Hepatitis Hugo — Viral Hepatitis A, B & C
Jaundice, dark urine, clay stools and RUQ tenderness — know your route of transmission to know your teaching
Hugo returned from a trip abroad two weeks ago and now feels exhausted, nauseated, and off his food. This morning his eyes look yellow in the mirror and his urine has turned the color of strong tea.
Hugo's liver becomes inflamed by a hepatitis virus, and the type matters enormously for prevention teaching: hepatitis A spreads fecal-orally through contaminated food or water and rarely becomes chronic, while hepatitis B and C spread through blood and body fluids and can become chronic, leading to cirrhosis or liver cancer. All types share fatigue, anorexia, RUQ tenderness, jaundice, dark urine and clay-colored stools as the liver fails to conjugate and excrete bilirubin normally.
Read Hepatitis Hugo's full story →The story arc
The setup
Hugo ate street food while traveling and now, two to six weeks later, develops fatigue, low-grade fever, anorexia and nausea.
The turn
Hugo notices dark, tea-colored urine, pale clay-colored stools, and yellowing of his sclera, along with RUQ tenderness.
The crisis
Hugo's ALT rises to 1,800 units/L, AST to 1,600 units/L, and his total bilirubin climbs to 6.8 mg/dL, with worsening fatigue and pruritus.
The save
The nurse provides rest, a high-calorie/moderate-protein diet, monitors for bleeding and mental status changes, avoids hepatotoxic medications, and teaches strict hand hygiene and standard/contact precautions to prevent spread.
NCLEX study section — Viral Hepatitis A, B & C
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Gastrointestinal & Renal
Take this chapter into practice questions on the same topic.