A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The assessment data related to this lab value includes: Select all that apply

Question

A) Yellowish discoloration of the skin
B) Colicky, intermittent pain associated with formula feeding
C) Xanthomas
D) Yellowing of the sclera of the eye
E) Dark-colored urine

Answer 1

Ans: A, D, E
Feedback:
Jaundice (i.e., icterus) results from an abnormally high accumulation of bilirubin in the blood, as a result of which there is a yellowish discoloration to the skin and deep tissues. Because normal skin has a yellow cast, the early signs of jaundice often are difficult to detect, especially in persons with dark skin. Bilirubin has a special affinity for elastic tissue. The sclera of the eye, which contains a high proportion of elastic fibers, usually is one of the first structures in which jaundice can be detected. Because intrahepatic jaundice usually interferes with all phases of bilirubin metabolism, both conjugated and unconjugated bilirubin are elevated, the urine often is dark because of bilirubin in the urine. Skin xanthomas (focal accumulations of cholesterol) may occur with cholestasis, the result of hyperlipidemia and impaired excretion of cholesterol. Intrahepatic cholestasis, rather than hyperbilirubinemia, causes primary biliary cirrhosis.