For years, nursing was a task-oriented career. A nurse’s primary responsibility was to provide for the physical needs of patients experiencing illness. Nursing has evolved into a profession, which holistically treats and educates patients in a variety of health situations including acute illness, chronic disease, and preventative care. The competent practice of patient education has become a critical element in nursing. This paper will show the process of formulating a detailed patient specific teaching plan for a patient newly diagnosed with Hepatitis C.
Hepatitis means liver inflammation and refers to a group of viral infections, most commonly Hepatitis A, Hepatitis B, and Hepatitis C. The Center for Disease Control and Prevention (2009, ¶1) states, “Hepatitis C virus (HCV) is the most common chronic bloodborne infection in the United States; approximately 3.2 million persons are chronically infected.” Neighbors and Tannehill-Jones (2006, p. 210) reports, “Over 12,000 individuals die each year from hepatitis C.” HCV is transmitted by exposure to infected blood; either by blood transfusions of unscreened blood or injecting drugs, although, other less common exposures to blood may result in HCV. “The majority of infected persons might not be aware of their infection because they are not clinically ill. However, infected persons serve as a source of transmission to others and are at risk for chronic liver disease or other HCV-related chronic diseases decades after infection” (CDCP, 2009, ¶2). Early symptoms of HCV are usually mild but may include fever, fatigue, dark urine, clay-colored stool, abdominal pain, jaundice, loss of appetite, nausea, vomiting, and joint pain (CDCP, 2009). Many times HCV infection is not detected until a physician orders routine liver enzyme tests or when a patient donates blood and the screen reveals HCV-positive result.
Treatment for HCV depends on the stage. Antiviral drugs are being used with some success. Alcohol is prohibited. Proper nutrition and rest are necessary. Vitamins, minerals and diet supplements may be should be considered to prevent malnutrition. Diuretics may be needed if ascites occur. Herbal medicines such as milk thistle, licorice, have been used in India for thousands of years in liver disease treatment and prevention though they do come with risks and should be used with caution. H.B. Trant is an active 83-year-old Caucasian male, with an extensive history of Coronary Artery Disease. He underwent Coronary Artery Bypass surgery, in the early 1980s and has received routine medical care after that for hypertension, squamous cell carcinoma skin lesions, and minor illnesses. He recently visited his physician with complaint of unplanned weight loss and fatigue. The physical assessment revealed unplanned 15-pound weight loss and enlarged spleen. In addition to comprehensive blood panel, his physician ordered anti-HCVtest, which had a positive result. Subsequently an RIBA, a supplemental anti-HCV test indicated a positive result. His ALT test was within normal limits.The patient has no history of illicit drug use or any other questionable activities. He stopped smoking shortly after his heart surgery and has not used alcohol since he was 20-years-old. The physician determined that the most likely cause of exposure was a blood transfusion he received during his heart surgery, in the early 1980s. At that time, there was inadequate screening of donated blood. The patient was diagnosed with Chronic Hepatitis C and scheduled to undergo liver biopsy to assess potential liver damage.
The patient is an active rancher in a small rural community, where he has lived his whole life. He graduated from high school and served in the United States Army. He is a long-time deacon of the Baptist church and teaches Sunday school class each week. His wife of 62 years is suffering from Alzheimer’s disease and remains at home....