Which phase of hepatitis would the nurse incur strict precautionary measures at?
A. Icteric
B. Non-icteric
C. Post-icteric
D. Pre-icteric
Correct Answer: D. Pre-icteric
Pre-icteric is the infective phase and precautionary measures should be strictly enforced. However, most patients are not always diagnosed during this phase. Nonspecific symptoms occur; they include profound anorexia, malaise, nausea and vomiting, a newly developed distaste for cigarettes (in smokers), and often fever or right upper quadrant abdominal pain. Urticaria and arthralgias occasionally occur, especially in HBV infection.
Option A: During the icteric phase, precautionary measures should already be in place. After 3 to 10 days, the urine darkens, followed by jaundice. Systemic symptoms often regress, and patients feel better despite worsening jaundice. The liver is usually enlarged and tender, but the edge of the liver remains soft and smooth. Mild splenomegaly occurs in 15 to 20% of patients. Jaundice usually peaks within 1 to 2 weeks.
Option B: There is no non-icteric phase. Some manifestations of acute hepatitis are virus-specific, but in general, acute infection tends to develop in predictable phases. Acute viral hepatitis is a common, worldwide disease that has different causes; each type shares clinical, biochemical, and morphologic features. The term acute viral hepatitis often refers to infection of the liver by one of the hepatitis viruses.
Option C: During the post-icteric phase, precautionary measures should already be in place. During this 2- to 4-week period, jaundice fades. Appetite usually returns after the first week of symptoms. Acute viral hepatitis usually resolves spontaneously 4 to 8 weeks after symptom onset.
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