Which of the following will the nurse include in the care plan for a client hospitalized with viral hepatitis?
A. Increase fluid intake to 3000 ml per day
B. Adequate bed rest
C. Bland diet
D. Administer antibiotics as ordered
Correct Answer: B. Adequate bed rest.
Treatment of hepatitis consists of bed rest during the acute phase to reduce metabolic demands on the liver, thus increasing blood supply and cell regeneration. Institute bed red or chair rest during the toxic state. Provide a quiet environment; limit visitors as needed. Promotes rest and relaxation. Available energy is used for healing. Activity and an upright position are believed to decrease hepatic blood flow, which prevents optimal circulation to the liver cells.
Option A: Monitor I&O, compare with periodic weight. Note enteric losses: vomiting and diarrhea. Diarrhea may be due to transient flu-like response to viral infection or may represent a more serious problem of obstructed portal blood flow with vascular congestion in the GI tract, or it may be the intended result of medication use (neomycin, lactulose) to decrease serum ammonia levels in the presence of hepatic encephalopathy.
Option C: Encourage intake of fruit juices, carbonated beverages, and hard candy throughout the day. Monitor dietary intake and caloric count. Suggest several small feedings and offer the “largest” meal at breakfast. Large meals are difficult to manage when a patient is anorexic. Anorexia may also worsen during the day, making intake of food difficult later in the day.
Option D: Establish isolation techniques for enteric and respiratory infections according to infection guidelines and policy. Encourage or model effective handwashing. Prevents transmission of viral disease to others. Thorough hand washing is effective in preventing virus transmission.
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