Acute Inflammatory DisordersDisturbances in

Metabolism

HEPATITIS

• Marked by:– Hepatocellular destruction– Necrosis– Autolysis

• Prognosis is poor if edema and end-stage liver disease develops

Hepatitis

Hepatitis A B C D E

A.K.A Infectious Hepatitis

Serum Hepatitis

Non-A, Non-B Hepatitis

Cause HAV HBV HCV HDV HEV

Mode of Transmis-sion

Fecal-oral; food-borne;Water-bourne; person-to-person contact

Parenteral; sexual; perinatal

Blood transfusions and parapher-nalia; sex with infected partner

Same as HBV

Fecal-oral

S/Sx

Flu-like(Pre-Icteric Phase; Icteric Phase)

With or without symptoms

Similar to HBV; less severe and anicteric

Similar to HBV

Similar to HAV; severe in pregant

Prognosis

Mild with recovery

may be severe; Risk for cirrhosis

Risk for hepatic cancer

Similar to HBV

Similar to HAV

Virus infect liver-interlobular infiltration

Necrosis and hyperplasia of kuffer cells

Failure of the bile to reach intestine in normalamount

Obstructed jaundice s/sx: dark urine, pale feces, itchness

Liver cell damageNecrosis and autolytic type destroy

parenchyma

VIRAL HEPATITIS• Assessment : s/sx

• Prodromal / Preicteric»S – symptoms of URTI»W – weight loss»A – anorexia , chills , fever»R – right upper quadrant pain»M – malaise

• Icteric»J – jaundice»A – acholic stool»B – bile colored urine ( tea colored)

APPENDICITIS

VIRAL HEPATITIS

• Nursing Mgt• Isolation of patient ( enteric isolation)• Standard precaution• Patient should be encouraged to rest during acute

or symptomatic phase• Improved nutritional status• Utilize appropriate measures to minimize spread of

the disease

VIRAL HEPATITIS• Nursing Mgt

• Observe patient for Melena and check stool for the presence of blood

• Provide optimum eye and oral care• Increase in ability to carry out activities

– Encourage the patient to limit activity when fatigued– Assist the client in planning period of rest and activity– Encourage gradual resumption of activities and mild exercise during recovery

• PREVENTION AND CONTROL– Handwashing every after use of toilet– Travelers should avoid water and ice if unsure of their purity– Educate on the mode of transmission of the disease.

• Monitor patient’s weight daily, and record fluid intake and output

• Observe stools for consistency and amount and record bowel movement

• Tell the client not to consume alcohol or use nonprescription drugs for 1 year

Special Considerations

APPENDICITIS

APPENDICITISPathophysiology:

Lumen of appendix - obstructed

Increased pressure in lumen of appendix

Restricted blood flow

Inflammation

Mucosa continues to secrete fluid

InfectionHypoxia Gangrene

PerforationPERITONITIS

APPENDICITIS

APPENDICITIS

APPENDICITIS

APPENDICITIS

APPENDICITIS

APPENDICITIS

PANCREATITIS

PANCREATITIS

ACUTE PANCREATITIS

PATHOPHYSIOLOGY• Spasm, edema or block in the Ampulla of Vater reflux of proteolytic enzymes auto digestion of the pancreas inflammation

PANCREATITIS

PANCREATITIS

CHOLECYSTITIS

CHOLECYSTITIS

Colleen C. Flores, RN

CHOLECYSTITIS

CHOLECYSTITIS