o The CDC does not recommend IG or antiviral agents such as interferon for

O the cdc does not recommend ig or antiviral agents

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o The CDC does not recommend IG or antiviral agents such as interferon for postexposure. Acute Intervention Viral Hepatitis (All types) In patients with hepatitis, assess for the presence and degree of jaundice . The urine may have a dark brown or brownish red color because of bilirubin. Comfort measures to relieve pruritus (if present), headache, and arthralgias are helpful. Ensure that the patient receives adequate nutrition. The anorexia and distaste for food cause nutritional problems. Assess the patient's tolerance of specific foods and eating pattern. Small, frequent meals may be preferable to three large ones and may also help prevent nausea. Often a patient with hepatitis finds that anorexia is not as severe in the morning, so it is easier to eat a good breakfast than a large dinner. Measures to stimulate the appetite, such as mouth care, antiemetics, and attractively served meals in pleasant surroundings, should be included in your nursing care plan. Drinking carbonated beverages and avoiding very hot or very cold foods may help alleviate anorexia . Adequate fluid intake (2500 to 3000 mL/day) is important. Assess the patient's response to the rest and activity plan, and modify it accordingly. Liver function tests and symptoms are used as a guide to activity. Psychologic and emotional rest is as essential as physical rest. Limited activity may produce anxiety and extreme restlessness in some patients. Diversional activities, such as reading and hobbies, may help. Ambulatory and Home Care Hepatitis Most patients with viral hepatitis are cared for at home. 10
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Assess the patient's knowledge of nutrition and provide the necessary dietary teaching. Caution the patient about overexertion and the need to follow the health care provider's advice about when to return to work. Teach the patient and the caregiver how to prevent transmission to other family members. Also teach what symptoms should be reported to the health care provider. Assess the patient for manifestations of complications. Bleeding tendencies with increasing prothrombin time values, symptoms of encephalopathy, or elevated liver function tests indicate problems. Instruct the patient to have regular follow-up for at least 1 year after the diagnosis of hepatitis. All patients with chronic HBV or HCV should avoid alcohol, since it can accelerate disease progression. The patient who is receiving interferon for the treatment of HBV or HCV requires education regarding this drug. Because interferon is administered subcutaneously, the patient or the caregiver needs to be taught how to administer the drug. The numerous side effects with the therapy, including flu- like symptoms (e.g., fever, malaise, fatigue), depression, make adherence to therapy challenging for some patients. Patients who are positive for HBsAg (chronic carrier status) or HCV antibody should not be blood donors. Resources: Lewis, Sharon L. Medical-surgical nursing Assessment and management of clinical problems 9th ed. 11
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