Bilirubin – Substance in Urine (Nursing)

by Prof. Lawes

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    00:00 Now, let's take a look at bilirubin.

    00:03 I got to tell you that was one of my favorite words I learned in medical terminology when we said hyperbilirubinemia. It just sounded fun to say but really what we're looking at is bilirubin in your urine.

    00:15 So I want to talk about what a normal level is.

    00:18 You can have a small amount.

    00:20 Remember this is on that list of things that it's okay to have some of but not too much.

    00:25 So a small amount is 0.5 to 1 milligram per deciliter.

    00:29 Now I have a picture up there for you of an organ you'll recognize as the liver.

    00:34 The reason I put the liver there is because I want to talk about the difference between unconjugated or unchanged bilirubin because unconjugated bilirubin is not water soluble.

    00:47 We're addressing bilirubin in your urine in order for it to make it to your urine.

    00:53 It's got to be water soluble.

    00:55 So if it's unconjugated it's not going to make it to the urine because it won't be able to pass through the glomerulus.

    01:02 The bilirubin has to be conjugated or changed in order for it to be water soluble.

    01:08 So when its present in the urine, it represents a state of bilirubinuria, in order my favorite word was emia that meant blood but we're talking about bilirubinuria.

    01:20 We're talking about bilirubin in your urine.

    01:24 So if I get a positive result for bilirubin in the urine let's talk about what that means.

    01:29 It's not supposed to be found in large amounts in the urine.

    01:34 So if I do see increased bilirubinuria higher than one, now this could be a sign of biliary tract disease.

    01:40 So bilirubin should be connected to the liver for you.

    01:44 The biliary tract is all the plumbing for the liver and the pancreas down into the small intestine.

    01:51 So keep in mind, that plumbing member connects your liver, your gallbladder, if you still have one, your pancreas down to the small intestine.

    02:00 That's the biliary tract.

    02:02 We've got some problems there that maybe while you have bilirubin excessively in your urine.

    02:08 Other liver problems cirrhosis, that can be an issue.

    02:12 Gallstones in the biliary tract, hepatitis, liver disease, tumors in the liver or the gallbladder.

    02:19 Okay.

    02:21 You have reached my limit.

    02:23 That is one two, three, four, five six things to memorize.

    02:27 Nobody can keep track of that, so let's make it simpler.

    02:30 Bilirubin has a picture of what up there? Right.

    02:34 The liver.

    02:35 Now keeping in mind what's involved in the liver is also the biliary tract, the plumbing, that takes the bile from the liver either stored in the gallbladder or can move it on down past the pancreas into the small intestine.

    02:51 So every one of those things is going to point to a problem with the liver or the organs that are attached to the biliary tract.

    03:01 So that's all you need to remember bilirubin and the liver, the biliary tract disease, or the liver are causes for elevated bilirubin.

    About the Lecture

    The lecture Bilirubin – Substance in Urine (Nursing) by Prof. Lawes is from the course Introduction to Urinalysis – Renal Assessment (Nursing).

    Included Quiz Questions

    1. Liver cirrhosis
    2. Diverticulitis
    3. Hepatitis
    4. Biliary tract disease
    5. Gallstones in the biliary tract

    Author of lecture Bilirubin – Substance in Urine (Nursing)

     Prof. Lawes

    Prof. Lawes

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