• Jaundice is a symptom or syndrome characterized by increased bilirubin concentration in blood. It is classified as hemolytic, hepatocellular, or obstructive.
II. Risk Factors
• Transfusion reaction
• Hemolytic anemia
• Severe burns
• Autoimmune hemolytic anemia
• Yellow fever
• Extrahepatic – obstruction may be caused by bile-duct plugging from gallstones, an inflammatory process, tumor or pressure from an enlarged gland.
• Intrahepatic – obstruction may result from pressure on channels from inflamed liver tissue or exudates.
• Caused by increased destruction of red blood cells, results in the inability to excrete bilirubin as quickly as it forms.
• Results from the inability of diseased liver cells to clear normal amounts of bilirubin because of defective uptake, consumption or transport mechanisms.
• Causes bile deposition in the skin, mucous membranes, and sclera which results in characteristic yellow tinging of these structures.
IV. Assessment/Clinical Manifestations/Signs and Symptoms
• Dark, foamy urine due to increased bile in the urine
• Light or clay-colored stools due to lack of bile in the small bowel
• Pruritus due to increased bile acids in the skin
• Inability to tolerate fatty foods due to absence of bile in the small intestine
• Mild to severe illness with other symptoms such as anorexia, fatigue, nausea, weakness and possibly weight loss.
V. Medical Management
• Treat the underlying cause of jaundice (Hemolytic jaundice, hepatocellular jaundice and obstructive jaundice)
VI. Nursing Diagnosis
• Disturbed body image related to jaundice
• Impaired skin integrity related to hyperbilirubinemia.
VII. Nursing Management
• Assess and document degree of jaundice of skin and sclera.
• Intervene to reduce anxiety. Reinforce the health care provider’s explanation about the cause and expected outcome of jaundice, and encourage the client to express feelings and concerns about body-image changes.
• Promote adequate nutrition. Assess dietary intake and nutritional status. Encourage the client to adhere to a high-carbohydrate diet, with protein intake consistent with that recommended for hepatic encephalopathy.