Institute bed red or chair rest during toxic state. Provide quiet environment; limit visitors as needed. Promotes rest and relaxation. Available energy is used for healing. Activity and an upright position are believed to decrease hepatic blood flow, which prevents optimal circulation to the liver cells.
Recommend changing position frequently. Provide and instruct caregiver in good skin care. Promotes optimal respiratory function and minimizes pressure areas to reduce risk of tissue breakdown.
Do necessary tasks quickly and at one time as tolerated. Allows for extended periods of uninterrupted rest.
Determine and prioritize role responsibilities and alternative providers and possible community resources available Promotes problem solving of most pressing needs of individual and family.
Identify energy-conserving techniques: sitting to shower and brush teeth, planning steps of activity so that all needed materials are at hand, scheduling rest periods. Helps minimize fatigue, allowing patient to accomplish more and feel better about self.
Increase activity as tolerated, demonstrate passive or active ROM exercises. Prolonged bedrest can be debilitating. This can be offset by limited activity alternating with rest periods.
Encourage use of stress management techniques: progressive relaxation, visualization, guided imagery. Discuss appropriate diversional activities: radio, TV, reading Promotes relaxation and conserves energy, redirects attention, and may enhance coping.
Monitor for recurrence of anorexia and liver tenderness or enlargement. Indicates lack of resolution and exacerbation of the disease, requiring further rest, change in therapeutic regimen.
Administer medications as indicated: sedatives, antianxiety agents: diazepam (Valium), lorazepam (Ativan). Assists in managing required rest. Use of barbiturates and antianxiety agents, such as prochlorperazine (Compazine) and chlorpromazine (Thorazine), is contraindicated because of hepatotoxic effects.
Monitor serial liver enzyme levels. Aids in determining appropriate levels of activity because premature increase in activity potentiates risk of relapse.
Administer antidote or assist with inpatient procedures as indicated (lavage, catharsis, hyperventilation) depending on route of exposure. Removal of causative agent in toxic hepatitis may limit degree of tissue involvement and damage.
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