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Hepatitis C Nursing Clinical Guide

Hepatitis C Overview

This content is intended as a Quick Reference for Hepatitis C and will cover an overview of Hepatitis C, diagnosis, and treatment methods. 

Hepatitis C Etiology and Epidemiology

Hepatitis C is a viral infection that causes inflammation and damage to the liver and is spread through contact with the blood of an infected individual (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2020).

There are two type of hepatitis C:

  1. Acute Hepatitis C: 

This type occurs within 6 months after a person is exposed to the virus and is a short-term infection.

      2. Chronic Hepatitis C: 

This type is a long-term illness that can lead to cirrhosis of the liver, liver failure, or cancer.

According to the CDC (2020), in the U.S. during 2018 there were approximately 50,000 cases of acute hepatitis C reported. Between 2013 to 2016, the estimated prevalence of individuals living with chronic hepatitis C was 2.4 million in the U.S.

According to the NIDDK (2020), injecting drugs is the most common way an individual can get hepatitis C. Other ways individuals can contract this disease include:

  • HIV infection
  • Work or live in a prison
  • Received blood transfusions or an organ transplant before 1992
  • Hemophiliacs
  • Born to a mother with hepatitis C
  • More than one sex partner
  • History of sexually transmitted disease
  • Sharing needles

Hepatitis C Screening & Diagnosis

Diagnosis of hepatitis C is made by a thorough history intake and physical examination by the healthcare provider. Signs and symptoms of acute hepatitis C will normally appear between 2 to 12 weeks from exposure and include:

  • Fever
  • Fatigue
  • Dark urine
  • Abdominal pain
  • Loss of appetite
  • Nausea and vomiting
  • Joint pain
  • Jaundice
  • Pale colored stool

Individuals with chronic hepatitis C are asymptomatic or have non-specific symptoms such as chronic fatigue and depression. They will eventually develop chronic liver disease.

Diagnostic testing may include:

  • Antibody tests
    • Enzyme immunoassay (EIA)
    • Enhanced chemiluminescence immunoassay (CLIA)
  • Hepatitis C RNA test
  • Genotype test
  • Complete blood count
  • Comprehensive metabolic panel
  • Liver functions studies
  • Thyroid function studies
  • Drug screening
  • CT scan

Hepatitis C Management

Treatment and management of hepatitis C may include:

  • Administer antiviral medications:
    • Daclatasvir (Daklinza®)
    • Elbasivir/grazoprevir (Zepatier®)
    • Simeprevir (Olysio®)
  • Administer antiemetics for nausea.
  • Administer appetite stimulant as ordered.
  • Administer pain medications as ordered.
  • Administer IV fluids as ordered.
  • Refer to counseling or support groups.
  • Refer to surgeon for liver transplant.

Hepatitis C Nursing Care Plan

Nursing Considerations

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for hepatitis C are listed below.

Hepatitis C Assessment

Assess for signs and symptoms of hepatitis C, such as:

  • Fever
  • Fatigue
  • Decreased appetite
  • Nausea
  • Abdominal pain
  • Dark urine
  • Joint pain
  • Jaundice

Nursing Diagnosis/Risk For

  • Imbalanced nutrition: Less than body requirements related to insufficient intake, evidenced by:
    • Verbalization of lack of interest in food
    • Decreased appetite
    • Weight loss
  • Fatigue related to decreased energy level, evidenced by:
    • Verbalization of lack of energy
    • Inability to maintain usual routines
  • Deficient knowledge related to lack of information of disease, evidenced by:
    • Verbalization of need for information
    • Lack of follow-through with instructions

Hepatitis C Interventions

  • Monitor dietary intake.
  • Consult with dietitian for nutritional support.
  • Provide small meals throughout the day.
  • Encourage bed rest.
  • Identify energy-conserving techniques.
  • Provide assistance with activities of daily living when needed.
  • Determine individual’s level of understanding.
  • Evaluate how the individual learns.
  • Provide education on disease process and treatment.

Expected Outcomes

  • Achieves and maintains adequate weight gain
  • Demonstrates an increase in energy level
  • Verbalizes understanding of disease process
  • Demonstrates effective coping

Individual/Caregiver Education

  • Condition, treatment, and outcomes
  • Review medication and side effects
  • Importance to adhering to medication regimen
  • Avoid alcohol and medications that can damage the liver
  • Follow-up with healthcare provider
  • Avoid the following:
    • Unprotected sex with multiple partners
    • IV drug use or sharing needles
    • Contact with infected blood
  • Notify healthcare provider or seek medical care for the following:
    • Increased fatigue
    • Abdominal pain
    • Jaundice
    • Changes in the appearance of stool

Current Treatment for Hepatitis C

To provide guidance on the disease course and management of patients with HCV, who are treatment-naïve without cirrhosis or who have compensated cirrhosis.

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Additional Information

Content Release Date

6/11/2024

Content Expiration

12/31/2025

Course Contributor

The content for this course was created by Bobbi Whittington, RN, BSN.

Bobbi started her nursing career as a CNA in long term care and developed a passion for working with older adults in the post-acute setting. She obtained her LPN certificate in 1997 from South Central Area Vocational Technical School in Missouri. Continuing her education, she earned her Associate degree in nursing in 2007 from Texas County Technical Institute in Missouri then obtained her Bachelor of Science degree in nursing from Chamberlain College of Nursing in 2013. Bobbi has over 24 years clinical and managerial experience in the skilled nursing industry.

References

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