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J.H ; Female ; 71yrs, RED: Pmhx and definiton. / TEAL: Labs. / ORANGE:…

- - - - Anemia
        
        As shown by
        
        Hgb: 78
        
        Iron: 6,3
        
        As a result of
        
        Inadequate red blood cell production by the liver
      - Possible Hepatorenal Syndrome
        
        defined as
        
        An injury to the kidneys as a result of longterm portal hypertension and possible systemic vasodilation
        
        reuslting in
        
        Decreasing arterial blood volume to the kidneys
        
        resulting in
        
        1 more item...
    - - A type of liver scarring and injury resulting in an inflammed liver with the presence of fat accumulation
        
        Causing
        
        Decrease of coagulation factors
        
        managed by
        
        Vitamin K suppliment PO
        
        Helps by
        
        1 more item...
    - - Asterixis
        
        defined as
        
        An invulontary reaction of rapid flexion and extension
        
        A result of
      - Puritus
        
        caused by
        
        Bile salts getting trapped under the skin
      - Ascites
        
        Managed by
        
        Paracentesis
        
        defined as
        
        Removing peritoneal fluid excess via inserting a needle into the pertoneal cavity
        
        Diuretics
        
        Furosemide
        
        Spironolactone
        
        works as
        
        A potassium sparring diuretic
        
        1 more item...
        
        D/C due to
        
        Assessment findings
        
        Positive fluid wave test (Abnormal)
        
        BS + x4
        
        Tympany x4 quadrants
      - Lower limb edema
        
        As a result of
        
        Increase portal pressure
        
        Resulting in a
        
        Push of protein into the pertioneal cavity
        
        Resulting in
        
        1 more item...
        
        Hypolalbuminemia
        
        causing
        
        A decrease in colloidal oncotic pressure
        
        managed by
        
        Albumin transfusion
        
        Monitor for
        
        3 more items...
      - Nausea & vomiting
        
        Managed by
        
        Ondansetron
        
        Functions by
        
        Blocking chemical triggers of nausea and vomiting
    - - Hepatic encephalopathy
        
        defined as
        
        A neuropsychiatric manifestation of cirrhosis
        
        caused by
        
        A build up of ammonia which is unable to be converted into urea & excreted via the kidneys
        
        Due to
        
        1 more item...
        
        Treated with
        
        Lactulose
        
        works by
        
        Binding to excess ammonia and excreting it through bowel movements
        
        Monitor for 3-4 stools per day
        
        Monitor for peri-rectal burns and agitation due to loose stools
        
        Monitor for signs of dehydration
        
        assessment finds
        
        Increase in somnelence (abnormaL)
- - - - Dilaudid 0,5mg IV
- - - - Portal hypertension
        
        Patient presented with signs of
        
        Hypertension of 145/85 or greater
        
        (Im sorry I can't connect it to the other symptoms I'll just rewrite them)
        
        Acites
        
        Edema of the lower limbs
        
        Hepatic encephalopathy
        
        Causing
        
        Varices
        
        defined as
        
        Swollen or engorged veins in the stomach or espohagus due to portal hypertension
    - - Melena
      - Frank blood from the mouth
      - Vomiting 'coffee ground' type
      - Pallor
      - Change in LOC (late sign)