Presented by My Anayat Farooq Msc nursing

1. JAUNDICE/ ICTERUS
PRESENTED BY:
Mr. Anayat Farooq

2. INTRODUCTION
 Jaundice, also known as hyperbilirubinemia.
Bile pigments: bilirubin & biliverdin
Normal serum bilirubin level: 0.3-1.0mg/dl
Conjugated : 0.1-0.3mg/dl
Unconjugated: 0.2-0.7mg/dl
Increase 3mg/dl ___ hyperbilirubinemia

3. Some bilirubin is bound to a certain protein (albumin) in the blood.
This type of bilirubin is called unconjugated, or indirect, bilirubin.
In the liver, bilirubin is changed into a form that your body can get
rid of. This is called conjugated bilirubin or direct bilirubin.

4. DEFINITION
Jaundice is yellowish discoloration of the skin, sclera,
and mucous membranes due to hyperbilirubinemia and
deposition of bile pigments.

5. TYPES OF JAUNDICE
1. Hemolytic jaundice
2. Hepatocellular jaundice
3. Obstructive jaundice

6. HEMOLYTIC JAUNDICE :
It is due to an increased breakdown of RBC’s which produces an
increased amount of unconjugated bilirubin in the blood.
HEPATOCELLULAR JAUNDICE:
It is due to result from the liver altered ability to take up bilirubin
from the blood or to conjugate or excrete it. In Hepatocellular
disease the hepatocytes are damaged and leak bilirubin.
OBSTRUCTIVE JAUNDICE occurs as a result of an obstruction
in the bile duct. The obstruction prevents the excretion of
bilirubin into the intestine. Bilirubin will then back up into the
liver and subsequently into the bloodstream.

7. ETIOLOGY
 Haemolysis (hemolytic anemia)
 Viral hepatitis (A,B,C)
 Viral infection (EBV Epstein–Barr virus, CMV)
 Gallstones
 Carcinoma of head of pancreas
 Gallblader Cancer
 Drugs : paraceptamol penicillin's, oral
contraceptives, chlorpromazine over dose
 Alcohol.
 Autoimmune disorders

8. CLINICAL MANIFESTATION
 Yellowish discoloration of the skin, mucous membrane ,eyes. Nail
beds and tongue.
 Light colored stool
 Yellowish brown colour urine
 Abdominal pain
 Fever, chills
 itchy skin
 weight loss

9. DIAGNOSTIC EVALUATION
 History collection
 Physical examination
 CBC
 Urine analysis
 USG (gallstones, bile duct dilation)
 CT scan (liver lesions, pancreatic lesions)
 X-ray

10. MANAGEMENT
MEDICAL MANAGEMENT:
 Antihistamine drugs (for itching)
Eg. Levocitrizine 5mg
avle 25mg
 Sedative for restlessness and irritability
example- lorazepam, diazepam
 Enema in constipation
 Antibiotics
 Antipyretics
 Vitamin K and B-complex

11. DIETARY MANAGEMENT:
 Advice the patient for restrict fat intake
 Provide high protein diet
 High carbohydrate diet
 Provide plenty of fluids, juices
 Give glucose water

12. NURSING MANAGEMENT:
 Provide comfort to the patient.
 Maintain fluid and electrolyte
balance to the patient.
 Maintain input and output
chart.
 Provide psychological support
to the patient.
 Give health education