Materiały źródłowe

• #1 6 Hepatitis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hepatitis-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with hepatitis. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing hepatitis. This guide equips you with the necessary information to provide effective and specialized care to patients dealing with hepatitis. […] Nursing care planning and management for patients with hepatitis includes: reducing the demands of the liver while promoting physical well-being, preventing complications of hepatitis, enhance self-concept, acceptance of situation, and providing information about the disease process, prognosis, and treatment. […] The following are the nursing priorities for patients with hepatitis: Manage symptoms and provide supportive care. Prevent further liver damage and promote liver health. Monitor liver function and assess disease progression. Administer antiviral medications, if applicable. Educate patients on lifestyle modifications to minimize liver stress. Prevent transmission of hepatitis to others. Address complications or comorbidities associated with hepatitis.

• #1 Nursing Care Plan (NCP) for Hepatitis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hepatitis

  Nursing Assessment for Hepatitis: Gather information on the patients medical history, including any known risk factors for hepatitis (intravenous drug use, unprotected sex, recent travel to endemic areas, etc.). […] Assess and document symptoms such as jaundice, fatigue, abdominal pain, nausea, vomiting, dark urine, and changes in bowel habits. […] Investigate potential exposure sources, such as recent travel, contact with infected individuals, or high-risk behaviors that may have led to hepatitis transmission. […] Explore the patients lifestyle, including alcohol consumption, substance use, and sexual practices, as these can impact the progression of hepatitis and influence treatment decisions. […] Perform a thorough physical examination, with a focus on signs of liver dysfunction (jaundice, hepatomegaly, ascites, etc.) and any extrahepatic manifestations. […] Order and review liver function tests (ALT, AST, bilirubin, etc.), viral hepatitis serology (HBsAg, anti-HCV, etc.), and other relevant blood tests to confirm the diagnosis and assess the severity of the condition. […] If necessary, collaborate with other healthcare professionals to order imaging studies (ultrasound, CT scan, etc.) to evaluate liver structure and identify any complications. […] Assess the patients mental and emotional well-being, as a hepatitis diagnosis can have psychological implications. Provide appropriate support and resources for coping with the diagnosis and potential lifestyle changes. […]

• #1 Hepatitis B: What It Is, Symptoms, Transmission & Treatment

  https://my.clevelandclinic.org/health/diseases/4246-hepatitis-b

  Hepatitis B is a viral infection that damages your liver. Treatment is medication to reduce the risk that the virus will spread or cause complications. […] Theres no cure for hepatitis B. But there are medications that can make the virus inactive. Inactive hepatitis B means you have the virus. But inactive viruses cant spread. […] Your treatment will be different depending on your situation. Treatments may include: […] Prophylactic treatment is when healthcare providers give you medication to prevent a disease. Providers prescribe prophylactic treatment if you were exposed to the virus within the past 24 hours. […] Chronic hepatitis B treatment varies depending on your symptoms and your overall health. Treatment options are: […] Your first step is to find out if you have the virus.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8029

  Hepatitis B is a disease caused by a virus that infects the liver. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. […] Reduce your activity to match your energy level. […] Avoid alcohol for as long as your doctor tells you to. This may be months. Alcohol can make liver problems worse. […] Make sure your doctor knows all the medicines you take. Some medicines, such as acetaminophen (Tylenol), can make liver problems worse. […] If your doctor prescribes antiviral medicine, take it exactly as prescribed. […] Tell the people you live with or have sex with about your illness as soon as possible. […] Do not donate blood or blood products, organs, sperm, or eggs (ova).

• #1 6 Hepatitis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hepatitis-nursing-care-plans/

  Goals and expected outcomes may include: The client will maintain adequate hydration, as evidenced by stable vital signs, good skin turgor, capillary refill, strong peripheral pulses, and individually appropriate urinary output. The client will report an improved sense of energy. The client will perform ADLs and participate in desired activities at the level of ability. The client will verbalize understanding of the disease process, prognosis, and potential complications. The client will identify the relationship between signs/symptoms of the disease and correlate symptoms with causative factors. The client will verbalize understanding of therapeutic needs. The client will initiate necessary lifestyle changes and participate in treatment regimen. […] Therapeutic interventions and nursing actions for patients with hepatitis may include: Encourage mouth care before meals. Enhances appetite by eliminating unpleasant tastes. Recommend eating in an upright position. Reduces the sensation of abdominal fullness and may enhance intake. Encourage the intake of fruit juices, carbonated beverages, and hard candy throughout the day. These supply extra calories and may be more easily digested or tolerated than other foods. Consult with the dietitian, and nutritional support team to provide a diet according to the patients needs, with fat and protein intake as tolerated.

• #1 6 Hepatitis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hepatitis-nursing-care-plans/

  Monitor IO, and compare with periodic weight. Note enteric losses: vomiting and diarrhea. Provides information about replacement needs and effects of therapy. Diarrhea may be due to the 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. […] Observe skin for areas of redness, and breakdown. Early detection of problem areas allows for additional intervention to prevent complications/promote healing. […] Assess effect of illness on economic factors of patient and SO. Financial problems may exist because of loss of patients role functioning in the family and prolonged recovery.

• #1 Nursing Care Plan (NCP) for Hepatitis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hepatitis

  Nursing Interventions and Rationales: Initiate bleeding precautions per facility protocol. […] Monitor fluid and electrolyte balance. […] Provide routine oral care before meals with a soft toothbrush. […] Encourage and assist with positioning. […] Administer medications appropriately and monitor for effectiveness and adverse reactions. […] Provide and monitor supplemental feedings and TPN as necessary. […] Nutrition and Lifestyle education, prevention and protection. […] […] Evaluation for Hepatitis: Regularly assess the patients clinical status, including improvement or resolution of symptoms, changes in liver function tests, and overall well-being. Document and communicate findings to the healthcare team. […] Evaluate the patients adherence to the prescribed treatment plan, including medication regimens, dietary recommendations, and lifestyle modifications. Identify and address any barriers to adherence. […] Monitor for potential complications of hepatitis, such as liver cirrhosis or failure, and promptly report any signs or symptoms. Conduct ongoing assessments of vital signs, laboratory results, and physical indicators of liver function. […] Assess the patients psychosocial well-being, including emotional responses to the diagnosis, coping mechanisms, and the impact of hepatitis on daily life. Offer support, counseling, or referrals to appropriate services as needed. […] Evaluate the patients understanding of hepatitis, its management, and strategies for prevention. Assess the effectiveness of education interventions by testing knowledge retention and addressing any misconceptions or gaps in understanding. […]

• #1 Patient education: Hepatitis B (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hepatitis-b-beyond-the-basics

  Patient education: Hepatitis B (Beyond the Basics) […] Fortunately, hepatitis B infection can be prevented by vaccination. Hepatitis B vaccines are safe and highly effective in preventing hepatitis B infection and are now given routinely to newborns and children in the United States and in many other countries (see „Patient education: Vaccines for adults (Beyond the Basics)”). For people who do develop chronic hepatitis B, several medications are available for treating the infection. […] Experts recommend that all people age 18 years and older be screened at least once for hepatitis B. This is because the infection can lead to complications if a person does not know that they have it. […] In people who develop chronic hepatitis, an antiviral medication might be recommended to reduce or reverse liver damage and to prevent long-term complications of hepatitis B. However, not everyone with hepatitis B needs immediate treatment.

• #1 Hepatitis B Foundation: Healthy Liver Tips

  https://www.hepb.org/treatment-and-management/adults-with-hepatitis-b/healthy-liver-tips/

  Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. […] Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with a bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage. […] Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. […] Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by aflatoxins, which are a known risk factor for liver cancer. […] Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.

• #1 6 Hepatitis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hepatitis-nursing-care-plans/

  Assess level of understanding of the disease process, expectations and prognosis, possible treatment options. Identifies areas of lack of knowledge or misinformation and provides opportunity to give additional information as necessary. Liver transplantation may be needed in the presence of fulminating disease with liver failure. […] Discuss the side effects and dangers of taking OTC and prescribed drugs (acetaminophen, aspirin, sulfonamides, some anesthetics) and necessity of notifying future healthcare providers of diagnosis. Some drugs are toxic to the liver; many others are metabolized by the liver and should be avoided in severe liver diseases because they may cause cumulative toxic effects and chronic hepatitis.

• #1

  https://www.who.int/news-room/fact-sheets/detail/hepatitis-b

  Hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given soon after birth with boosters a few weeks later. It offers nearly 100% protection against the virus. […] Care for acute hepatitis B should focus on making the person comfortable. They should eat a healthy diet and drink plenty of liquids to prevent dehydration from vomiting and diarrhoea. […] Chronic hepatitis B infection can be treated with oral medicines, including tenofovir or entecavir. […] Treatment can slow the advance of cirrhosis, reduce cases of liver cancer, and improve long term survival. […] Most people who start hepatitis B treatment must continue it for life. […] Hepatitis B is preventable with a vaccine. […] All babies should receive the hepatitis B vaccine as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. […] Hepatitis B can be passed from mother to child. This can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine.

• #1 Caring for Pregnant Women and Newborns with Hepatitis B or C | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1115/p1225.html

  Without prophylaxis, the risk of perinatal HBV infection in an infant with an HBsAg positive mother is less than 10 percent if the mother’s HBeAg status is negative, but is 70 to 90 percent if her HBeAg status is positive. […] However, the combination of hepatitis B vaccine and hepatitis B immune globulin is 85 to 95 percent effective in reducing HBV infection from vertical transmission when given within 12 hours of birth. […] Proper management of maternal hepatitis during the prenatal phase ensures better outcomes in the infant. […] Pregnant women who are positive for HBsAg should be referred to the appropriate local case management program, as well as for counseling and medical management of HBV infection. […] Patients should also be educated about the need for infant immunoprophylaxis at birth.

• #1 Hepatitis B Foundation: Healthy Liver Tips

  https://www.hepb.org/treatment-and-management/adults-with-hepatitis-b/healthy-liver-tips/

  Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver. […] Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus. […] Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. […] Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver. […] Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver.

• #1 Clinical Care of Hepatitis B | Hepatitis B | CDC

  https://www.cdc.gov/hepatitis-b/hcp/clinical-care/index.html

  Clinicians should work with patients to monitor and slow liver damage. […] Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality. […] People with chronic hepatitis B should be under the care of a clinician with expertise in managing hepatitis B. […] Clinicians should make supportive care treatment decisions based on the patient. […] Treatment for chronic hepatitis B will depend on several factors. […] If a person has been exposed to HBV, clinicians should give appropriate prophylaxis as soon as possible, preferably within 24 hours, to effectively prevent infection. […] The AASLD recommends giving pregnant patients with HBV DNA levels greater than 200,000 IU/ML antiviral therapy to reduce perinatal HBV transmission.

• #1 Recommendations | Hepatitis B (chronic): diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/cg165/chapter/recommendations

  Offer antiviral treatment to adults younger than 30 years who have HBV DNA greater than 2000 IU/ml and abnormal ALT (greater than or equal to 30 IU/L in males and greater than or equal to 19 IU/L in females) on 2 consecutive tests conducted 3 months apart if there is evidence of necroinflammation or fibrosis on liver biopsy or a transient elastography score greater than 6 kPa. […] Offer antiviral treatment to adults with cirrhosis and detectable HBV DNA, regardless of HBeAg status, HBV DNA and ALT levels. […] Offer tenofovir disoproxil to women with HBV DNA greater than 107 IU/ml in the third trimester to reduce the risk of transmission of HBV to the baby. […] Advise women that there is no risk of transmitting HBV to their babies through breastfeeding if guidance on hepatitis B immunisation has been followed, and that they may continue antiviral treatment while they are breastfeeding.

• #1 Clinical Care of Hepatitis B | Hepatitis B | CDC

  https://www.cdc.gov/hepatitis-b/hcp/clinical-care/index.html

  In addition, clinicians should advise pregnant patients with hepatitis B that their newborns should receive both hepatitis B vaccine and HBIG at the time of birth. […] Patients coinfected with HCV infection and HBV infection who are receiving direct-acting antiviral (DAA) therapy for HCV infection are at risk of HBV reactivation. […] People with chronic hepatitis B should be under the care of a clinician with expertise in managing hepatitis B. […] To help patients stay healthy, clinicians should talk to their patients about: […] Checking with a health care professional before taking any prescription pills, nutritional or herbal supplements, or over-the-counter medications, as these can potentially damage the liver.

• #1 Hepatitis B Management: Guidance for the Primary Care Provider – HBV Primary Care Workgroup – Hepatitis B Online

  https://www.hepatitisb.uw.edu/page/primary-care-workgroup/guidance

  The purpose of this document is to provide simplified, up-to-date, and readily accessible guidance for primary care medical providers related to the prevention, diagnosis, and management of hepatitis B virus (HBV) infection, including hepatocellular carcinoma surveillance. […] This guidance was produced in collaboration with the University of Washingtons National Hepatitis Training Center (HTC). The UW HTC will host and feature the most current version of these guidelines on the free Hepatitis B Online website (hepatitisB.uw.edu). […] HBV Screening, Testing, and Diagnosis […] Initial Evaluation of Persons with Chronic Hepatitis B […] When to Initiate HBV Treatment […] Choosing an Initial HBV Treatment Regimen […] Monitoring Persons On and Off HBV Therapy […] Preventing HBV Perinatal Transmission […] Screening for Hepatocellular Carcinoma […] Occupational HBV Postexposure Prophylaxis […] Hepatitis B Reactivation in the Setting of Immunosuppression.

• #1 Patient education: Hepatitis B (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hepatitis-b-beyond-the-basics

  Once you start treatment, you will have regular blood tests to see how well the treatment is working and to detect side effects or drug resistance. Monitoring will continue after finishing treatment to determine if the infection has come back. […] If your doctor thinks you should be treated, there are two types of antiviral medications that can be used, nucleos(t)ide analogs (these are oral medications that you take daily) and interferon (an injectable medication). […] Most people will need long-term treatment to maintain control of the hepatitis B virus. In some cases, lifelong therapy is needed. […] Everyone with chronic hepatitis B should be vaccinated against hepatitis A unless they are known to be immune. […] Regular screening for liver cancer is also recommended, particularly for older individuals, those with cirrhosis, and people with a family history of liver cancer.

• #1 Primary Care Management of Hepatitis B – Quick Reference (HBV-QR) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/primary-care-management-hepatitis-b-quick-reference.html

  All patients being treated for chronic HBV require laboratory monitoring of HBV DNA levels and liver biochemistry every 3 – 6 months. […] The following patients with chronic HBV should have lifelong screening for HCC at 6-month intervals using abdominal ultrasound: Any patient with cirrhosis, Any patient with HIV or HCV co-infection, People of African descent 20 years of age or older, Men 40 years of age or older, Women 50 years of age or older, Any patient with a family history of hepatoma. […] The primary care provider advises patient of positive result, advises patient that hepatitis B is reportable to public health; reports to local public health department if not reported by laboratory staff, reviews history (including family history) and risk factors. […] Provides education and counselling based on identified risk factors and provisional diagnosis.

• #1 Nursing care plan on hepatitis B | PPT

  https://www.slideshare.net/slideshow/nursing-care-plan-on-hepatitis-b/102574535

  […] […] 3. Evaluate pain relief and control at regular intervals. Adjust medication regimen as necessary. Goal is maximum pain control with minimum interference with ADLs. Demonstrate use of relaxation skills and diversional activities as indicated for individual situation. Inform patient and SO of the expected therapeutic effects and discuss management of side effects This information helps establish realistic expectations, confidence in own ability to handle what happens. Discuss use of additional alternative or complementary therapies (acupuncture and acupressure). May provide reduction or relief of pain without drug-related side effects. […] […] […] 4. Situational low self-esteem related to Annoying/debilitating symptoms, confinement /isolation, length of illness/recovery period Verbalization of change in lifestyle; fear of rejection/reaction of others, feelings of helplessness Assess effect of illness on economic factors of patient and SO. Financial problems may exist because of loss of patient’s role functioning in the family and prolonged recovery. Verbalize acceptance of self in situation, including length of recovery/need for isolation. Offer diversional activities based on energy level. Enables patient to use time and energy in constructive ways that enhance self-esteem minimize anxiety and depression.

• #1 How nurses contribute to the elimination of hepatitis B? A systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37944357/

  With approximately one-third of the global population exhibiting serological evidence of exposure, the hepatitis B virus remains a serious public health threat. Elimination of hepatitis B faces enormous challenges, from prevention to diagnosis, treatment, and long-term monitoring. Nurses are pivotal in optimising the hepatitis B care continuum; however, their contributions have been neglected. […] To identify the role of nurses in the elimination of hepatitis B and to synthesise the effectiveness of interventions with nursing roles in approaching the elimination target. […] The synthesis from 16 studies identified 13 nursing roles that primarily involved (1) health education and counselling for informed patient decision-making regarding hepatitis B prevention, vaccination, screening, and disease monitoring; (2) case management and health promotion to advocate elimination services at multiple levels and enable equitable access among marginalised communities; and (3) running specialist clinics to lead advanced practices in prescribing and carrying diagnostic tests, formulating evidence-based individualised care plans, and coordinating care throughout the disease process.

• #1

  https://journals.lww.com/md-journal/fulltext/2024/05240/nursing_observations_of_stage_based_care_in.34.aspx

  This study explored techniques and effects of stage-based care on patients with chronic hepatitis B virus (HBV) infection. […] Patients were categorized into early, intermediate, and late hepatitis stages and received targeted clinical care during the various phases of chronic HBV infection. […] Stage-based nursing interventions have shown positive results since they address specific patient conditions and meet specialized nursing requirements at different disease stages. […] Few studies have investigated the clinical care of patients at different stages of chronic HBV infection. Therefore, this study focused on clinical-care techniques during different stages of chronic HBV infection and their impact on patient outcomes. […] If routine nursing care is not offered according to specific disease-stage conditions, the prognosis is poor and the patients clinical needs will not be met.

• #1

  https://journals.lww.com/md-journal/fulltext/2024/05240/nursing_observations_of_stage_based_care_in.34.aspx

  Targeted care was provided for the EG group patients in different stages of chronic type B hepatitis. […] Individualized care plans, including clinical knowledge, diet, psychological information, exercise, and medication guidance, were formulated and provided to patients. […] Care for early-stage patients: Patients in the early stage showed mild symptoms, including gastrointestinal discomfort, physical weakness, jaundice, no ascites, or obvious encephalopathy. […] Care for middle-stage patients: The middle-stage patients exhibited significant ascites and hepatic encephalopathy with bleeding points and bleeding tendencies. […] Care for late-stage patients: Patients in the late stage experienced severe hepatic encephalopathy and exhibited severe hepatorenal syndrome, notable bleeding, serious infection, and other complications.

• #1 Nurses need to help wipe out chronic hepatitis B, a disease borne by 300 million people – Hepatitis B Foundation

  https://www.hepb.org/blog/nurses-need-help-wipe-chronic-hepatitis-b-disease-borne-300-million-people/

  Nurses such as you and me yes, that means all nurses (and our welcomed health care counterparts) likely come across a patient or parent who declines vaccinations for themselves or their children. […] While every nurse may provide vaccine education at some point in a patients life, those in neonatal and maternal-newborn nursing have a greater responsibility with the hepatitis B vaccine. […] However, communicating those reasons to parents of our newborn patients takes a compassionate, strong and skillful approach. […] There are various clinical settings and times when nurses can educate new parents and those with children about how the hepatitis B vaccine works and why it is necessary. […] When addressing the highly recommended CDCs vaccine schedule with parents, the rule of thumb is letting them know to expect their child will get the hep B vaccine series starting at birth.

• #1 Nurses need to help wipe out chronic hepatitis B, a disease borne by 300 million people – Hepatitis B Foundation

  https://www.hepb.org/blog/nurses-need-help-wipe-chronic-hepatitis-b-disease-borne-300-million-people/

  First and foremost, determining the why in what is making the parent hesitant about or declining the hep B vaccine is vital when trying to help them understand the reason vaccination is strongly advised. […] Educating parents about complications that acquiring hepatitis B can have on the body can emphasize the vaccines purpose. […] Nurses need to use language that is concise and easy to understand. […] Nurses can let parents know hepatitis B is a virus that causes inflammation of the liver that damages and compromises its function, which can and often does lead to liver disease and ultimately cancer. […] Unlike a common bacterial infection that can quickly be treated with antibiotics, acquiring a hepatitis B infection can mean living with a chronic, life-long and potentially life-threatening illness.

• #1 Nursing Care Plan for Hepatitis – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-hepatitis/

  Hepatitis refers to inflammation of the liver, which can be caused by viral infections, toxins, or autoimmune disorders. As a nurse, your role is vital in the assessment, management, and support of patients with hepatitis. This nursing care plan aims to outline evidence-based interventions to assess, manage, and support patients with hepatitis. […] Medical Diagnosis: Hepatitis […] Fatigue related to hepatic inflammation and metabolic disturbances. […] Risk for Infection related to compromised immune function. […] Impaired Nutrition: Less than Body Requirements related to anorexia, nausea, and altered metabolism. […] Deficient Knowledge regarding hepatitis, transmission, prevention, and self-care strategies. […] Fatigue related to liver inflammation and altered metabolism as evidenced by the patients report of tiredness, decreased energy levels, or difficulty performing daily activities.

• #1 Nursing care plan on hepatitis B | PPT

  https://www.slideshare.net/slideshow/nursing-care-plan-on-hepatitis-b/102574535

  1. NURSING DIAGNOSIS PLANNING/GOAL INTERVENTIONS RATIONAL EVALUATION Imbalance nutrition (less than body required) related to Insufficient intake to meet metabolic demands anorexia, nausea /vomiting Aversion to eating/lack of interest in food; altered taste sensation Monitor dietary intake and caloric count. Suggest several small feedings and offer largest meal at breakfast. Large meals are difficult to manage when patient is anorexic. Anorexia may also worsen during the day, making intake of food difficult later in the day. Demonstrate progressive weight gain toward goal with normalization of laboratory values and no signs of malnutrition Provide supplemental feedings and TPN if needed. May be necessary to meet caloric requirements if marked deficits are present and symptoms are prolonged.

• #1 Nursing Care Plan (NCP) for Hepatitis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hepatitis

  Implementation for Hepatitis: Collaborate with the healthcare team to implement medical interventions based on the type and severity of hepatitis. This may include antiviral medications, immunizations, and supportive therapies. […] Administer prescribed medications to alleviate symptoms such as nausea, abdominal pain, and pruritus. Monitor the patients response to medications and report any adverse effects. […] Emphasize strict infection control measures to prevent the spread of hepatitis, especially in a healthcare setting. Educate the patient and caregivers on hand hygiene, safe disposal of bodily fluids, and other preventive measures. […] Collaborate with a registered dietitian to develop a nutrition plan that supports liver health. Encourage a well-balanced diet, adequate hydration, and restrictions on substances that may exacerbate liver damage, such as alcohol and certain medications. […] Provide comprehensive education on the nature of hepatitis, the importance of medication adherence, potential side effects of treatment, and strategies for preventing transmission. Emphasize the need for regular follow-up appointments and monitoring. […]

• #1 Treatment of Hepatitis B | Hepatitis B | CDC

  https://www.cdc.gov/hepatitis-b/treatment/index.html

  People with hepatitis B can live healthy and normal lives; it is important to see a doctor to optimize your care. […] If you are diagnosed with hepatitis B, your doctor should check your liver regularly for signs of damage. […] The treatment your doctor will recommend depends on whether you have acute or chronic hepatitis B. […] There are several medications approved to treat people who have chronic hepatitis B, and new drugs are in development. […] For some people with hepatitis B, these medications can prevent severe liver disease. […] However, not every person with chronic hepatitis B needs medication, and the drugs may cause side effects in some people. […] People who start hepatitis B treatment may need to take medication for the rest of their lives because these medications do not lead to a cure. […] People with hepatitis B can live a normal and healthy life. […] Have your liver checked regularly (every 36 months).

• #2 11.15 Hepatitis – Health Alterations

  https://wtcs.pressbooks.pub/healthalts/chapter/11-15-hepatitis/

  Hepatitis can be an acute or a chronic condition. […] Hepatitis B and C are transmitted via contact with infected body fluids via contaminated blood transfusions, sharing of needles, or other parenteral measures. […] Hepatitis B and C can also be transmitted sexually and via pregnancy/childbirth. […] Common early signs and symptoms of hepatitis are loss of appetite, nausea, vomiting, and fatigue. […] In severe cases of autoimmune and alcoholic hepatitis, clients may also have excessive fluid buildup in the abdomen referred to as ascites and mental status changes related to the buildup of toxins, such as ammonia, referred to as hepatic encephalopathy. […] Nursing priorities for clients with hepatitis include managing fatigue, promoting adequate nutrition, reducing the risk for bleeding, and providing health teaching.

• #2 6 Hepatitis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hepatitis-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with hepatitis. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing hepatitis. This guide equips you with the necessary information to provide effective and specialized care to patients dealing with hepatitis. […] Nursing care planning and management for patients with hepatitis includes: reducing the demands of the liver while promoting physical well-being, preventing complications of hepatitis, enhance self-concept, acceptance of situation, and providing information about the disease process, prognosis, and treatment. […] The following are the nursing priorities for patients with hepatitis: Manage symptoms and provide supportive care. Prevent further liver damage and promote liver health. Monitor liver function and assess disease progression. Administer antiviral medications, if applicable. Educate patients on lifestyle modifications to minimize liver stress. Prevent transmission of hepatitis to others. Address complications or comorbidities associated with hepatitis.

• #2

  https://www.hepbpositive.org.uk/acute-hepatitis-how-best-to-clear

  Acute Hepatitis B lasts for about 6 months and 95% of adults can expect to clear the virus. […] It is very important people who know they have acute Hepatitis B get regular sleep if tired and avoid alcohol and antibiotics as both can make the Virus lasting and chronic. […] Diet should be mild avoiding fried and fatty foods and far less red meat. […] Water is also important to help flush the virus out. […] Stay calm, stay confident and you will clear. […] We have tracked our last 50 or more acute HBV patients with this approach and they all cleared. […] At about 8 weeks after infection many patients have a very high ALT score of 1500 to 3000, again do not panic this is the liver fighting back against the Hepatitis B, a process termed „Immune Response” and not a sign of terrible long term consequences.

• #2 11.15 Hepatitis – Health Alterations

  https://wtcs.pressbooks.pub/healthalts/chapter/11-15-hepatitis/

  Nursing diagnoses for clients with hepatitis are created based on the specific needs of the client, their signs and symptoms, and the etiology of the disorder. […] Medical treatment for acute viral hepatitis consists of supportive care such as rest, fluids, and a nutritious diet. […] Chronic hepatitis may be treated with antiviral medications and medications that suppress the immune system, but these medications can have serious side effects that must be monitored. […] Nursing priorities for clients with hepatitis include managing symptoms, providing supportive care, preventing further liver damage, monitoring liver function and disease progression, and administering antiviral medications as prescribed. […] Nurses also teach clients about lifestyle modifications to promote liver health, the prevention of hepatitis transmission to others, and to promptly report symptoms of potential complications to the health care provider. […] Nurses monitor vital signs, 24-hour input and output, daily weight trends, and for signs of edema. […] Nurses provide health teaching about several topics to clients with hepatitis.

• #2 Hepatitis B – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hepatitis-b/diagnosis-treatment/drc-20366821

  Diagnosis involves the steps that your healthcare professional takes to find out if you have hepatitis B. Your healthcare professional gives you a physical exam and looks for symptoms of liver damage. These symptoms can include yellowing skin and stomach pain. […] Blood tests can detect the hepatitis B virus in your body. They also can tell your healthcare professional if the infection is acute or chronic. A simple blood test also can find out if you’re immune to the condition. […] If you know you’ve been exposed to the hepatitis B virus, call a healthcare professional right away. It’s important to know if you’ve been vaccinated for hepatitis B. A healthcare professional asks you when you were exposed and what kind of exposure you had. […] Most people with chronic hepatitis B virus infection need treatment for the rest of their lives. The decision to start treatment depends on many factors, including whether the virus is causing inflammation or scarring of the liver, also called cirrhosis.

• #2 Clinical Care of Hepatitis B | Hepatitis B | CDC

  https://www.cdc.gov/hepatitis-b/hcp/clinical-care/index.html

  Clinicians should work with patients to monitor and slow liver damage. […] Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality. […] People with chronic hepatitis B should be under the care of a clinician with expertise in managing hepatitis B. […] Clinicians should make supportive care treatment decisions based on the patient. […] Treatment for chronic hepatitis B will depend on several factors. […] If a person has been exposed to HBV, clinicians should give appropriate prophylaxis as soon as possible, preferably within 24 hours, to effectively prevent infection. […] The AASLD recommends giving pregnant patients with HBV DNA levels greater than 200,000 IU/ML antiviral therapy to reduce perinatal HBV transmission.

• #2 Hepatitis A, B, C, D, E Nursing NCLEX Review

  https://www.registerednursern.com/hepatitis-a-b-c-d-e-nursing-nclex-review/

  Handwashing (strict) […] Eat low fat and high carb meals (needs proper nutrition to help with liver regeneration and low fat intake because bile production is altered remember bile helps digest fats) […] Personal hygiene products NOT to be shared (inform about the types of products: toothbrushes, razors, drinking cups, utensils, towels etc.) […] Activity conservation patient needs to REST to help the liver heal […] Toxic substances AVOIDED especially over-the-counter products that are liver toxic: alcohol, sedative, aspirin, acetaminophen etc. […] Individual bathrooms don’t share bathroom with family members […] Test results: […] Hepatitis B: HBsAG (infectious) and anti-HBV (recovered/immune) […] Interferon (Peginterferon alfa-2a given subq) and Immune globulin for Hepatitis B Immune globulin (within 24 hours of exposure)

• #2 Management of chronic hepatitis B virus | Nursing Times

  https://www.nursingtimes.net/infection-prevention-and-control/management-of-chronic-hepatitis-b-virus-14-02-2014/

  Patients receiving oral antiviral agents need to attend every six months once they are established on treatment; blood samples should be taken to check full blood count, liver and renal profiles, and response to treatment. […] Patients living with long-term conditions are encouraged to self-manage where possible. […] All patients with CHB should receive individualised education on the following: Modes of HBV transmission, how to avoid onward transmission, and the need for testing and vaccination of close household contacts, sexual partners and direct family members. […] A crucial, ongoing element of nurses roles will be to give people with CHB up-to-date information so they can make informed decisions. […] Nurses roles cover assessment, education, self-management, adherence, monitoring and providing support, advice and care.

• #2 Essential Interventions – A National Strategy for the Elimination of Hepatitis B and C – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442228/

  Viral hepatitis elimination is an international effort, but the scope of the problem varies by country. […] This chapter discusses some crucial actions that would help reduce the national burden of both infections. […] Prevention is the first step to making HBV and HCV infections rare. Hepatitis B is preventable with immunization, so prevention is a matter of ensuring widespread vaccination and taking steps to prevent transmission from mother to child. […] Hepatitis B is preventable. The vaccines licensed in the 1980s confer durable immunity to 95 percent of people who receive three doses. […] Perfect vaccination of children would end HBV transmission in two generations, but the elimination goals set out in Chapter 2 require faster action than that. […] In the United States, better attention to adult vaccination and changes to the management of HBsAg+ pregnant women may be all that stands in the way of ending the transmission of HBV.

• #2 Perinatal Hepatitis B: What Nurses need to Know | doh

  https://dchealth.dc.gov/page/perinatal-hepatitis-b-what-nurses-need-know

  What Nurses Need to Know About Hep B and Pregnancy […] As nurses, you have a vital role in perinatal hepatitis B prevention. Some of the latest recommendations for nursing care include: […] Review the maternal HBsAg (antigen) original test result for each maternal admission. If unknown, obtain a STAT order from admitting provider. If pregnant delivery parent is HBsAg (antigen) positive, alert the nursery personnel. Following your hospital infectious disease protocol for care of infant. Administer hepatitis B vaccine and hepatitis B immune globulin (HBIG) as indicated within 12 hours of birth. Educate the parent in hepatitis B and its prevention in a language appropriate for parent. […] Report the delivery to your Perinatal Hepatitis B Nurse Specialist.

• #2 Patient education: Hepatitis B (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hepatitis-b-beyond-the-basics

  Alcohol should be avoided since it can worsen liver damage. All types of alcoholic beverages can be harmful to the liver. […] Some people find it helpful to connect with and get support from others living with hepatitis B. A number of organizations are available around the world. […] Preventing infection of close contacts — Acute and chronic hepatitis B are contagious. Thus, people with hepatitis B should discuss measures to reduce the risk of infecting close contacts. […] If a pregnant person tests positive for hepatitis B surface antigen, certain steps can be taken to decrease the risk of transmitting the virus to their baby.

• #2 Viral Hepatitis NCLEX Review – Straight A Nursing

  https://straightanursingstudent.com/viral-hepatitis/

  Hepatitis B can be acute or chronic and is spread through contact with infected body fluids such as blood, saliva, vaginal fluids and semen. […] When an individual is unable to recover from acute hepatitis B, they develop chronic hepatitis B, which can cause serious liver disease such as cirrhosis and even liver cancer. […] Key things to teach your patient with hepatitis include: Patients should be vaccinated against other forms of hepatitis. […] Individuals with hepatitis B should be tested for hepatitis D if their condition worsens or they notice signs of new infection such as fever. […] Avoid alcohol as this can be damaging to the liver. […] Avoid medications that can harm the liver further – this includes acetaminophen, NSAIDs, statins, sulfa antibiotics, some anti seizure medications, and herbs such as black cohosh and kava.

• #2 Caring for Pregnant Women and Newborns with Hepatitis B or C | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1115/p1225.html

  Family physicians encounter diagnostic and treatment issues when caring for pregnant women with hepatitis B or C and their newborns. […] All pregnant women should be screened for hepatitis B as part of their routine prenatal evaluation; those with ongoing risk factors should be evaluated again when in labor. […] Infants of mothers who are positive for hepatitis B surface antigen should receive hepatitis B immune globulin and hepatitis B vaccination within 12 hours of birth, and other infants should receive hepatitis B vaccination before hospital discharge. […] Maternal infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) can expose the newborn to a subsequent chronic hepatitis infection. […] The risk of vertical transmission depends on the time at which the pregnant woman acquired HBV infection, and on her statuses of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg).

• #2 Hepatitis B & C

  https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/hepatitis-b-and-c

  Hepatitis B and C are common liver infections among people living with HIV. […] Given the risks of hepatitis B or hepatitis C coinfection to people with HIV, it is important to understand these risks, take steps to prevent infection, know your status, and, if necessary, get medical care from a health care provider who is experienced in treating people who are coinfected with HIV and HBV, or HIV and HCV. […] Viral hepatitis screening and care prevention are important parts of HIV care. […] Yes. Everyone with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually. […] Hepatitis B: Vaccination is the best way to prevent all the ways that hepatitis B is transmitted. People with HIV who do not have active HBV infection should be vaccinated against it.

• #2 Management and care of hepatitis B | ASHM Health

  https://ashm.org.au/hepatitis-b-toolkit/management-and-care-of-hepatitis-b/

  Everyone living with chronic hepatitis B requires initial assessment and then regular monitoring. It is recommended that certain people with hepatitis B undergo hepatocellular carcinoma (HCC or liver cancer) surveillance. […] Regular monitoring includes blood tests every 6 months to monitor for progression from one phase of infection to another and determine antiviral treatment eligibility. The natural history of hepatitis B can be divided into 4 progressive phases based on viral load, liver function tests and HBeAg/Ab status. Eligibility for antiviral treatment and specific monitoring is based on the patient’s current disease phase. […] Monitoring and/or HCC surveillance can be done by a GP or nurse practitioner, with support and advice from and referral to either a tertiary specialist or hepatitis B s100 prescriber when required.

• #2 Patient education: Hepatitis B (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hepatitis-b-beyond-the-basics

  Once you start treatment, you will have regular blood tests to see how well the treatment is working and to detect side effects or drug resistance. Monitoring will continue after finishing treatment to determine if the infection has come back. […] If your doctor thinks you should be treated, there are two types of antiviral medications that can be used, nucleos(t)ide analogs (these are oral medications that you take daily) and interferon (an injectable medication). […] Most people will need long-term treatment to maintain control of the hepatitis B virus. In some cases, lifelong therapy is needed. […] Everyone with chronic hepatitis B should be vaccinated against hepatitis A unless they are known to be immune. […] Regular screening for liver cancer is also recommended, particularly for older individuals, those with cirrhosis, and people with a family history of liver cancer.

• #2 Hepatitis B Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/hepatitis-b

  If you develop liver failure, you may be considered for a liver transplant. A liver transplant is the only cure in some cases of liver failure. […] More information and support for people with HBV condition and their families can be found by joining a support group. […] The best way to prevent hepatitis B is to get the vaccine. The CDC recommends that children and adults get the hepatitis vaccine.

• #2 How nurses contribute to the elimination of hepatitis B? A systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37944357/

  Nurses play multifaceted roles in advocating hepatitis B screening and vaccination, initiating outreach efforts in marginalised communities, and leading advanced practices that effectively contribute to the elimination of hepatitis B. Policymakers should consider how nurses may help the achievement of the elimination target.

• #2

  https://journals.lww.com/md-journal/fulltext/2024/05240/nursing_observations_of_stage_based_care_in.34.aspx

  Targeted care was provided for the EG group patients in different stages of chronic type B hepatitis. […] Individualized care plans, including clinical knowledge, diet, psychological information, exercise, and medication guidance, were formulated and provided to patients. […] Care for early-stage patients: Patients in the early stage showed mild symptoms, including gastrointestinal discomfort, physical weakness, jaundice, no ascites, or obvious encephalopathy. […] Care for middle-stage patients: The middle-stage patients exhibited significant ascites and hepatic encephalopathy with bleeding points and bleeding tendencies. […] Care for late-stage patients: Patients in the late stage experienced severe hepatic encephalopathy and exhibited severe hepatorenal syndrome, notable bleeding, serious infection, and other complications.

• #2 Hepatitis Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/hepatitis-nursing-diagnosis/

  Monitor for complications. […] Nursing Diagnosis: Fatigue related to inflammatory process and increased metabolic demands secondary to hepatitis as evidenced by verbalized exhaustion and decreased activity tolerance. […] Nursing Diagnosis: Risk for Impaired Liver Function related to hepatitis viral infection as evidenced by elevated liver enzymes and presence of viral markers. […] Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to nausea and decreased appetite secondary to hepatitis as evidenced by weight loss and reduced oral intake. […] Nursing Diagnosis: Deficient Knowledge related to hepatitis disease process, transmission, and management as evidenced by verbalized misconceptions and questions about the condition. […] Nursing Diagnosis: Anxiety related to chronic illness diagnosis and potential lifestyle changes secondary to hepatitis as evidenced by verbalized worries and increased heart rate.

• #2 Nursing care plan on hepatitis B | PPT

  https://www.slideshare.net/slideshow/nursing-care-plan-on-hepatitis-b/102574535

  […] […] 2. NURSING DIAGNOSIS Deficient fluid Volume related to Osmotic diuresis (from hyperglycemia) Excessive gastric losses: diarrhea. Maintain body fluid level and reduce the intensity of the symptoms of Disease Assess patient’s history related to duration or intensity of symptoms such as vomiting, excessive urination. Assists in estimation of total volume depletion. Symptoms may have been present for varying amounts of time (hours to days). Fluid level is maintained and patient feeling comfortable Note orthostatic BP changes. Hypovolemia may be manifested by hypotension and tachycardia. Estimates of severity of hypovolemia may be made when patient’s systolic BP drops more than 10 mmHg from a recumbent to a sitting then a standing position. Demonstrate adequate hydration as evidenced by stable vital signs, palpable peripheral pulses, good skin turgor and capillary refill, individually appropriate urinary output, and electrolyte levels within normal range.

• #2 Nursing Care Plan (NCP) for Hepatitis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hepatitis

  Implementation for Hepatitis: Collaborate with the healthcare team to implement medical interventions based on the type and severity of hepatitis. This may include antiviral medications, immunizations, and supportive therapies. […] Administer prescribed medications to alleviate symptoms such as nausea, abdominal pain, and pruritus. Monitor the patients response to medications and report any adverse effects. […] Emphasize strict infection control measures to prevent the spread of hepatitis, especially in a healthcare setting. Educate the patient and caregivers on hand hygiene, safe disposal of bodily fluids, and other preventive measures. […] Collaborate with a registered dietitian to develop a nutrition plan that supports liver health. Encourage a well-balanced diet, adequate hydration, and restrictions on substances that may exacerbate liver damage, such as alcohol and certain medications. […] Provide comprehensive education on the nature of hepatitis, the importance of medication adherence, potential side effects of treatment, and strategies for preventing transmission. Emphasize the need for regular follow-up appointments and monitoring. […]

• #2 How nurses contribute to the elimination of hepatitis B? A systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37944357/

  With approximately one-third of the global population exhibiting serological evidence of exposure, the hepatitis B virus remains a serious public health threat. Elimination of hepatitis B faces enormous challenges, from prevention to diagnosis, treatment, and long-term monitoring. Nurses are pivotal in optimising the hepatitis B care continuum; however, their contributions have been neglected. […] To identify the role of nurses in the elimination of hepatitis B and to synthesise the effectiveness of interventions with nursing roles in approaching the elimination target. […] The synthesis from 16 studies identified 13 nursing roles that primarily involved (1) health education and counselling for informed patient decision-making regarding hepatitis B prevention, vaccination, screening, and disease monitoring; (2) case management and health promotion to advocate elimination services at multiple levels and enable equitable access among marginalised communities; and (3) running specialist clinics to lead advanced practices in prescribing and carrying diagnostic tests, formulating evidence-based individualised care plans, and coordinating care throughout the disease process.

• #3 Hepatitis Nursing management – MedMuv

  https://medmuv.com/en/hepatitis-nursing-management/

  Hepatitis can be acute or chronic. Although most cases of hepatitis are self-limiting, approximately 5%10% of clients with hepatitis B and 80%85% of clients with hepatitis C progress to a chronic state. Chronic inflammation can lead to fibrotic scarring (cirrhosis) and can be fatal. […] Nursing Priorities: 1. Reduce demands on liver while promoting physical well-being. 2. Prevent complications. 3. Enhance self-concept, acceptance of situation. 4. Provide information about disease process, prognosis, and treatment needs. […] Discharge Goals: 1. Meeting basic self-care needs. 2. Complications prevented/minimized. 3. Dealing with reality of current situation. 4. Disease process, prognosis, transmission, and therapeutic regimen understood. 5. Plan in place to meet needs after discharge. […] Nursing Care: The patient must be isolated (enteric isolation). Patient should be encouraged to rest during acute or symptomatic phase. Improve nutritional status. Utilize appropriate measures to minimize spread of the disease.

• #3 Hepatitis B Treatment & Management: Approach Considerations, Pharmacologic Management, Surgical Intervention

  https://emedicine.medscape.com/article/177632-treatment

  The primary treatment goals for patients with hepatitis B (HBV) infection are to prevent progression of the disease, particularly to cirrhosis, liver failure, and hepatocellular carcinoma (HCC). […] A synergistic approach of suppressing viral load and boosting the patients immune response with immunotherapeutic interventions is needed for the best prognosis. […] The prevention of HCC often includes the use of antiviral treatment using pegylated interferon (PEG-IFN) or nucleos(t)ide analogues. […] Therapy is currently recommended for patients with evidence of chronic active hepatitis B disease (ie, abnormal aminotransferase levels, positive HBV DNA findings, positive or negative hepatitis B e antigen [HBeAg]). […] The National Institutes of Health (NIH) recommends nucleos(t)ide therapy for the treatment of patients with acute liver failure, as well as cirrhotic patients who are HBV DNA positive and those with clinical complications, cirrhosis or advanced fibrosis with positive serum HBV DNA, or reactivation of chronic HBV during or after chemotherapy or immunosuppression.

• #3 Nursing Care Plan & Diagnosis for Hepatitis | Fatigue & Imbalanced Nutrition

  https://www.registerednursern.com/nursing-care-plan-diagnosis-for-hepatitis-fatigue-imbalanced-nutrition/

  Nursing Outcomes: -The patient will participate in activities that stimulate and balance physical and cognitive areas of the body within 48 hours of hospitalization. -The patient will rate his energy level greater than 5 on 1-10 scale with 10 being very energetic before discharge. -The patient’s caloric intake will equal his recommended daily caloric intake within 48 hours. […] Nursing Interventions: -The nurse will encourage and assist the patient to the bedside chair three times a day with each meal. -The nurse will encourage and assist the patient with performing bedside exercises and provide him with reading material to stimulate cognitive function daily. -The nurse will assess the patient’s energy level before and after each nursing shift. -The nurse will collaborate with the nutritionist about patient’s current caloric intake and recommended daily caloric intake on day 1 of patient’s hospitalization. -The nurse will follow out the nutritionist’s plan of care regarding patient caloric intake daily for each meal and snacks. -The nurse will administer Zofran 4mg IV every 8 hours for nausea and vomiting. -The nurse will teach the patient 2 non-pharmacological ways to decrease nausea within 24 hours of admission.

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