Question

question 10 of 10
the nurse notes icterus of a clients sclera. for which condition(s) should the nurse assess as possible causes of icterus?

select all that apply.

biliary obstruction
kidney dysfunction
mercury toxicity
liver dysfunction
hemolytic anemia

Explanation:

• Biliary obstruction: When there is a blockage in the bile ducts (biliary obstruction), bile (which contains bilirubin) cannot flow properly. Bilirubin then accumulates in the body, leading to icterus (jaundice, which is the yellowing of the sclera and skin).
• Liver dysfunction: The liver processes bilirubin. In liver dysfunction (e.g., hepatitis, cirrhosis), the liver's ability to conjugate and excrete bilirubin is impaired. Unconjugated or conjugated bilirubin builds up, causing icterus.
• Hemolytic anemia: In hemolytic anemia, there is increased breakdown of red blood cells. Red blood cells contain hemoglobin, which is metabolized to bilirubin. Excessive red - blood - cell destruction leads to an overproduction of bilirubin. If the liver cannot process this excess bilirubin quickly enough, icterus occurs.
• Kidney dysfunction: While kidney dysfunction can cause other problems like uremia (accumulation of waste products in the blood), it is not a direct cause of icterus. The main role of the kidneys is in filtering waste (not primarily in bilirubin metabolism related to icterus).
• Mercury toxicity: Mercury toxicity affects the nervous system, kidneys, etc. It does not have a direct pathophysiological link to icterus (jaundice) as it is not involved in the bilirubin metabolism pathway in a way that would cause yellowing of the sclera.

Answer:

biliary obstruction, liver dysfunction, hemolytic anemia