NCLEX Review Guide: Pediatric Hepatitis - Gastrointestinal & Nutrition

Hepatitis A (HAV)

• Fecal-oral transmission through contaminated food, water, or close contact with infected individuals
• Most common in children ages 2-6 years with acute onset and complete recovery expected
• Incubation period is 15-50 days with symptoms including fatigue, nausea, abdominal pain, and jaundice

Hepatitis B (HBV)

• Blood-borne transmission through infected blood, sexual contact, or vertical transmission from mother to infant
• Can become chronic in children, especially if infected before age 5 years
• Prevention includes universal vaccination series starting at birth

Physical Assessment Findings

• Jaundice appears first in sclera, then skin, indicating elevated bilirubin levels
• Hepatomegaly with right upper quadrant tenderness and possible splenomegaly
• Dark amber urine and clay-colored stools due to altered bilirubin metabolism

Nutritional Support

1. Provide small, frequent meals to accommodate decreased appetite and prevent nausea
2. Offer high-calorie, low-fat diet as fat digestion may be impaired
3. Encourage adequate fluid intake to prevent dehydration
4. Avoid hepatotoxic substances including acetaminophen and aspirin

Activity and Rest

• Bed rest is not required but activity should be limited based on child's energy level
• Gradual return to normal activities as symptoms improve and liver enzymes normalize

NCLEX Success Strategies

• Focus on prevention - vaccination schedules and infection control measures are frequently tested
• Remember that supportive care is key - there's no specific cure for viral hepatitis
• Distinguish between acute vs. chronic presentations and their implications for long-term care