Symptom exhibited during the icteric phase of viral hepatitis?

KPSC Staff Nurse - 2016

Medical & Surgical Nursing

Easy

Appeared in: KPSC Staff Nurse - 2016

Explanation

The icteric phase of viral hepatitis is defined by the presence of jaundice.
Jaundice is the yellow discoloration of body tissues, most noticeably the sclera of the eyes, due to high levels of bilirubin in the blood (hyperbilirubinemia).
The liver's inflammation during hepatitis impairs its ability to conjugate and excrete bilirubin, leading to its accumulation.
Other classic signs of this phase include dark urine and pale (clay-colored) stools, which result from the altered bilirubin metabolism and excretion.

Option A: Tarry stools (melena) are a sign of upper gastrointestinal bleeding. In viral hepatitis, the stools are typically pale or clay-colored (acholic) due to cholestasis (reduced bile flow), not bloody.
Option B: Shortness of breath (dyspnea) is a respiratory or cardiovascular symptom and is not a characteristic feature of the icteric phase of viral hepatitis.
Option D: During the icteric phase, excess conjugated bilirubin is excreted by the kidneys, causing the urine to become dark (often described as tea-colored or cola-colored). Light-colored urine is the opposite of what is expected.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of the icteric phase of viral hepatitis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must be able to recognize the signs of the icteric phase to monitor disease progression and provide appropriate care, including managing pruritus and educating the patient about symptoms.
Assessment for jaundice should be done in natural light. Gently pressing on the skin can reveal the underlying yellow color. The sclera is one of the first places jaundice becomes visible.
Patient education is crucial. The nurse should instruct the patient and family to monitor for worsening jaundice, changes in urine and stool color, and signs of dehydration or bleeding, and to report them promptly.

How to Approach the Question

First, identify the key term in the question: 'icteric phase'.
Recall the definition of 'icteric'. It relates to 'icterus', which means jaundice.
Understand the pathophysiology of jaundice in hepatitis: liver inflammation impairs bilirubin processing, causing it to build up in the blood.
Evaluate the options based on this understanding. Jaundice manifests as yellowing of tissues.
Option C, 'Yellow coloured sclera', is a direct description of scleral icterus, the primary sign of jaundice.
Eliminate the other options by identifying why they are incorrect in the context of hepatitis: tarry stools indicate bleeding (hepatitis causes pale stools), shortness of breath is respiratory, and light urine is the opposite of the dark urine seen in hepatitis.

Concept Tested & Keywords

Concept Tested: Clinical manifestations of the icteric phase of viral hepatitis.
Stem keywords: Symptom, icteric phase, viral hepatitis
Lead-in keywords: BEST, MOST RELEVANT CLUE
Clinical cues: icteric phase
Negative lead-in flag: false

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