Hepatitis A

2. Diagnosis: Hepatitis A.

3. Condition:

4. Vital signs: Call MD if:

6. Nursing: Contact precautions.

8. IV Fluids: D5NS IV at maintenance rate.

9. Symptomatic Medications:

-Trimethobenzamide (Tigan)

15 mg/kg/day IM/PO/PR q6-8h, max 100 mg/dose if <13.6 kg or 200 mg/dose if 13.6-41kg. [caps: 100, 250 mg; inj: 100 mg/mL; supp: 100, 200 mg].

-Acetaminophen (Tylenol) 15 mg/kg PO/PR q4h prn temp >38° C or pain.

-Meperidine (Demerol) 1 mg/kg IV/IM q2-3h prn pain.

10. Special Medications:

-Hepatitis A immune globulin, 0.02 mL/kg IM (usually requires multiple injections at different sites), when given within 2 weeks after exposure to HAV, is 85% effective in preventing symptomatic infection.

-Hepatitis A vaccine (Havrix) if >2 years: 0.5 mL IM, repeat in 6-12 months.

11. Extras and X-rays: Abdominal x-ray series.

12. Labs: IgM anti-HAV antibody, HAV IgG, liver function tests, INR, PTT, stool culture for enteric pathogens.

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