A patient is admitted to the hospital with a diagnosis of acute hepatitis B. The nurse would expect a rise in which of the following serum labs?

ALT
AST
Bilirubin

Explanation

• The liver is responsible for modifying bilirubin to allow for excretion. With hepatitis, bilirubin cannot be excreted and instead builds up in the body. Hyperbilirubinemia causes jaundice.

• ALT and AST are enzymes normally found circulating in the bloodstream and are associated with the liver, although not exclusively. If these enzyme levels are elevated, it can indicate inflammation or chronic damage to the liver. ALT and AST can be up to 10 times the upper limits of normal during an acute hepatitis B infection.

• Creatinine is increased with kidney damage or failure.

• Neutrophils are elevated during a bacterial infection. Hepatitis B is caused by a viral infection.

• Platelet count will decrease with hepatitis because platelets are made by the liver, and production is decreased with a hepatitis infection.

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