Definition , treatment of jaundice

1.  JAUNDICE

2. CONTENTS
 INTRODUCTION
 DEFINITION
 TYPES / CAUSES
 CLINICAL MANIFESTATION
 PATHOPHYSIOLOGY
 DIAGNOSTIC EVALUATION
 MEDICAL MANAGEMENT
 DIETARY MANAGEMENT
 NURSING MANAGEMENT
 NURSING DIAGNOSIS

3. INTRODUCTION
Jaundice can also results from the
excessive breakdown of RBC and too much
bilirubin is released into blood stream

6. DEFINITION
Jaundice is a yellow discolouration of the skin,
mucus membrane and whites of eyes [
sclera ] caused by increase amount of bilirubin in
the blood
Bilirubin levels exceeds up to 3 times than
normal.
The normal value - 0.3 – 1.2 mg/dl

7. TYPES/CAUSES
 There are three types of jaundice
 1. HEMOLYTIC JAUNDICE ( PRE-HEPATIC )
 It is due to breakdown of RBCs that leads to increase unconjugated bilirubin level in the blood-
but liver function are normal
 CAUSES:-- blood transfusion reaction
 haemolytic anaemia
 Gall bladder stone

8. 2 . HEPATOCELLULAR JAUNDICE ( INTRAHEPATIC )
 It is due to dysfunctioning of the liver cells
 CAUSES
 - infection ( hepatitis virus )
 - drug or chemical toxicity
 - excessive alcohol consumption

9. 3. OBSTRUCTIVE JAUNDICE ( POST HEPATIC)
 It is due to obstruction of the bile duct that leads to altered secretion of bile.
 It is of two types
 A. Extra hepatic obstruction
 Due to blockage in the bile duct
 Eg. gall stone, tumour
 B. Intra hepatic cholestatis
It occur due to blockage or swelling in intra hepatic duct

10. CLINICAL MANIFESTATION
Yellowish skin and sclera
Light gray or clay coloured ( alcoholic ) stool
Itchy skin
Nausea
Lack of appetite
Tea coloured urine
Prothrombin time increase

12. PATHOPHYSIOLOGY
 due to any chemical toxin & blood transfusion


 Increase the destruction of RBCs

 Increase the amount of unconjugated bilirubin in blood & hepatocellular & obstructive
causes

 jaundice

13. DIAGNOSTIC EVALUATION
Increase level of serum bilirubin( > 0.4 mg/100 ml)
conjugated
Increase unconjugated serum bilirubin values ( > 0.8
mg/100 ml)
Absence of bilirubin in urine
Reduce fetal urobilinogen because it does not reach in
intestine
Prolonged prothrombin time

14. MEDICAL MANAGEMENT
 1. Antihistamine drugs ( for itching)
 eg. Levocitrizine 5 mg

 2. sedative for restlessness and irritability
 Eg lorazepam, diazepam
 3. Purgative enema if constipation
4. antibiotics
 5. antipyretics drugs
 Vitamin K & B complex

15. DIETARY MANAGEMENT
Advice to pt. for restrict fat intake
Provide high protein diet
High carbohydrate diet
Provide plenty of fluids, juices
Give glucose water

16. NURSING MANAGEMENT
# Provide comfort to pt.
#Maintainfluidandelectrolyte balance to pt.
#Maintainoutput input chart.
#Provide psychological support to the pt.
#Give health education.

17. NURSING DIAGNOSIS
Skin integrity impaired to pururitis.
Risk of haemorrhage related to disturb prothrombin factor
Constipation related to disease
Abdominal pain related to disease
Anxiety related to disease disease condition
Altered nutrition less than body requirement related to
constipation & abdominal pain & discomfort.

18. THANKS