Hepatocellular dysfunction ↑Collagen

↓Androge ↓Vitamin K Inability of the liver Liver unable to ↑renin, ADH Compression Obstruction of
n↑Estroge absorption to metabolize synthesize & of blood bile cannaliculi
ammonia to urea
Alkaline Phosphate

↓Libid Liver unable to Ammonia ↓Albumin Blockage of

↑renal Obstruction of
synthesize remains in Synthesis bile ducts
reabsorption of blood flow
clotting factors circulation sodium and water
Lactulose 10cc TID

↓capillary oncotic
↓capillary Collateral Gallbladder
↑risk for bleeding pressure
oncotic pressure circulatio unable to
empty
↑risk
↑riskfor
forconfusion
confusion&
Protime change in mentation
& change in ↓effective plasma
control
11.5 sec=↑ volume Portal
hypertension

↓colloidal Bile
becomes

↑fluid shift to
Spleenomegaly
Lasix (Furosemide) 40mg IVTT
Abdominal grith=39,38cm UTZ=
Spironolactone 500mg 1tab OD
(+)shifting dullness spleenomegal
(+)fluid wave
↑sequestrati
Edema Ascites on of blood

SOB, Dyspnea Hgb=9.0 ↓

Pressure on RR=26-31cpm
diaphragm Hct= 29 ↓ Excessive
↓IV RBC lysis
fluid Pail nail beds
CRT=3 sec
Dry bucal mucosa, cracked ↓lung
lips, scaly skin, poor skin expansio Bilirubin Hepatocyte
turgor Direct=8.7 ↑ unable to
Indirect=5.66 ↑ conjugate &
Total=14.56 ↑ excrete
Jaundice, icteric sclera, Bilirubin
pruritus
deposit in