Care Planning

Planning care – Hepatitis C and sleep problems
The care plan is a legal document that identifies the care to be given, and a record
(written/electronic) that shows who has planned and gave that care.
 The goals (short term/ long term)

 The support services patient needs, who is in charge of providing these services,
what the support services have agreed to do and when they will do it.
 Emergency numbers, such as who a patient should contact if you become very
unwell and your doctor's surgery is closed.
 Medicines plan
 An eating plan and an exercise plan
The goals should include hospital treatment and back patient to the house, returning to
life, or starting a hobby.
Support services
Testing for HCV infection, counseling and support of patients before and after testing is
crucial. Patient need to understand the implications of positive and negative results. Miss
Ruth Jones should be given their test results personally whenever possible. Patient should be
aware of consequences contaminates hepatitis C. Patient is informed of transmission routes to
reduce the risk of further infection.
The National Institute for Health and Clinical Excellence (NICE) has produced guidelines on
the use of interferon.
Emergency numbers
At the first appointment, the nurse performs a range of blood tests and arranges a liver
ultrasound if appropriate. A detailed medical, drug and alcohol history is taken, which
provides an opportunity to offer individualized advice and support. The aim of the specialist
nurse service is to empower patients to take an active role in their care. There is a 24-hour
helpline with an answer phone, which the nurses respond to throughout the day. If a liver
biopsy is required after medical review, this will be arranged by the nurse specialist as a day
case.
Medicines plan
Hepatitis C is diagnosed via two blood tests:
 the antibody test, and

 the PCR test
Treatment is usually a combination of two drugs: interferon (which is given as an injection)

and ribavirin (given as a capsule or tablet).
 Interferon is a protein that is naturally produced by your body in response to a viral
infection. It prevents the virus multiplying inside your cells.
 Ribavirin is a type of antiviral drug that stops the hepatitis C virus from spreading
inside the body.
Treatment usually lasts for six or 12 months. A blood test is done after four weeks,
and again after 12 weeks, to see how well you are responding. Treatment is usually stopped if
you do not show a good response after 12 weeks.
Side effects
Interferon can have a number of side effects, which are often worse at the beginning of
treatment. The ones of the side effects include:
 insomnia
 depression
The specialist centre will monitor you closely for side effects, and it may need to adjust the
dose of your medications.
Depression is monitored using the hospital anxiety and depression scale. If the patient
becomes depressed referrals are made by the nurse to the support group, GP, or psychiatrist
as appropriate. `
Sleep hygiene is an important first line treatment strategy and should be tried before any
pharmacological approach is considered.
An eating plan
The hospital dietician can advise a patient on what she can and cannot eat/ drink. Alcohol can
increase the damage to patient liver.
If liver is badly damaged. However, the doctor may suggest limiting intake of salt and protein
to avoid putting too much strain on the liver.
An exercise plan
Diminished liver function can cause insufficient levels of oxygen in the blood. Oxygen is crucial for
energy production, and exercise increases the need for oxygen. Patients with reduced liver function
have poorer oxygen delivery during exercise. They also experience fatigue at lower exercise
intensities and have difficulty using energy stored in muscle. People with cirrhosis respond differently
to exercise. Some have normal aerobic capacity, while others experience reduced capacity.
To reduce the risk of passing hepatitis C on to others patient should:
 keeping personal items, such as toothbrushes or razors, for your own use
 cleaning and covering any cut or a graze with a waterproof dressing
 cleaning any blood from surfaces with household bleach
 not sharing needles or syringes with others
 not donating blood
 using condoms when having sex with new partners (seek advice about long-term partners)
Reference:
CARPETINO-MOYET L., J. (2007)Understanding the nursing process. Concept

mapping and care planning for students. London. Lippincott Williams &Wilkins.
Littlejohn C,(2002) Are nursing models to blame for low morale? Nursing Standard
Vol 16(17) p.3941
Kowalak J & Hughes A et al (2002) Best practices a guide to excellence in nursing

care. Philadelphia. Lippincott Williams & Wlikins.

Care Planning

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Planning care – Hepatitis C and sleep problems

 The goals (short term/ long term)

Hepatitis C is diagnosed via two blood tests:

 the antibody test, and

Treatment is usually a combination of two drugs: interferon (which is given as an injection)

To reduce the risk of passing hepatitis C on to others patient should:

CARPETINO-MOYET L., J. (2007)Understanding the nursing process. Concept

Kowalak J & Hughes A et al (2002) Best practices a guide to excellence in nursing

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