A nurse notes that a patient has yellow-tinged skin during a follow-up after chemotherapy. Which blood tests should be done to further evaluate this sign?

• A. Liver function tests (LFTs)
• B. Complete blood count (CBC)
• C. Platelet count
• D. Blood urea nitrogen and creatinine

Answer: (A)

Jaundice—yellow-tinged skin—usually signals that the liver isn’t processing bilirubin normally, or that there may be biliary obstruction. To evaluate this sign after chemotherapy, you want tests that directly assess liver function and injury. Liver function tests measure enzymes like AST and ALT, alkaline phosphatase, bilirubin (total and direct), and other markers of liver synthetic function. These results help determine whether the liver is inflamed or damaged and whether bilirubin clearance is impaired, which are the changes most commonly associated with chemotherapy-related hepatotoxicity or biliary issues.

Other tests you might see in practice, such as a complete blood count or platelet count, monitor bone marrow suppression from chemotherapy, and blood urea nitrogen with creatinine assess kidney function. They don’t specifically address the cause of jaundice or liver injury, so they’re less informative for this presenting sign.