Nanda - Nursing Care Plan

Nursing Diagnosis for Hepatitis B : Activity Intolerance


Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV).

Hepatitis B is the most common liver infection in the world and is caused by the hepatitis B virus. The hepatitis B virus enters the body and travels to the liver via the bloodstream. In the liver, the virus attaches to healthy liver cells and multiplies. This replication of the virus then triggers a response from the body’s immune system. People are often unaware they have been infected with the hepatitis B at this stage.

When a person first gets hepatitis B, they are said to have an 'acute' infection. Most people are able to eliminate the virus and are cured of the infection.

Risk factors for hepatitis B infection include:
  • Being born, or having parents who were born in regions with high infection rates (including Asia, Africa, and the Caribbean)
  • Being infected with HIV
  • Being on hemodialysis
  • Having multiple sex partners
  • Men having sex with men

Infection can be spread through:
  • Blood transfusions (not common in the United States)
  • Direct contact with blood in health care settings
  • Sexual contact with an infected person
  • Tattoo or acupuncture with unclean needles or instruments
  • Shared needles during drug use
  • Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person

Symptoms resulting from acute hepatitis B infection among adults are common, with jaundice occurring approximately 12 weeks after initial infection.
The symptoms of acute hepatitis B include:
  • loss of appetite
  • nausea and vomiting
  • tiredness
  • abdominal pain
  • muscle and joint pain
  • jaundice (yellowish eyes and skin, dark urine and pale-coloured faeces/poo).

Nursing Diagnosis for Hepatitis B

Activity intolerance related to general weakness, decreased strength / endurance; pain, have limited activity; depression

characterized by: a report weakness, decreased muscle strength, refused to move.

Goal: Clients showed improvement on activity.

Expected outcomes: expressed understanding of the situation / risk factors and individual treatment programs.

Intervention and Rational:

1. Increase bed rest, create a tranquil environment.
Rationale: Increasing rest, and provides the energy used for healing.

2. Change position often, give a good skin care.
Rational: improving respiratory function and minimizes pressure on certain areas to reduce the risk of tissue damage.

3. Increase activity as tolerated premises.
Rational: prolonged bed rest can reduce the ability.

4. Encourage stress management techniques, examples of progressive relaxation, visualization, imagination guidance, provide appropriate entertainment activities.
Rationale: increased relaxation and increased energy.

5. Monitor recurrence of anorexia and enlarged liver tenderness.
Rational: shows a lack of resolution of the disease, requiring a break-up.

6. Assist in the procedure as indicated
Rational: removing the causative agent of toxic hepatitis can limit the degree of tissue damage.

7. Give medications as indicated: sedative, anti-anxiety agents.
Rational: to assist in the management of sleep needs.

8. Monitor liver enzyme levels.
Rational: to help determine the appropriate level of activity as a potential increase in the risk of recurrent preterm.