Jaundice

Definition

Jaundice (icterus) is the yellow discoloration of skin, sclera, and mucous membranes caused by elevated serum bilirubin (usually >2 to 3 mg/dL).

Classification

• Prehepatic: Hemolysis (increased breakdown of RBCs).
• Hepatic: Liver dysfunction (hepatitis, cirrhosis, drugs).
• Posthepatic (obstructive): Bile duct obstruction (gallstones, tumor, stricture).

Associated Findings

Dark urine (conjugated bilirubin in urine), clay-colored stools (absence of bile), pruritus, fatigue, RUQ pain, hepatomegaly.

Nursing Interventions

Identify cause through labs (bilirubin fractions, LFTs, CBC, lipase) and imaging, such as manage pruritus (cholestyramine, cool environment, gentle skin care). Nutrition support, for neonatal jaundice, phototherapy with eye and skin protection. Avoid hepatotoxic medications.

NCLEX Relevance

Assess sclera under natural light (easier than skin in dark-skinned patients).