Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He’s jaundiced and reports weakness. Which intervention will you include in his care?
A. Regular exercise.
B. A low-protein diet.
C. Allow the patient to select his meals.
D. Rest period after small, frequent meals.
Correct Answer: D. Rest period after small, frequent meals.
Rest periods and small frequent meals are indicated during the acute phase of hepatitis B. 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 A: Institute bed red or chair rest during the toxic state. Provide a quiet environment; limit visitors as needed. This 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 B: If tolerated, a normal or increased protein intake helps with liver regeneration. Protein restriction may be indicated in severe disease (fulminant hepatitis) because the accumulation of the end products of protein metabolism can potentiate hepatic encephalopathy.
Option C: Consult with a dietitian, nutritional support team to provide diet according to patient’s needs, with fat and protein intake as tolerated. Useful in formulating dietary programs to meet individual needs. Fat metabolism varies according to bile production and excretion and may necessitate the restriction of fat intake if diarrhea develops.
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