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Peradangan hati • Acute hepatitis • Chronic hepatitis
or other poisons • Obat: Acetaminophen • Kelainan bawaan: cystic fibrosis. bacteria.Penyebab • Infeksi dari viruses. poisonous mushrooms. hemochromatosis. penyakit Wilson . or parasites • kerusakan hati dari alkohol.
RISK FACTORS • pengguna obat intravena • overdosis acetaminophen • perilaku seksual beresiko • makanan yang terkontaminasi • Bepergian ke suatu daerah yang sering terjadi penyakit tersebut • tinggal di rumah perawatan atau pusat rehabilitasi • ada anggota keluarga yang menderita hepatitis A .
tears. menstrual blood and breast milk.. vaginal secretions.Cont. sweat. saliva. because of blood contact • pernah menggunakan tattoo • pernah terkontaminasi blood. semen. . • peminum alkohol • pernah menerima organ transplantasi • menderita HIV or AIDS • pernah menerima blood transfusion • lahir dari seorang ibu yang menderita hepatitis B or C •health care worker.
PREVENTION 1. To prevent from Viral Hepatitis • Vaccination • Immune Globulin for Traveling Abroad • Hand Washing • Avoid Used Needles • Protected Sex • Avoid Sharing Certain Personal Items • Wear Gloves When Handling Body Fluids • Avoid Contaminated Water and Food .
3. • Wear protective equipment if applicable .2. To prevent alcoholic hepatitis: • Limit the amount of alcohol consumption. To prevent toxic/drug-induced hepatitis: • Be aware of the lethal contents of all chemicals.
VIRAL HEPATITIS Hepatitis caused by viruses: Hepatitis A virus (HAV) Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Hepatiti s D Virus (HDV) Hepatiti s E Virus (HEV) .
INTRODUCTION TO VIRAL HEPATITIS Hepatitis doesn't always present symptoms .Karen Gonzales .
Called HAV Infected Food water human waste . . Anal –oral contact during sex .
tatoo. . Called HBV Injected blood sharing of needles unprotected sex .
Called HCV. Direct contact with blood. Unprotected sex. .
Cirrhosis [liver scaring ] Risk factor Older Male gender Heavy alcohol used. .
. Already infected with HBV. Infected needles. Infected blood Unprotected sex. Called HDV.
Anal or oral sex. Similar to HAV. . Drinking water.
. Relative of HCV. Newly discovered. HXV is unknown.
Mild Rash flu Diarrhea Mild fever Abdominal pain Vomiting Weightloss .
.Cont… Circulation Dark problem urine Dizziness Drowsiness Enlarged spleen Headache Hives Itchy skin Light closed feces Yellow skin .
. Growing normally. Difficulty gaining weight. Mental development.
Blood sample Tissue sample Albumin level Liver function test Liver biopsy .
HEPATITIS A VIRUS .
Hepatitis a infection is caused by HAV (RNA single type of serotype) The first successful vaccine Invented by maurice hillmen at merk. .
hepatitis a vaccine is available as HAV(alone) HAV with the combination of HBV HAVRIX(hepatitis a vaccine) VAQTA (hepatitis a vaccine) TWINRIX (with hepatitis B vaccine) .
.Product Havrix Manufacture by GLAXOSMITHKLINE Year licensed 1995 Havrix is sterile suspension Inactivated virus for intramuscular administration A vaccine is whole killed hepatitis a virus. It does not contain live virus so u cant get hepatitis from vaccines.
Manufactured by MERCK Generic name: hepatitis a vaccine Vaqta is inactivated whole virus vaccine Derived from hepatitis A. .
a series of 2 injections is usually given 6 to 8 month period.The vaccine is usually given by injections intra muscular By a health care professional . .
5 ml booster dose administered between 6 to 12 months … ADULT DOSE.CHILDREN AND ADOLESCENTS. Primary immunization for children (12 months to 18 years age) Consist of a single 0.5ml and 0. Primary immunization for adults Consist of a single 1ml dose And 1ml booster dose administered Between 6 to 12 months .
Manufactured by. .GSK Main use .prevention of hepatitis A and B IT Contains inactivated hepatitis a virus and extract of hepatitis B virus.
TWINRIX adult is suitable for adult aged 16 years and over Twinrix children is suitable for adolescents 1 to 5 years .
such injection may result in a suboptimal response .Shake well before use . Do not administer by gluteal region. only as a 1ml dose only.thoroughly agitation Use the sterile needles and sterile syringes . TWINRIX administer by intra muscular deltoid Region.
HEPATITIS B VIRUS .
HBV (hepatitis B virus) Genus : Orthohepadnavirus Family : Hepadnaviridae Arrangement: icosahedral Diameter: 42nm Type: enveloped partially double stranded DNA virus Heat and pH resistant HBV virions are also known as Dane particles. almost 1.2 million people worldwide die each year from HBV related diseases
Transmission of hepatitis B virus results from exposure to infectious blood or body fluids containing blood. Possible forms of transmission include sexual contact, blood transfusions and transfusion with other human blood products, reuse of contaminated needles and syringes, and vertical transmission from mother to child (MTCT) during childbirth.
into which the genetic code for HBsAg has been inserted. . A course of three (3) vaccine injections is given.The first vaccine became available in 1981. Afterward an immune system antibody to HBsAg is established in the bloodstream. This antibody and immune system memory then provide immunity to hepatitis B infection. The antibody is known as anti-HBsAg. The vaccine contains : HBsAg It is produced by yeast cells.
there are at least six drugs available: 1. • Pegylated interferon not approved for children. • . currently. Treatment duration is relatively short (24 to 48 weeks) compared to other hepatitis B therapies. • Most expensive compared to the other drugs. Chronic hepatitis B requires proper medication. Side effects: • Not available for people with failing livers.Acute hepatitis B does not require medication. Interferon: • Usually a good choice for young people without serious liver disease.
Side effects: • Often loses its effectiveness against the hepatitis B virus. so a lot is known about its safety. Might be helpful in treating HIV co-infection in combination with tenofovir. Approved for both children and adults. • Requires long-term treatment. One of the older hepatitis B drugs. Lamivudine: • • • • Least expensive. .2.
3. Adefovir dipivoxil • Can be used in patients with lamivudine-resistant hepatitis B virus. . Side effects: •Can be toxic to your kidneys at high doses. •Requires long-term treatment.
4. . Entecavir: • Has an extremely low rate of resistance. Side effects: • A newer drug. • Might be helpful in patients with failing livers. •Requires long-term treatment.
• Requires long-term treatment. Telbivudine: • More powerful antiviral drug than lamivudine and adefovir. • Not approved for children. Side effects: • As likely as lamivudine to become resistant to hepatitis B virus. .5.
Requires long-term treatment. . •Treats both HIV and the hepatitis B virus.6. Regular monitoring of kidney function is necessary. Side effects: • • • • It's a relatively new drug for treating hepatitis B. Tenofovir: • Excellent at treating regular and drug-resistant types of hepatitis B virus. Not approved for children.
HEPATITIS C VIRUS .
.Hepatitis C virus (HCV or sometimes HVC) is a small (55–65 nm in size). enveloped . Hepatitis C virus is the cause of hepatitis C in humans.positive sense single-stranded RNA virus of the family Flaviviridae.
it must complete eight key steps to carry out its life cycle . While little is known about the exact natural processes of hepatitis C. like other viruses.this is why it is associated with liver disease.The Life Cycle of Hepatitis C The hepatitis C virus must attach to and infect liver cells in order to carry out its life cycle and reproduce .
kissing and sharing food or drinks with an infected person. blood products and organ transplants. receipt of contaminated blood transfusions. food or water or by casual contact such as hugging. Hepatitis C may be transmitted through sex with an infected person. . being born to a hepatitis Cinfected mother. Hepatitis C is not spread through breast milk. The hepatitis C virus is most commonly transmitted through exposure to infectious blood. injections given with contaminated syringes and needle-stick injuries in health-care settings.
There is no vaccine currently available for hepatitis C virus. . Pegylated interferon and ribavirin for chronic HCV.
were approved FDA in May 2011 for patients with HCV genotype 1. Boceprevir and Telaprevir cannot be taken together and are not monotherapies. Boceprevir and Telaprevir. . They will be used in combination with pegylated interferon and ribavirin. Two new oral medications that are protease inhibitors.
ASUHAN KEPERAWATAN PENGKAJIAN Data dasar tergantung pada penyebab dan beratnya kerusakan/gangguan hati Aktivitas Kelemahan Kelelahan Malaise Bradikardi ( hiperbilirubin berat ) Ikterik pada sklera kulit. membran mukosa Urine gelap Diare feses warna tanah liat Sirkulasi Eliminasi Makanan dan Cairan Anoreksia Berat badan menurun Mual dan muntah Peningkatan oedema Asites .
Neurosensori Peka terhadap rangsang Cenderung tidur Letargi Asteriksis Kram abdomen Nyeri tekan pada kuadran kanan Mialgia Atralgia Sakit kepala Gatal ( pruritus ) Demam Urtikaria Lesi makulopopuler Eritema Splenomegali Pembesaran nodus servikal posterior Pola hidup / perilaku meningkat resiko terpajan Nyeri / Kenyamanan Keamanan Seksualitas .
DIAGNOSA KEPERAWATAN Perubahan nutrisi kurang dari kebutuhan tubuh berhubungan dengan gangguan absorbsi metabolisme pencernaan makanan dan kegagalan masukan untuk memenuhi kebutuhan metabolik karena anoreksia. Gangguan rasa nyaman (nyeri) berhubungan dengan pembengkakan hepar yang mengalami inflamasi hati dan bendungan vena porta. Hypertermi berhubungan dengan invasi agent dalam sirkulasi darah sekunder terhadap inflamasi hepar Keletihan berhubungan dengan proses inflamasi kronis sekunder terhadap hepatitis Resiko tinggi kerusakan integritas kulit dan jaringan berhubungan dengan pruritus sekunder terhadap akumulasi pigmen bilirubin dalam garam empedu Risiko tinggi terhadap transmisi infeksi berhubungan dengan sifat menular dari agent virus . mual dan muntah.
Intervensi Keperawatan Buatlah Intervensi Keperawatan dari Diagnosa Keperawatan diatas .
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