HEPATITIS

Sukma Randani Ismono, S.Kep.,Ns

Program Studi Ilmu Keperawatan
Fakultas Keperawatan Universitas Airlangga

HEPATITIS

Liver inflammation

Etiology : viruses, chemicals, drugs,

alcohol, the patients own immune system

Hepar function:
- processing the bodys nutrients,
-

manufacturing bile to help digest fats,

synthesizing many important proteins,
regulating blood clotting,
breaking down potentially toxic substances into
harmless ones that the body can use or
excrete.

CLASIFICATION and TRANSMISSION

Hepatitis A water and food cotamination

Hepatitis B exposure to blood or body
fluid, infected needles, through sexual
relations, and from mother to baby acute
hepatitis
Hepatitis C contaminated blood, sharing
of needles, contaminated equipment,
sexual activity chronic hepatitis
Hepatitis D exposure to blood or
infected needles
Hepatitis E = hepatitis A
Chemically induced Hepatitis
Acetaminophen + alkohol ; lingkungan
Autoimmune Hepatitis

PATHOLOGY
Necrose of hepar
Inflamation of hepar
Proliferation Kupfer Cell

MANIFETATION PROCESS
1.

Incubasion : < 4 days

2. Prodromal/Preikterik : 3-4 days, fatigue,

nausea, loss of appetite, fever, and abdominal
pain
3. Ikterik : 1-2 weeks, dark colored urine,
icterik sklera, body jaundice, and light colored
stools. A physical examination may reveal a
liver that is enlarged (hepatomegali) and pain
4. Recovery : 2-6 weeks,ikterus and other signs
<<

Perfect recovery 3-4 month

CLINICAL MANIFESTATION

Acute :fatigue, nausea, loss of appetite,

fever, and abdominal pain, jaundice, dark
colored urine, and light colored stools. A
physical examination may reveal a liver
that is tender and enlarged, ascites

Chronic :no symptoms or may be

noticeable as only a loss of energy and
tiredness. In some people, chronic hepatitis
can gradually damage the liver and, after
many years, cause liver failure. The chronic
form typically lasts for many years

ICTERUS

Increase and stagnant bile product

cause
yellow colour in plasma, mucous and
skin

Bilirubin Serum
- Normal 0,2-0,9 mg/100 ml
- Bilirubin > 2 mg/100 ml ikterus
- Elastin rich tissue
: slera, subtongue

Terdapat 4 Mekanisme:
1. Peningkatan pembentukan bilirubin
2. Gangguan pengambilan bilirubin tak
terkonjugasi oleh hati
3. Gangguan konjugasi bilirubin
4. Penurunan ekskresi bilirubin
terkonjugasi dalam empedu akibat faktor
intrahepatik yang bersifat obstruktif
fungsional atau mekanik

Ciri klinis

Hemolitik

Hepatoseluler

Obstruktif

1. Warna kulit

Kuning pucat

Jingga, kuning
muda sampai tua
Gelap ( bili
terkonj)

Kuning, hijau
muda sampai tua
Gelap ( bili
terkonyugated)

N/gelap
(stercobiloin)
Tak menetap

Pucat
( stercobilin )

Warna seperti
dempul
Biasanya
menetap

/N

N/

2. Warna kemih Normal (dpt gelap

krn urobilin)
3. Warna feses
4. Pruritus
5. Bili serum
indirrect
6. Bili serum
dir
7. Bilirubin
kemih
8. Urobilinogen
kemih

Tidak menetap

Sedikit

+
/-

DIAGNOSIS TEST
Hepatitis virus serologies
Liver function tests
Autoimmune blood markers
Abdominal ultrasound
Liver biopsy to determine severity of the
liver damage
Paracentesis if fluid in abdomen is
present

PROGNOSIS

take months for the liver to heal

80% of those with hepatitis C go on
to have chronic liver disease and,
possibly, liver failure (cirrhosis) or
liver cancer

COMPLICATION

Permanent liver damage, liver

failure, or liver cancer can occur.
Other complications include
spontaneous bacterial peritonitis
(when fluid in the abdomen
becomes infected), and esophageal
varices, which can bleed
significantly.

CARE MANAGEMENT

Bed rest until decrease sign

symptom then start mobilisation

High calorie and protein + vitamin

Parenteral nutrition if needed:

dekstrose 10-20%, 1500 2000
cal/day

PREVENTION

Avoid contact with blood or blood products. Take precautions if this is

part of your work.
Avoid sexual contact with a person infected with hepatitis or unknown
health history. Practice safe sex at all times.
Wash your hands after going to the bathroom and before handling food.
Avoid sharing plates, utensils, or bathrooms with someone who has
hepatitis A.
DO NOT share razors, needles, or toothbrushes.
When traveling to endemic areas, DO NOT eat uncooked or partially
cooked foods. Drink bottled water.
DO NOT use recreational IV drugs. If you are already an IV drug user,
never share needles and seek help from a needle exchange or drug
treatment program.
Be cautious when receiving tattoos or piercings.
DO NOT drink alcohol at the same time that you take acetaminophen. If
you already have hepatitis, do not use either (to avoid further liver
damage).