Gastrointestinal System Disorders Q 142 - Gyan Darpan : Learning Portal
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Thursday 14 April 2022

Gastrointestinal System Disorders Q 142

A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:
    A. Severe abdominal pain radiating to the shoulder.
    B. Anorexia, nausea, and vomiting.
    C. Eructation and constipation.
    D. Abdominal ascites.

Correct Answer: B. Anorexia, nausea, and vomiting.

Hallmark signs and symptoms of hepatitis A include anorexia, nausea, vomiting, fatigue, and weakness. Acute hepatitis usually presents as a self-limited illness; development of fulminant hepatitis is rare. Typical symptoms of acute infection include nausea, vomiting, abdominal pain, fatigue, malaise, poor appetite, and fever; management is with supportive care.

Option A: Abdominal pain may occur but doesn’t radiate to the shoulder. Extrahepatic manifestations rarely occur but may include pancreatitis, rash, acute kidney injury with interstitial nephritis or glomerulonephritis, pneumonitis, pericarditis, hemolysis, and acute cholecystitis.
Option C: Eructation and constipation are common in gallbladder disease, not hepatitis A. Patients may develop dark urine and pale stools within a week, followed by jaundice, icteric (yellow-tinted) sclera, and pruritus. Patients usually have elevated levels of serum alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase, and lambda-glutamyl transpeptidase.
Option D: Abdominal ascites is a sign of advanced hepatic disease, not an early sign of hepatitis A. Ascites is the pathologic accumulation of fluid within the peritoneal cavity. It is the most common complication of cirrhosis and occurs in about 50% of patients with decompensated cirrhosis in 10 years. The development of ascites denotes the transition from compensated to decompensated cirrhosis.

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