Hepatitis Case Study

Topics: Liver, Bilirubin, Hepatitis Pages: 19 (3911 words) Published: August 25, 2013
Lab test results show a positive anti-HCV and confirm that Chad has Hepatitis C. The nurse explains to Chad that Hepatitis is liver disease with inflammation of the cells of the liver. Chad states "I can't have Hepatitis. I had all three of the vaccinations before I started working as a paramedic." There are five major types of viral Hepatitis: A, B, C, D, and E.

1.
What information about the vaccination series for Hepatitis received by healthcare workers will the nurse use in response to Chad's statement? A) Each of the injections is specifically formulated to protect against Hepatitis A, B, or C. INCORRECT

There is currently no vaccination for Hepatitis C.

B) Each of the injections is specifically formulated to protect against Hepatitis B, D, or E. INCORRECT
There is no separate vaccination for Hepatitis D. The Hepatitis B vaccination protects against both Hepatitis B and D. Hepatitis E has no vaccine.

C) All three injections are given to protect against Hepatitis B. CORRECT
The three routine Hepatitis vaccinations administered to healthcare workers are the three-part hepatitis B vaccination. All three parts of this vaccination must be administered at the correct intervals (0, 1, and 6 months) to provide maximum protection. This vaccination also protects against hepatitis D. This vaccine is now included in the recommended childhood vaccines.

D) All three injections are given to protect against Hepatitis A. INCORRECT
There is a vaccination for Hepatitis A. However, it is a single dose with an available booster dose administered after 6-12 months. This vaccination is not routinely recommended for healthcare workers.

Prevention of Hepatitis
Hepatitis can be caused by hepatotoxins or medications, but the primary cause is viral. Viral Hepatitis is transmitted by two major routes: enteral (oral-fecal) and percutaneous/mucosal (blood or blood products, other body fluids, or maternal-fetal transmission). This second route is also referred to as blood borne.

2.
Which of the five major types of viral Hepatitis are transmitted via percutaneous/mucosal means? A) B, C, and D.
CORRECT
Hepatitis B, C, and D are all transmitted by the percutaneous/mucosal route. High risk populations include IV drug users, hemophiliacs, and persons receiving long-term dialysis. Hepatitis A and E are transmitted by the enteral route. High-risk populations for Hepatitis A include children in day care settings and persons in institutional settings. High-risk populations for Hepatitis E include persons living in underdeveloped countries.

B) C, D, and E.
INCORRECT
Hepatitis E is transmitted by the enteral route.

C) A, B, and C.
INCORRECT
Hepatitis A is transmitted by the enteral route.

D) A and E.
INCORRECT
Hepatitis A and E are both transmitted by the enteral route.

Since the average time from exposure to symptom onset is 6-7 weeks, and knowing that it can take up to 6 months for seroconversion to occur, the clinic nurse questions Chad about exposure to persons with infections over the last several months. Chad remembers being involved in the emergency care and transport of a number of clients.

3.
Contact with which client places the healthcare worker at greatest risk for Hepatitis? A) 16-year-old with a spinal cord injury and a history of intravenous drug abuse. CORRECT
This client is at high risk for Hepatitis B, C, and D because of the history of IV drug abuse, which accounts for over half of all Hepatitis C transmissions in the U.S. today.

B) 70-year-old with viral pneumonia and congestive heart failure. INCORRECT
The viruses that cause viral pneumonia do not cause Hepatitis.

C) 80-year-old with an MRSA-infected wound and a history of cirrhosis. INCORRECT
MRSA (methicillin-resistant staphylococcus aureus) is a bacterial infection, and Hepatitis is a virus. A history of cirrhosis indicates possible alcoholism, but neither cirrhosis nor alcoholism is a risk factor for Hepatitis....
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