The nurse cares for a pregnant client with a history of cholestasis who presents to the emergency department complaining of severe itching, particularly on the palms of the hands and soles of the feet. The nurse anticipates which of the following clinical manifestations associated with cholestasis?
The nurse cares for a pregnant client with a history of cholestasis who presents to the emergency department complaining of severe itching, particularly on the palms of the hands and soles of the feet. The nurse anticipates which of the following clinical manifestations associated with cholestasis?
A. Jaundice
[76%]
B. Hypotension
[6%]
C. Hyperglycemia
[17%]
D. Bradycardia
[2%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Antepartum
Client Need
Test Plan
Physiological Adaptation
Related Topic
Alterations in Body Systems
Item Type
Item Type
Knowledge/Comprehension
Explanation
Choice A is correct. Jaundice, characterized by yellowing of the skin and sclerae, is a common clinical manifestation of cholestasis. When bile flow is obstructed or impaired, bilirubin accumulates in the bloodstream, leading to jaundice.
Choice B is incorrect. Hypotension is not typically associated with cholestasis. Cholestasis primarily affects the liver and bile ducts, leading to symptoms such as jaundice and pruritus (itching), but it does not directly cause hypotension.
Choice C is incorrect. Hyperglycemia is not a typical manifestation of cholestasis. Cholestasis primarily affects the liver's ability to process bile and does not directly affect blood glucose levels.
Choice D is incorrect. Bradycardia is not typically associated with cholestasis.
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3 Key Topics
Cholestasis
28.5 Infection & Complication Risks
Additional Info
✓ Cholestasis is a condition characterized by a decrease or interruption in bile flow from the liver to the small intestine. Bile is a digestive fluid produced by the liver that aids in the digestion and absorption of fats and fat-soluble vitamins. When bile flow is impaired, it can lead to the accumulation of bile acids and other substances in the liver and bloodstream, resulting in various signs and symptoms, including severe itching with or without jaundice. Generalized pruritis usually begins in the third trimester of pregnancy and commonly affects the palms and soles. It can also occur on any part of the body and usually worsens at night. Dark urine and light-colored stools may also be present. Cholestasis of pregnancy occurs more frequently in the winter months, is more commonly seen in pregnant women with multiple gestations, and women who are older than 35 years of age.
✓ It is estimated to affect approximately 0.1% to 2% of pregnancies worldwide.
✓ There is no known prevention, so the focus is always on early recognition and intervention. This may include:
- Regular monitoring of liver function tests, bilirubin levels, and symptoms is crucial for the management of cholestasis.
- Medications such as Ursodiol. Ursodiol, a medication that improves bile flow, may be prescribed to manage cholestasis and alleviate symptoms.
- induction of labor may be considered if the condition is severe or if the gestational age is near term (37 weeks).
