Hepatitis- Pearson

The last 24 hours Hepatitis B prophylaxis must be administered within 24 hours of exposure to the virus. It is administered intramuscularly into a large​ muscle, and the client should also begin the hepatitis B vaccine series concurrently.

A nurse is caring for a young woman who was exposed to hepatitis B by a previous sexual partner. Before administration of​ prophylaxis, the nurse should verify that exposure occurred within which time​ frame? The last 2 months The last month The last 24 hours The last 2 weeks

Prodromal The prodromal phase occurs between exposure to the virus and onset of​ jaundice, and tends to occur about 2 weeks after exposure. Clinical manifestations include​ nausea, vomiting,​ fatigue, joint​ pain, and loss of appetite. During the icteric​ phase, the client will develop darkening urine and​ clay-colored stools, and may become jaundiced. During the​ convalescent, or​ recovery, phase, the client starts to feel better as symptoms start to ease.

A client exposed to hepatitis presents to a community clinic with complaints of​ nausea, vomiting,​ fatigue, joint​ pain, and loss of appetite. The nurse suspects that the client is in which stage of hepatitis​ infection? Icteric Recovery Convalescent Prodromal

Hepatitis C Illicit drug​ use, tattooing,​ piercing, and blood products received before 1987 are risk factors for hepatitis C. Risk factors for hepatitis D include​ male-to-male sexual​ contact, and illicit drug use and sharing of needles. Risk factors for hepatitis E include drinking contaminated water or eating undercooked​ food, and traveling to areas with high rates of infection. Risk factors for hepatitis B include​ male-to-male sexual contact and living with an affected individual.

A client has a history that includes illicit drug​ use, tattooing,​ piercing, and receiving blood products before 1987. For which type of hepatitis is the client at​ risk? Hepatitis C Hepatitis E Hepatitis D Hepatitis B

Chronic hepatitis Chronic hepatitis is the primary cause of liver damage leading to​ cirrhosis, and liver cancer and can also cause liver failure. Autoimmune hepatitis causes persistent inflammation and​ necrosis, causing fibrosis with​ scarring, but does not cause liver failure. Neither Hepatitis B nor Hepatitis A causes liver failure.

A client presents to the emergency department with symptoms of right upper quadrant​ pain, fatigue,​ nausea, and vomiting. Laboratory work is completed and indicates that the client is in liver failure. Which condition should the nurse expect to find in the​ client's history? Hepatitis B Hepatitis A Chronic hepatitis Autoimmune hepatitis

Icteric The icteric phase of hepatitis occurs with the onset of clinical manifestations such as jaundice. It begins around 5-10 days after exposure to the virus and can be insidious or rapid. Early symptoms often mimic those of the flu. The prodromal phase begins between exposure to the virus and the appearance of clinical manifestations, such as jaundice. The recovery or convalescent phase begins around 2-3 weeks after the acute illness begins, as patients begin to feel better.

A patient presents to the emergency department with a new onset of jaundice that has developed over the last few days. The nurse understands that this means that the patient is in which phase of hepatitis? Prodromal Active Icteric Recovery

"Most people with hepatitis recover without any medication." Treatment for hepatitis is mostly supportive, and nearly all individuals with acute hepatitis recover fully without any medical treatment. There are medications available to prevent and treat postexposure hepatitis A and B, as well as chronic viral hepatitis. It is not accurate that medication is prohibitively expensive or experimental.

A patient with a new diagnosis of acute hepatitis asks the nurse, "Why am I not being given any medication?" How should the nurse reply? "Medical treatment for hepatitis is experimental and only reserved for very serious cases." "The medication to treat hepatitis is very expensive." "There is no medication available to treat hepatitis." "Most people with hepatitis recover without any medication."

Interferon alfa Interferon alfa is used to reduce the risk of chronic hepatitis in patients with acute hepatitis C. Lamivudine, adefovir, and entecavir are used to treat severe acute hepatitis B.

A patient with hepatitis C is admitted to a medical-surgical unit. Which medication should the nurse anticipate will be ordered for this patient to reduce the risk of chronic hepatitis? Adefovir Entecavir Lamivudine Interferon alfa

Obtain and review the​ child's vaccination records. Before planning the next​ steps, the nurse should review the​ child's vaccination records to see if the child has been vaccinated or started the vaccine series before coming to the United States. If the child has not been​ vaccinated, then the nurse can suggest that the child undergo testing to look for immunity or offer the vaccine as necessary.

A school nurse was notified that a new student will be joining the school. The student is a refugee from South America and the nurse becomes concerned about the risk of hepatitis B to the other students in the school. Which should the nurse do​ first? Send the child for a hepatitis B titer. Have the​ child's parents sign a waiver of refusal to vaccinate. Vaccinate the child before school starts. Obtain and review the​ child's vaccination records.

Standard immune globulin Postexposure prophylaxis for hepatitis A must be administered within 2 weeks of exposure. Hepatitis A immune globulin would be administered to promote passive immunity to the virus. HepaGam B is the immune globulin for hepatitis B virus. Hepatitis A vaccine is given to prevent infection before exposure. Roferon-A is an interferon to treat the actual infection.

A woman presents to the clinic after learning that she was exposed to hepatitis A in a restaurant that she went to last week. Which treatment does the nurse anticipate will be ordered for this patient? HepaGam B Standard immune globulin Hepatitis A vaccine Roferon-A

The patient has become lethargic and is hyperventilating. Lethargy and hyperventilation are concerns because the drug can cause lactic acidosis. If the patient becomes lethargic, the drug should be discontinued, and the healthcare provider notified promptly.

The nurse is assessing a patient with chronic hepatitis who is receiving the antiretroviral agent lamivudine (Epivir). Which assessment finding is a priority to communicate to the healthcare provider? The patient has frequent loose stools. The patient has a temperature of 99°F orally. The patient has become lethargic and is hyperventilating. The patient has nausea.

​"I must use hormonal birth control to prevent​ pregnancy." The client should use barrier​ contraception, not hormonal birth​ control, in order to prevent transmission of the infection to her spouse. It is strongly recommended that the spouse get vaccinated if he is not already immune. Careful hand hygiene and avoidance of hepatotoxins is crucial for clients with hepatitis

The nurse is caring for a client with a new diagnosis of Hepatitis B and is performing teaching to the client and family. Which statement by the client requires immediate​ correction? ​"My husband will get a hepatitis B vaccination​ immediately." ​"I will avoid alcohol and​ Tylenol." ​"We will wash our hands very carefully throughout the​ day." ​"I must use hormonal birth control to prevent​ pregnancy."

Risk for Infection Deficient Knowledge Risk for Impaired Skin Integrity A client with severe pruritus or itching is at risk for skin breakdown​ (from scratching) and infection​ (from potentially introducing harmful bacteria into a break in the​ skin). The client also has deficient knowledge related to caring for​ hepatitis-associated pruritus. Imbalanced nutrition and nausea are not applicable for this client.

The nurse is caring for a client with active hepatitis infection. The client is complaining of severe pruritus. Which are the priority nursing diagnoses for this​ client? (Select all that​ apply.) Imbalanced Nutrition​ (less than body​ requirements) Risk for Infection Nausea Deficient Knowledge Risk for Impaired Skin Integrity

Preparation for liver transplantation Liver transplantation may be necessary if a client goes into liver failure secondary to chronic hepatitis. If antivirals​ aren't working, a transplant may be the only treatment option to restore liver function and promote survival. Supportive care and a​ high-protein diet will not be effective alone if the antivirals are not working. Hospice or palliative care may not be​ appropriate, as there are other options.

The nurse is caring for a client with chronic hepatitis. Recent liver enzyme testing results indicate liver​ failure, despite use of antiviral medication. Which plan of care should the nurse anticipate​ next? Preparation for liver transplantation ​High-protein diet Supportive care Hospice or palliative care

Proper diet Avoiding alcohol Rest Treatment for hepatitis consists mostly of supportive measures. Supportive therapy includes​ rest, proper​ diet, and avoiding alcohol and diet drinks.

The nurse is caring for a client with hepatitis. Which supportive treatment should the nurse​ encourage? (Select all that​ apply.) Proper diet Increase in dietary fat Avoiding alcohol Consumption of diet drinks Rest

Hepatitis A Hepatitis A is commonly spread through the fecal-oral route and is found in populations with unsafe food and water preparation practices, such as the homeless population. This is not a risk factor for hepatitis B, C, D, or E.

The nurse is caring for a homeless patient who does not have access to clean water to prepare meals. The patient is experiencing nausea and vomiting, fatigue, and mild fever. The nurse notes yellowish sclera and mucous membranes. The nurse should recognize these clinical manifestations as being consistent with which form of hepatitis? Hepatitis D Hepatitis C Hepatitis B Hepatitis A

Drawing blood for a hepatitis B panel The nurse should anticipate drawing blood to test for the presence of hepatitis B. The vaccine should not be administered without confirming that the mother wasn't already immune to the disease. Because of the potential complications of hepatitis B infection, the infant should be treated to prevent transmission.

The nurse is caring for a newly pregnant woman who recently learned that her husband has an active hepatitis B infection. Which collaborative intervention should the nurse anticipate? Drawing blood for a hepatitis B panel Administering the hepatitis B vaccine Administering hepatitis B immune globulin Nothing; hepatitis B is self-limiting and doesn't put infant at risk

Hepatitis A Hepatitis A is spread through the fecal-oral route through contaminated food, water, shellfish, or direct contact. This type of hepatitis is often contracted during travel outside the United States. Cirrhosis and nonalcoholic fatty liver disease are not transmitted between people. Hepatitis C is spread through contact with infected blood or body secretions.

The nurse is caring for a patient admitted for abdominal pain and jaundice. The patient reports having recently traveled outside the United States. Which condition should the nurse suspect? Hepatitis A Hepatitis C Cirrhosis Nonalcoholic fatty liver disease

"The disease is into the next stage, during which you may feel hungrier, have itchy and yellowish skin, and see changes in your urine and stool." By providing information that pruritus, jaundice, and passing brown urine and clay-colored stools are typical presentations, the nurse teaches the patient about manifestations of the hepatitis disease process. Although speaking with the healthcare provider about the patient's concerns is always valid, information about manifestations of the disease process could be shared. It is unlikely that the patient will develop another fever. Ascites and an increased risk for bleeding are potential complications of cirrhosis. Telling the patient that the changes could be insignificant ignores his real and valid concern about his health. Suggesting meeting his nutritional needs is changing the subject, and it does not address the patient's real concern.

The nurse is caring for a patient who has been diagnosed with early-stage hepatitis. The patient says to the nurse, "My fever has gone down, I am less achy, and I am not vomiting anymore. I thought I was getting better, but now my skin is yellow, and I am itchy. What's happening?" Which is the nurse's best response to the patient? "I suggest that you ask your healthcare provider about your progress. Since you feel better, I suggest we walk down the hall." "So far you are making progress. We will be alert for the possibility of retaining fluid in your abdomen and bleeding." "The disease is into the next stage, during which you may feel hungrier, have itchy and yellowish skin, and see changes in your urine and stool." "I am not sure about these changes. It could be nothing at all. Is there something that I can get for you to eat because you seem to have an appetite now?"

"To prevent the complications of hepatitis B, which include liver cancer or cirrhosis" Hepatitis B is caused by the hepatitis B virus that is transmitted by exposure to infected blood or body fluids. Complications include chronic hepatitis, cirrhosis, and liver cancer. Complications of hepatitis B do not include fulminant hepatitis, death, gallstones, or biliary failure.

The nurse is caring for a patient who just found out that his spouse was diagnosed with hepatitis B. The nurse recommends that the patient get a hepatitis B vaccination. The patient asks, "Why is this necessary. Which is the best reply by the nurse? "To prevent the complications of hepatitis B, which include liver cancer or cirrhosis" "To prevent the complications of hepatitis B, which include bile stones and gall bladder failure" "To prevent the complications of hepatitis B, which include fulminant hepatitis" "To prevent the complications of hepatitis B, which include death"

​"Hepatitis D is rarely seen in the United States due to the use of hepatitis B vaccination in​ babies." Hepatitis D can only occur in the presence of hepatitis B. It is rarely seen in children in the United States because of widespread hepatitis B vaccination during infancy or young childhood. Hepatitis A is more commonly spread in daycare centers with children in diapers or who are potty training. Hepatitis A and E are spread through fecaldash-oral transmission. Hepatitis D is associated with chronic​ hepatitis, liver​ cancer, or fulminant​ hepatitis, not cirrhosis.

The nurse is caring for a young child whose parents express concerns about a local hepatitis outbreak. Which statement by the parents indicates effective teaching regarding their​ child's risk for hepatitis​ D? ​"Hepatitis D is only found in young children with​ cirrhosis." ​"Hepatitis D is rarely seen in the United States due to the use of hepatitis B vaccination in​ babies." ​"Hepatitis D is most commonly spread in daycare centers when children are in​ diapers." ​"Hepatitis D is commonly spread through poor hand​ hygiene."

Administration of an antiviral medication Antiviral medication is contraindicated in the older population due to advanced age and concurrent medical problems. Referral to a​ nutritionist, testing of liver enzymes to screen for advancing liver​ failure, and eating a​ high-protein diet are all appropriate interventions for an older adult client with hepatitis C.

The nurse is caring for an older adult client with hepatitis C. Which collaborative intervention should the nurse​ question? Periodic testing of liver enzymes Provision of​ high-protein diet Administration of an antiviral medication Referral to a nutritionist

"Hepatitis A is more serious in older adults because of nutritional deficits and diminished immune response." In older adults, hepatitis A tends to be more serious and with more complications due to nutritional deficits, diminished immune response, and cumulative toxin exposure. Therefore, older adults should recive the vaccine. Hepatitis A has a higher morbidity rate, not mortality rate. Hepatitis B, not hepatitis A, tends to be asymptomatic.

The nurse is caring for an older adult patient who was never vaccinated for hepatitis A. The nurse offers the vaccine and the patient asks why it's necessary for someone "as old as" her. Which response by the nurse is accurate? "Hepatitis A has a high mortality rate in the older population." "Hepatitis A vaccination may not be necessary in the older population." "Hepatitis A is usually asymptomatic in the older population, leading to delays in treatment." "Hepatitis A is more serious in older adults because of nutritional deficits and diminished immune response."

Receive hepatitis A and B vaccinations The most important recommendation for the nurse to give that older adults living in nursing homes or other community settings is to receive the hepatitis A and B vaccinations since the disease can spread rapidly.​ Also, older adults have a higher likelihood of complications from hepatitis than other populations. Food preparation in communal dining rooms is highly regulated and should be considered safe. All individuals should be sure food is cooked well prior to consuming. The older population living in a community setting is at no greater risk than that of all populations for contracting infection from blood transfusion.

The nurse is caring for older clients in an assisted living complex. Which behavior is most important for the nurse​ encourage? Avoid any blood transfusions Avoid eating fish prepared in communal dining areas Receive hepatitis A and B vaccinations Drink only bottled water

"A vaccination is available for hepatitis B." There are vaccinations available that promote active immunity against hepatitis A and hepatitis B. They can be administered as individual injections or as one combination vaccination. There are no vaccinations available against hepatitis C, hepatitis D, and hepatitis E.

The nurse is providing a reveiw session about hepatits to colleagues. Which statement regarding vaccination availability for viral hepatitis should the nurse include? "A vaccination is available for hepatitis D." "A vaccination is available for hepatitis B." "A vaccination is available for hepatitis C." "A vaccination is available for hepatitis E."

"Plan rest periods during the day." Patients diagnosed with hepatitis are at risk for fatigue. The nurse will educate regarding the need to plan rest periods throughout the day. Although they are all appropriate interventions that address other issues that patients with hepatitis often encounter, encouraging smaller meals, adhering to the plan of care, and bathing in warm water do not address the patient's fatigue.

The nurse is providing discharge teaching to a patient diagnosed with hepatitis. Which instruction should the nurse include for dealing with daily fatigue? "Bathe in warm water." "Adhere to the follow-up plan of care." "Plan rest periods during the day." "Take small meals."

"Use barrier contraception every time you have sex." Someone with hepatitis B can spread the infection through blood or body fluids. Counseling the patient to avoid those activities, such as having unprotected sex, is essential to minimize transmission to others. Hence, this is the priority teaching point. Comfort measures, energy preservation, and avoidance of hepatotoxins are important but not the priority.

The nurse is providing discharge teaching to a patient with chronic viral hepatitis. Which is the priority teaching point for this patient? "Avoid hepatotoxins such as alcohol or acetaminophen." "Attend to management of pruritis and promotion of skin integrity." "Use barrier contraception every time you have sex." "Limit activity to prevent fatigue."

​"It is best to eat small meals with snacks in between​ meals." Clients should be encouraged to eat small meals with snacks in between meals. Diet drinks and alcoholic beverages should be​ avoided, as clients with liver disease have decreased liver function and have difficulty detoxifying and breaking down certain foods. Clients should be encouraged to use nutritional supplements. Clients with liver disease are often malnourished and require additional supplementation to improve nutritional status.

The nurse is providing nutritional teaching to a client recently diagnosed with hepatitis. Which statement is appropriate for the nurse to​ include? ​"It is acceptable to drink diet​ drinks." ​"No nutritional supplements are​ needed." ​"Moderate alcohol intake is​ acceptable." ​"It is best to eat small meals with snacks in between​ meals."

"I will come back in 2 weeks for the next dose." Conventional interferons have a short half-life and require administration several times a week. It is not accurate for the new graduate nurse to have the patient return in 2 weeks for the next dose. There are also longer-acting preparations; however, they have a higher rate of side effects.

The nurse is providing teaching to a patient receiving a conventional interferon. Which patient statement indicates the need for further teaching? "I will make sure to use a reliable form of birth control." "I will come back in 2 weeks for the next dose." "I may experience flu-like symptoms as I get used to this medication." "Side effects should go away the longer I am taking the medicine."

The patient has long red scratches on the arms. Having long red scratches on the arms indicates that the patient's skin is not intact, owing to continued issues with itching. The patient may need further intervention to promote skin integrity and manage pruritis.

The nurse is seeing a patient who is recovering from an acute hepatitis A infection. Which observation by the nurse indicates a need for further intervention? The patient has long red scratches on the arms. The patient states that he is eating already-prepared meals. The patient denies having abdominal pain. The patient is eating a high-protein snack.

Assess the patient for pruritis and skin integrity. Itching and pruritis are a sign that the patient has continued problems resulting from hepatitis infection. The nurse must assess the patient to get more information before recommending an intervention. Bed rest will not relieve the patient's itching. It is not normal to continue to feel itchy during recovery. The nurse will need to get an order from the healthcare provider before applying a hydrocortisone cream.

The nurse is seeing a patient who is recovering from an acute hepatitis A infection. The nurse notes long red scratch marks on the patient's arms. Which is the nurse's next step? Reassure the patient that it is normal to feel itchy during recovery. Put the patient on bed rest for 1 week to promote rest. Assess the patient for pruritis and skin integrity. Administer hydrocortisone cream to relieve itching.

​"I will take acetaminophen for arthritis​ pain." : Acetaminophen is toxic to the liver and should be avoided in a client with liver dysfunction. A​ low-fat, high-carbohydrate diet and dry toast to relieve nausea are appropriate.

The nurse is teaching a client with hepatitis who has an increased alanine aminotransferase​ (ALT) lab value. Which statement by the client requires further teaching by the​ nurse? ​"I will follow a​ low-fat, high-carbohydrate​ diet." ​"I will eat dry toast to relieve my​ nausea." ​"I will require increased periods of​ rest." ​"I will take acetaminophen for arthritis​ pain."

"In this phase I will have dark urine." The urine may be dark during the icteric phase owing to increased levels of conjugated bilirubin, which results from the breakdown of hemoglobin conjugated by hepatocytes and excreted in the bile. A decrease in appetite and muscle aches and fever are noted before the icteric phase of hepatitis.

The nurse is teaching a patient recently diagnosed with hepatitis about the icteric phase. Which statement by the patient indicates teaching has been effective? "In this phase I will have dark urine." "In this phase I will have muscle aches." "In this phase I will have fever." "In this phase I will have a decrease in appetite."

Impaired flow of bile into the biliary system Inflammation in the liver causes damage to the cells. Eventually, this cellular damage restricts the flow of bile through the biliary system, causing jaundice of the skin and mucous membranes. It is not associated with a lymph blockage or backup of bile in the skin. Bile salts are processed by the liver, not the kidney.

The nurse is teaching a patient recently diagnosed with hepatitis. Which description best explains the cause of jaundice? Accumulation of yellow lymph in the lymph nodes in the neck Buildup of excess bile into the cells of the skin and mucous membrane Increased excretion of bile salts from the kidney Impaired flow of bile into the biliary system

Hepatitis A Hepatitis A and hepatitis E are both transmitted through the fecal-oral route. It is important to practice diligent hand hygiene, especially before handling or preparing food and using the restroom. Hepatitis B, C, and D are transmitted through blood and body fluids.

The risk of which type of hepatitis virus is reduced through diligent hand washing before preparing or handling food? Hepatitis D Hepatitis A Hepatitis C Hepatitis B

Color of urine and stool The color of urine and stool will change with the presence of cirrhosis. Stool is clay​ colored, and urine is brown. Although lipid metabolism may be​ affected, this finding is also present in other disease conditions. Hypoxia is not a finding of cirrhosis. Dysphagia and gastric reflux are not noted in cirrhosis.

When documenting the assessment of a client who possibly has​ hepatitis, which item should be most important for the nurse to​ include? Pulse oximetry reading to note hypoxia Color of urine and stool Dysphagia and gastric reflux Review of serum lipid profile

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) Once a patient has tested positive for chronic hepatitis, it is important to determine the extent of liver damage. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are two enzymes that are produced by the liver; elevated levels indicate liver damage. BUN/Cr test for kidney damage. Gallbladder biopsy and amylase levels do not test for liver damage.

Which blood test(s) should the nurse anticipate the healthcare provider to order for a patient newly diagnosed with chronic hepatitis? Amylase Blood Urea Nitrogen (BUN) and Creatinine (Cr) Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) Gallbladder biopsy

One who is living with an infected person Risk factors for hepatitis A include male-to-male sexual contact, illicit drug use and sharing needles, drinking contaminated water or eating undercooked food, traveling in areas with high rates of infection, having HIV positive status, and living with an infected individual.

Which patient is at greatest risk for developing hepatitis A? One who is on high doses of acetaminophen One who has a history of autoimmune disorder One who suffers from alcoholism One who is living with an infected person

Hepatitis C Hepatitis B Hepatitis B and hepatitis C can be passed to an unborn child through an infected mother. The nurse should recommend testing for these two conditions so that treatment can be initiated quickly after birth if an active infection is present.

A nurse is caring for a pregnant woman and offers testing for which types of hepatitis to prevent vertical​ transmission? (Select all that​ apply.) Hepatitis C Hepatitis E Hepatitis D Hepatitis B Hepatitis A

​Anti-HAV IgM Anti-HAV IgM is the antibody that is found in the serum during an acute illness and would be most appropriate for the provider to order.​ AST/ALT and bilirubin are used to determine the extent of liver damage.​ Anti-HAV IgG is found in the blood during recovery and indicates immunity to the virus. Presence of this antibody does not indicate active infection.

A nurse is caring for a client who presented to the emergency department after exposure to hepatitis A at a local restaurant last week. Which serum testing should the nurse anticipate that the healthcare provider will​ order? ​Anti-HAV IgM ​AST/ALT ​Anti-HAV IgG Bilirubin

"Drink and use only bottled water, do not eat raw fruits and vegetables, and wash your hands before eating anything." Hepatitis A is transmitted by the fecal-oral route through contaminated food, water, shellfish, and direct contact. Using and consuming only bottled water and not eating any raw food reduces the possibility of contracting the disease. Hand washing before eating is very important. Although the onset is abrupt, the virus is in the body of the infected person for about 2 weeks before symptoms appear. Another form of hepatitis is not a precursor to hepatitis A.

A patient planning travel to South American to volunteer at a health clinic asks the nurse, "I heard hepatitis A is common there. How can I avoid it? " Which is the nurse's best response to the patient? "Hepatitis A is contagious only if you are infected with hepatitis B, and you have been immunized for hepatitis B." "Wash your hands after contact with a patient and before eating." "Drink and use only bottled water, do not eat raw fruits and vegetables, and wash your hands before eating anything." "Be sure to wash your hands whenever you come in contact with a patient."

Smaller meals with between-meal snacks and nutritional supplements. Adequate nutrition is important for immune function and healing in patients with hepatitis. Encourage the patient to eat smaller meals and to eat snacks in between meals to maintain nutrient and calorie intake. Also, encourage the use of nutritional supplements such as Ensure or instant breakfast drinks. Intake of low-fat proteins such as egg whites and beans may need to be increased. Instruct the patient to avoid alcohol, diet drinks, and fatty meals.

In addressing the impaired nutritional balance for a patient who has been diagnosed with hepatitis B, which dietary changes should the nurse discuss with the patient? Limit alcohol and diet drinks. Increase dietary fat intake. Decrease low-fat proteins such as egg whites and beans. Smaller meals with between-meal snacks and nutritional supplements.

"Hepatitis A can spread through a daycare center where children are in diapers or potty training." Hepatitis A is commonly spread at daycare centers, where children are in diapers or being potty trained. Vaccination against this virus is the best way to prevent transmission of the disease. The parents should also ensure that there are strict handwashing protocols in place at the daycare.

The nurse informs the parents of 1-year-old child the hepatitis A vaccine is scheduled to be given. The parents ask why it would be necessary to vaccinate their baby against a disease like hepatitis. Which is the best reply by the nurse? "Hepatitis A can spread through a daycare center where children are in diapers or potty training." "Hepatitis A can be transmitted when being in close proximity with someone else who has the disease." "It is good to vaccinate your child before they start high school and becomes sexually active." "Hepatitis A can be spread if a child gets hurt and bleeds on the floor or other surfaces."

"Recovery times vary, but it may be up to 6 months." The convalescent, or recovery, phase of hepatitis B starts with a feeling of well-being after 2-3 weeks of feeling acutely ill. Complete recovery from hepatitis B can take up to 6 months.

The nurse is teaching a patient with hepatitis B about the recovery phase of the disease. Which statement should the nurse include? "Recovery from hepatitis can take several years." "Recovery can take up to 2 months after the acute illness." "There is no complete recovery from hepatitis B." "Recovery times vary, but it may be up to 6 months."

This disease is a risk factor for primary liver cancer. This disease is transmitted through infected blood and body fluids. Liver cells are damaged by the immune response. Hepatitis B is spread through infected blood and body fluids and increases the risk for primary liver cancer. In​ addition, damage to liver cells is caused by the immune response. Hepatitis B is common in the United States and must be present for hepatitis D to occur.

The nurse prepares a presentation on hepatitis B for new nurses. Which information should be​ included? (Select all that​ apply.) This disease is a risk factor for primary liver cancer. This disease is transmitted through infected blood and body fluids. Liver cells are damaged by the immune response. This disease is rare in the United States. Pathogens cause infection only in persons who are also infected with hepatitis D.

Hepatitis A Hepatitis B There are currently vaccinations against Hepatitis A and Hepatitis B. There are no developed vaccinations against Hepatitis​ C, D, or E.

The nurse should encourage all clients to receive vaccinations against which type of​ hepatitis? (Select all that​ apply.) Hepatitis E Hepatitis C Hepatitis A Hepatitis B Hepatitis D

Current medications The nurse will ask about current medications during the health history portion of the nursing assessment. Weight, skin color, and peripheral pulses are assessed during the physical examination portion of the nursing assessment.

Which data should the nurse include in the health history portion of an assessment of a patient diagnosed with hepatitis? Skin color Peripheral pulses Current medications Current weight

A patient with hepatitis E and fecal incontinence The use of contact precautions is needed only when a patient has hepatitis A or hepatitis E and fecal incontinence due to the risk of transmission. A patient with a new diagnosis of Hepatitis B, who is in the icterus phase of hepatitis C, or who is recovering from hepatitis A (without fecal incontinence) does not require contact precautions.

Which patient requires contact precautions? A patient with hepatitis E and fecal incontinence A patient with a new diagnosis of Active Hepatitis B A patient who is recovering from hepatitis A A patient in the icterus phase of hepatitis C

​"I have recently been​ overseas." Hepatitis A is most commonly spread through contaminated food and water in developing countries with high rates of hepatitis A. To prevent hepatitis​ A, travelers in developing countries should boil​ water, cook food​ thoroughly, and peel raw vegetables and fruits.

Which statement suggests that a client is at risk for contracting viral hepatitis​ A? ​"I am a healthcare​ worker." ​"I had a blood transfusion​ recently." ​"I have recently been​ overseas." ​"I have renal failure and receive hemodialysis three times a​ week."

Use of contact precautions Hepatitis A is transmitted through the fecal-oral route. If a patient with this condition is also experiencing fecal incontinence, contact isolation is required to prevent transmission of infection to other patients and staff members.

While working with a patient with hepatitis A, which is the most appropriate action by the nurse? Initiating droplet precautions Use of a mask when entering the room Use of standard precautions Use of contact precautions