Jordin is a client with jaundice who is experiencing pruritus. Which nursing intervention would be included in the care plan for the client?
**Core Concept**
Jaundice, characterized by yellow discoloration of the skin and mucous membranes, is often accompanied by pruritus (itching). This symptom is a common manifestation of cholestatic jaundice, where bile flow is obstructed, leading to the accumulation of bile salts in the skin. The primary goal of nursing intervention in this scenario is to alleviate the pruritus and improve the client's quality of life.
**Why the Correct Answer is Right**
Pruritus in jaundice is primarily caused by the accumulation of bile salts in the skin. To alleviate this symptom, nursing interventions focus on reducing the concentration of bile salts in the skin. One effective strategy is to use cool or lukewarm baths or showers, which can help to dilute the bile salts in the skin and provide temporary relief from pruritus. Additionally, moisturizing the skin with gentle, fragrance-free cleansers and applying topical creams or ointments containing menthol or capsaicin can also help to reduce pruritus.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because administering oral cholestyramine may actually worsen pruritus in the short term due to its ability to bind bile salts in the gut, which can lead to their reabsorption and further exacerbate the itching sensation.
**Option B:** This option is incorrect because administering antihistamines may provide some relief from pruritus, but they are not the most effective treatment for this symptom in the context of jaundice.
**Option C:** This option is incorrect because administering topical steroids may provide some relief from pruritus, but they are not the most effective treatment for this symptom in the context of jaundice.
**Option D:** This option is incorrect because administering oral ursodeoxycholic acid may actually worsen pruritus in the short term due to its ability to increase bile salt production, which can lead to further exacerbation of the itching sensation.
**Clinical Pearl / High-Yield Fact**
A key consideration when managing pruritus in jaundice is to avoid using harsh soaps or cleansers, which can strip the skin of its natural oils and further exacerbate the itching sensation. Instead, gentle, fragrance-free cleansers and moisturizing creams or ointments should be used to maintain skin hydration and comfort.
**Correct Answer: C. Administering topical creams or ointments containing menthol or capsaicin to reduce pruritus.**