TRANSMISSION
   Percutaneous
   SEVERITY
   Does not appear to cause liver
    disease.
   DIAGNOSTIC TESTS
   Anti-HGV
   PROPHYLAXIS
   Hygiene
JAUNDICE   ABDOMINAL PAIN
   Lethargy
   Irritability
   Myalgia
   Arthralgia
   Nausea
   Vomitting
   Diarrhea or
    constipation
   Fever
   Flu like manifestation
   Fatigue
   Malaise
   pruritis
 Darker
  urine(the
  color of tea
  or mahogany)
 Clay-colored
  stool
 drowsiness
 REDUCE   FATIGUE:
 Rest
 Maintain nutritional and fluid balance:
 High calorie,low-fat,high-carbohydrate diet
  more easily digested & more palatable
 Reduce effects of hepatitis:
 Antiviral
 Antiemetics
 Parenteral vit K
 Antihistamines
 Glucocorticoids:
 It may reduce serum aminotransferase &
  bilirubin level.
 Bile acid sequestentrants:
 Questran
 Colestid
 Vaccines:
 HAV
 HBV
 HVC
 Medication to avoid:
 Chlorpromazian, aspirin, acetaminophane
   Bed rest
   High calorie, low fat, high carbohydrate diet.
   Avoid alcohol
   Vit. K supplements
   Relieve nausea & vomitting
   Psychological support
   Client teaching
   Administer medications
   Promote rest
 Avoid  hepatotoxins
 Promote nutrition
 Client teaching
 Promote rest
 Prevent infection and reinfection
Inflammation of liver by ketan thummar

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Inflammation of liver by ketan thummar

  • 1. KETAN THUMMAR 2nd BSc.Nursing RN:40
  • 2.  Hepatitis is an inflamation of the liver.  This inflammation may be caused by viruses,toxins or chemicals.  There are several types of hepatitis such as viral,toxic,chronic and alcoholic.
  • 3. It is the most common blood-borne infection.  The most common of type of hepatitis are:  Hepatitis A virus [HAV]  Hepatitis B virus [HBV]  Hepatitis C virus [HCV]  Hepatitis D virus [Delta agent]  Hepatitis E virus
  • 4.  Other agents which may cause hepatitis;  Rubella virus,varicella virus,retro viruses,yellow fever virus,adeno viruses and marbug virus.  Epstein-barr virus,cytomegalo virus,herpes simplex are other possible causes of viral hepatitis.
  • 5.  Hepatitis A  Hepatitis B  Hepatitis C  Hepatitis D  Hepatitis E  Hepatitis F  Hepatitis G
  • 6.
  • 10.  INCUBATION PERIOD:  It is about 30 days.
  • 11. RISK FACTORS/HIGH RISK GROUPS Close personal contact
  • 14. Peaple who work with animals from HAV endemic areas
  • 15. Peaple who eat raw or steamed shell fish
  • 16.  Infected feces,fecal oral route,may be airborne if copious secretion,shellfishes from contaminated water.  No carrier state
  • 17.  Mortality low  Rarely causes fulminating hepatic failure
  • 18.  Anti HAV-IgM Positive in acute hepatitis  IgG positive after infection
  • 19.  Hygiene  Immune globulin(possive)  Inactivated hepatitis A vaccine-havrix & vaqta(active)  Adult1st dose 1ml IM  2nd dose 1ml IM after 6 to 12 months.
  • 20.  Hepatocytes undergo pathologic changes induced by the body’s immune response to the virus. Inflammation of the liver with areas of necrosis occurs,and the resultant damage leads to impairment of function.  The degree of functional impairment depends on the amount of hepatocellular damage.
  • 21. The endoplamic reticulamis the first cellular organelle to undergo change and liver functions thats depends on these processes are alters.  Kuffer cells increase In both size and number.  Vascular and ductular tissues undergo inflammatory changes.
  • 22. OCCURRENCE: World-wide,especiallyin drug addicts,homosexuals,people exposed to blood and blood product. Occurs all year.
  • 23. 6 weeks to 6 months;mean 12-14 weeks
  • 24. Risk factors /high risk groups Health workers in contact with body secretions
  • 25. Hemodialysis and post transfusion clients
  • 26. Blood and blood products
  • 29.  Heterosexual transmission  Contact with blood and body fluids  Carrier state
  • 30.  More serious  May be fatal
  • 31.  HBsAg  HBV-DNA  Anti-HBc-IgM  HbeAg  Anti-HBsAg
  • 32.  Hygiene  Avoidance of risks  HBIG(Passive)  Recombinant hepatitis B vaccine(active)  Hepatitis B vaccine(passive)  3 IM injection(deltoid) 0,1,6 months
  • 33.  The HBV is a DNA virus that has an inner core and a surface envelope.  The body forms antibodies to the viral antigens HBsAg.  The presence of resolving infection blood denotes: 1. A previous or resolving infection with hepatitisB 2. A Continuing,chronic infection, 3. Immunization with immunoglobulin or HBV vaccine.
  • 34. IV drug use accounts for 60% of HCV transmission.  The risk ralated to injecting drug use is that shared drug paraphenalia used to prepare or inject the drug may have contaminated with HCV infection.  Tattooing and body piercing tools contaminated with small amount of blood may also contribute to HCV infection.  The tattoo artist or piercer must use good health practices such as hand-washing,sterized or disposable tattoing needles,disposable gloves.
  • 35. OCCURRENCE:  Post-transfusion  Those working around blood and blood products.  IV drug users  Occurs all year INCUBATION PERIOD:  6-7 weeks
  • 36.  Similar to that for hepatitis B  IV drug use  Intranasal cocaine use  Body piercing  Multiple sex partners
  • 37. TRANSMISSION  SEVERITY  Contact with  Canlead to blood and body chronic fluids. hepatitis.  Source of infection uncertain in many clients.  Carrier state.
  • 39. Anti-HCV interferon alfa-2b in combination Hygiene with ribavirin(Rebetol)
  • 40.  Itis also known as delta hepatitis.  Hepatitis D is transmitted only through blood contact and thus seen most commonly in clients exposed to blood and blood products,such as IV drug users and people with hemophilia.
  • 41.  Hepatitis D virus requires the helper function of HBV for its replication and expression.  Hepatitis D virus can either infect a person stimultaneously with HBV(co-infection) or infect a person already infected with HBV(superinfection)
  • 42. OCCURRENCE INCUBATION  Hepatitis D virus PERIOD AND causes hepatitis RISK only in FACTORS/HIGH association with RISK GROUPS hepatitis B virus  Same as for and only in presence of hepatitis B HBsAg
  • 43.  Co infect with hepatitis B  Close personal contact  Carrier state
  • 44.  Similar to hepatitis B  More severe if occurs with chronic hepatitis B  Increased risk of hepatocellular carcinoma.
  • 45. HDAg-possitive(anti- HDV RNA serum HDV)
  • 46. HEPATITIS B HYGIENE VACCINE(ACTIVE)
  • 47.  This form of hepatitis primarily affect young adults.  It has a short incubation and there is no evidence that it becomes chronic.  The hepatitis E virus alters hepatocellular function in almost the other types of hepatitis viruses.  It causes necrosis and liver cell damage.
  • 48. OCCURRENCE  INCUBATION  Parts of PERIOD Asia,Africa,India,  14-60 Maxico,Philipines days;mean 40 where there is days poor sanitation.
  • 49.  RISK  TRANSMISSION FACTORS/HIG  Fecal-oral route,food-or H RISK water-borne. GROUPS  No carrier state  Travelling or living in areas where incidence is high.
  • 50.  Illness self- limiting  Mortality rate in pregnant women 10%- 20%
  • 51.  DIAGNOSTIC  PROPHYLAXIS TESTS AND ACTIVE  Anti-HEV OR PASSIVE IMMUNITY  Hygiene  Sanitation  No immunity
  • 52. Hepatits f seems to be similar to hepatitis A and E in its mode of transmission.  There is no serologic test for hepatitis F, and diagnosis is by electron microscopic identification of the virus.
  • 53. Hepatitis G is spread through contact with blood,blood product, and body fluids.  Most clients are asymptomatic, and chronic infection develops in 90% to 100% of infected individuals.  Hepatitis G virus, like HCV,is a blood borne RNA virus.  Current data indicate that a large portion of client infected with hepatitis G are also infected with HCV.
  • 54. Hepatitis G virus does not alter the severity of hepatitis C, nor is it associated with acute or chronic liver injury,although the latter finding requires continused study.
  • 55.  Associated with chronic viremia lasting 10 years.  Rarely causes frank hepatitis.
  • 56.  Health care workers in hemodialysis.  IV drug users.  Hemodialysis clients.  Chronic hepatitis B or C clients.
  • 57. TRANSMISSION  Percutaneous  SEVERITY  Does not appear to cause liver disease.  DIAGNOSTIC TESTS  Anti-HGV  PROPHYLAXIS  Hygiene
  • 58. JAUNDICE ABDOMINAL PAIN
  • 59. Lethargy  Irritability  Myalgia  Arthralgia  Nausea  Vomitting  Diarrhea or constipation  Fever  Flu like manifestation  Fatigue  Malaise  pruritis
  • 60.  Darker urine(the color of tea or mahogany)  Clay-colored stool  drowsiness
  • 61.  REDUCE FATIGUE:  Rest  Maintain nutritional and fluid balance:  High calorie,low-fat,high-carbohydrate diet more easily digested & more palatable  Reduce effects of hepatitis:  Antiviral  Antiemetics  Parenteral vit K  Antihistamines
  • 62.  Glucocorticoids:  It may reduce serum aminotransferase & bilirubin level.  Bile acid sequestentrants:  Questran  Colestid  Vaccines:  HAV  HBV  HVC  Medication to avoid:  Chlorpromazian, aspirin, acetaminophane
  • 63. Bed rest  High calorie, low fat, high carbohydrate diet.  Avoid alcohol  Vit. K supplements  Relieve nausea & vomitting  Psychological support  Client teaching  Administer medications  Promote rest
  • 64.  Avoid hepatotoxins  Promote nutrition  Client teaching  Promote rest  Prevent infection and reinfection