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Jaundice (Subjective Data (A severe jaundice with dark urine indicates a…
Jaundice
Subjective Data
A severe jaundice with dark urine indicates a liver or biliary disorder. Patients often notice the dark urine before skin discoloration.
Mild jaundice without dark urine suggests uncon¬jugated hyperbilirubinaemia caused by haemolysis or Gilbert's syndrome rather than hepatobiliary
disease.
Dyspepsia, intolerance of fatty foods and steatorrhoea may indicate less bile in the intestine to help digest dietary fat.
Nausea and vomiting which precedes jaundice may indicate acute hepatitis or common bile duct obstruction by a stone.
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Anorexia and malaise occur in many conditions and may suggest alcoholic liver disease or chronic hepatitis.
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Diffuse lymphadenopathy suggests mononucleosis in acute jaundice and lymphoma or leukaemia in chronic illness.
In obstructive jaundice, the skin is itchy due to presence of bile products in the circulation.
Prolonged jaundice from cholestasis produces a muddy skin colour and fatty yellow deposits in the skin.
Nursing Management
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Administer prescribed medications timeously. Oral cholestyramine resin may provide relief by binding with the bile salts to facilitate elimination through the intestines. Antihistamines may be prescribed to provide relief from itching.
Provide emotional support as jaundice may affect the patient's body image as it interferes with his/her appearance. It may also cause physical, social and emotional isolation.
Allow the patient to voice his/her feelings and con-cerns by providing an environment of acceptance. Unconditional support by family members and the health team is important, as the patient may be preoccupied with his/her physical appearance and suffer a low self-concept.
Answer all questions truthfully and honestly to help patient cope with the altered physical appearance.
Objective Data
Imaging is valuable in diagnosing infiltrative and cholestatic disorder, as is an abdominal ultrasound. CT and MRI scans are often used to detect metastatic and liver lesions. These may also reveal bloated bile ducts which imply mechanical obstruction.
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Hepatocellular jaundice
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the liver cells or hepatocytes are damaged and leak bilirubin, thereby increasing the circulating levels of both conjugated and unconjugated bilirubin
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Definition
Yellow discoloration due to high levels of unconjugated and conjugated bilirubin in the blood stream
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Pathophysiology
Normally, damaged or old red blood cells are removed from circulation by the spleen. Haemoglobin splits
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