Hepatitis A
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HEPATITIS A 1. CHIEF COMPLAINT •Hepatitis A 2. HPI 3. ROS 4. SYMPTOMS •Anorexia •Nausea •Vomiting •Fatigue •Malaise •Low-grade fever •Myalgia •Headache •Dark urine •Pale stool •Jaundice •Abdominal pain •Pruritus •Arthralgias •Skin rash 5. HISTORY •FAMILY HISTORY •SOCIAL HISTORY •PAST MEDICAL HISTORY •SURGICAL HISTORY •CHRONIC CONDITIONS 6. ALLERGIES 7. PHYSICAL EXAMINATION •Hepatomegaly •Jaundice •Scleral icterus •Fever
8. SPECIFIC DATA LIKE GRADING ETC 9. TESTS TO BE ORDERED •Anti–hepatitis A virus immunoglobulin M •Liver enzymes •Hepatic synthetic function •Bilirubin level •Prothrombin time •CBC count •Molecular diagnostic techniques performed on blood and feces for hepatitis A virus RNA are purely research tools. •Serum acetaminophen •Liver biopsy 10.ASSESSMENT /PLAN Surgical Care •Liver transplantation 11.EDUCATION Diet •Encourage an adequate diet. Patients should avoid alcohol and medications that may accumulate in liver disease. Otherwise, no specific dietary restrictions are necessary. Activity •Bed rest during the acute illness may be important, although data to support this practice are lacking. Restricting transmission is important, especially in the early phases of the illness. Returning to work should probably be delayed for 10 days after the onset of jaundice. 12.MEDICATION •Acetaminophen •Metoclopramide •Hepatitis A vaccine, inactivated •hepatitis B vaccine •Immune globulin, intramuscular 13.FOLLOW-UP
8. SPECIFIC DATA LIKE GRADING ETC 9. TESTS TO BE ORDERED •Anti–hepatitis A virus immunoglobulin M •Liver enzymes •Hepatic synthetic function •Bilirubin level •Prothrombin time •CBC count •Molecular diagnostic techniques performed on blood and feces for hepatitis A virus RNA are purely research tools. •Serum acetaminophen •Liver biopsy 10.ASSESSMENT /PLAN Surgical Care •Liver transplantation 11.EDUCATION Diet •Encourage an adequate diet. Patients should avoid alcohol and medications that may accumulate in liver disease. Otherwise, no specific dietary restrictions are necessary. Activity •Bed rest during the acute illness may be important, although data to support this practice are lacking. Restricting transmission is important, especially in the early phases of the illness. Returning to work should probably be delayed for 10 days after the onset of jaundice. 12.MEDICATION •Acetaminophen •Metoclopramide •Hepatitis A vaccine, inactivated •hepatitis B vaccine •Immune globulin, intramuscular 13.FOLLOW-UP
