Total Bilirubin (T. Billi) Lab Values
Included In This Lesson
Study Tools For Total Bilirubin (T. Billi) Lab Values
Outline
Overview
- Total bilirubin
- Normal Value Range
- Pathophysiology
- Special considerations
- Elevations in Total bilirubin
Nursing Points
General
- Normal values
- 0.1-1.2 mg/dL
- Patho
- Breakdown product of RBCs
- Specifically heme (iron portion of hemoglobin)
- Transported to liver
- Bound with bile
- Excreted via GI tract and kidneys
- Conjugated
- Water soluble
- Unconjugated
- Not able to excrete it
- Carried to liver via albumin
- Conjugated in liver
- Breakdown product of RBCs
- Special Considerations
- Submit in green top tube
- Usually submitted with liver function tests
- Elevated Total Bilirubin
- Newborn jaundice
- Treated with phototherapy
- Liver tumors
- Liver disease
- Cirrhosis
- Hepatitis
- Alcoholism
- Cholecystitis
- Biliary obstruction
- Newborn jaundice
Assessment
- Assess patients for jaundice or icterus, or changes in color of stool (clay colored)
Therapeutic Management
- Phototherapy for newborns, as they are unable to properly breakdown bilirubin
- Treat primary cause of liver/gallbladder disease
Nursing Concepts
- Lab Values
- Gastrointestinal/Liver Metabolism
Transcript
In this lesson we’re going to take a look at total bilirubin
Bilirubin is a marker that we use to take a look at liver function. The normal value is in 0.1 to 1.2 mg per deciliter, and it’s often measured with direct bilirubin. In order to understand why we measure it, we need to look at how it works.
So we have all these millions of red blood cells in your body, and eventually they don’t work anymore, and they need to be broken down. Part of that breakdown means that heme, the iron-containing compound in red blood cells, needs to be broken down, and what facilitates this is bilirubin.
Bilirubin comes in two forms. It comes in conjugated, and unconjugated. Conjugated bilirubin means that it’s water-soluble, and that means that it can be transported out of the body most of the time by the digestive system. The unconjugated form is not water-soluble. So what happens is the unconjugated bilirubin is sent to the liver, and is then converted to conjugated bilirubin, and then that excreted out through the digestive system.
Now a problem that we run into is that when the liver stops functioning appropriately, you get this buildup of bilirubin because it can’t be broken down by the liver. So what ends up happening is your patient can experience things like jaundice, or icterus, which is a yellowing of the white portion of the eye. Essentially, bilirubin is an indicator of liver dysfunction, and we should take a closer look at our patients that have high bilirubin to see what’s going on with your liver.
Bilirubin is often included with liver function tests, and sometime some larger chemistries , and you’re going to send these off to the lab in a green top tube.
You’re going to see elevations of total bilirubin in patients that have some sort of liver disease, so they could have alcoholic cirrhosis, or different type of hepatitis, whether an infection or viral. You’re also going to see it in cases where the gallbladder is affected, so cholecystitis or biliary obstruction. You’re also going to see it in cases of liver tumors, or in cases where red blood cells are being broken down too fast, so you might see this in certain autoimmune diseases. You’re going to see it most prevalently in newborn jaundice.
Unfortunately newborns don’t have the ability to properly break down that bilirubin like they should. So we do things like this, which is called phototherapy. Bilirubin is extremely susceptible the light, and break down easily under photons, or light therapy. So we very commonly will use for the therapy for extremely jaundiced patients. Decreased levels of bilirubin are ideal, so you will rarely see a total bilirubin of less than 0.1.
For our nursing concept with total bilirubin, we’re looking at the lab values of our gastrointestinal and liver metabolism, so that’s why.
So let’s recap.
Normal values for total bilirubin are 0.1 to 1.2 mg per deciliter.
Bilirubin is required for the process of breaking down heme, and then it sent to the liver to be excreted.
If you have a buildup of bilirubin, it indicates that there’s a problem with the system. So you’ll probably need to take a look at the liver and see what’s going on with it.
Bilirubin is very sensitive to light, so that’s why we use phototherapy for treating newborn jaundice.
Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!
Rina’s NCLEX Study Plan 2026
Concepts Covered:
- Endocrine System
- Studying
- Urinary System
- Tissues and Glands
- Nervous System
- Circulatory System
- Medication Administration
- Hematologic System
- Skeletal System
- Digestive System
- Respiratory System
- Emergency Care of the Cardiac Patient
- Reproductive System
- Endocrine and Metabolic Disorders
- Basics of Human Biology
- Muscular System
- Sensory System
- Communication
- Legal and Ethical Issues
- Basics of NCLEX
- Prenatal Concepts
- Prioritization
- Fundamentals of Emergency Nursing
- Documentation and Communication
- Delegation
- Community Health Overview
- Factors Influencing Community Health
- Concepts of Mental Health
- Test Taking Strategies
- Note Taking
- Substance Abuse Disorders
- Behavior
- Concepts of Population Health
- Concepts of Pharmacology
- Health & Stress
- Labor and Delivery
- Gastrointestinal Disorders
- Microbiology
- Depressive Disorders
- Postpartum Care
- Emergency Care of the Trauma Patient
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Respiratory Disorders
- EENT Disorders
- Infectious Disease Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Renal and Urinary Disorders
- Oncologic Disorders
- Anxiety Disorders
- Cognitive Disorders
- Eating Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Bipolar Disorders
- Developmental Considerations
- Psychological Emergencies
- Somatoform Disorders
- Perioperative Nursing Roles
- Preoperative Nursing
- Central Nervous System Disorders – Brain
- Lower GI Disorders
- Peripheral Nervous System Disorders
- Cardiac Disorders
- Integumentary Disorders
- Musculoskeletal Disorders
- Noninfectious Respiratory Disorder
- Postoperative Nursing
- Respiratory Emergencies
- Intraoperative Nursing
- Disorders of Pancreas
- Urinary Disorders
- Neurological Emergencies
- Central Nervous System Disorders – Spinal Cord
- Renal Disorders
- Infectious Respiratory Disorder
- Sexually Transmitted Infections
- EENT Disorders
- Shock
- Cardiovascular
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Neurological
- Respiratory
- Hematologic Disorders
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Immunological Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Vascular Disorders
- Male Reproductive Disorders
- Newborn Complications
- Disorders of Thermoregulation
- Neurological Trauma
- Integumentary Important Points
- Multisystem
- Emergency Care of the Neurological Patient
- Emergency Care of the Respiratory Patient
- Prefixes
- Suffixes
- Fetal Development
- Terminology
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Basics of Mathematics
- Basics of Sociology
- Pregnancy Risks
- Labor Complications
- Newborn Care
- Postpartum Complications
- Understanding Society
- Adult
- Dosage Calculations
- Adulthood Growth and Development
- Learning Pharmacology