J.H ; Female ; 71yrs
Past Medical History
NASH Liver Cirrhosis
Dislipidemia
Gout
Angioplasty
Resulting in
Defined as
A type of liver scarring and injury resulting in an inflammed liver with the presence of fat accumulation
Anemia
As shown by
Hgb: 78
Iron: 6,3
Patient presented with
Asterixis
Puritus
Ascites
Lower limb edema
As a result of
Inadequate red blood cell production by the liver
As a result of
Increase portal pressure
Hypolalbuminemia
Resulting in a
Push of protein into the pertioneal cavity
Resulting in
An increase in fluids in the peritoneal cavity and lower limbs
causing
A decrease in colloidal oncotic pressure
Admitting diagnoses
Rib fracture after falling
Causing
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
Treated with
Lactulose
works by
Binding to excess ammonia and excreting it through bowel movements
Managed by
Managed by
Paracentesis
Possible Hepatorenal Syndrome
caused by
Bile salts getting trapped under the skin
defined as
An invulontary reaction of rapid flexion and extension
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
A result of
Due to
Diuretics
Furosemide
Spironolactone
resulting in
Kidney injury
as evidence by
Oliguria & Bladder scan of 400mL
works as
D/C due to
Createnine 241
A potassium sparring diuretic
managed by
Albumin transfusion
Assessment findings
Positive fluid wave test (Abnormal)
BS + x4
Tympany x4 quadrants
Monitor for 3-4 stools per day
monitor for
urine retention
Lower back pain (5/10 or more) with peristent and increasing pain
Increasing BUN and serum creat.
Monitor for peri-rectal burns and agitation due to loose stools
assessment finds
Increase in somnelence (abnormaL)
CABG
defined as
Removing peritoneal fluid excess via inserting a needle into the pertoneal cavity
priority problem
Gastrointestinal bleed
Monitor for signs of dehydration
Monitor for
Rashes
purirutus
Increase WOB or SOB
Monitor
Serum potassium levels
Proteinuria, glucose in urine
Nausea & vomiting
Managed by
Ondansetron
Functions by
Blocking chemical triggers of nausea and vomiting
Due to
Portal hypertension
Assessment finding
Dilaudid 0,5mg IV
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
Monitor for
Melena
Frank blood from the mouth
Causing
Varices
Vomiting 'coffee ground' type
defined as
Swollen or engorged veins in the stomach or espohagus due to portal hypertension
Pallor
Change in LOC (late sign)
Causing
Decrease of coagulation factors
managed by
Vitamin K suppliment PO
Helps by
Assisting certain coagulation factors into mature forms
RED: Pmhx and definiton. / TEAL: Labs. / ORANGE: monitoring / PINK: Signs and symtpoms. / GREY: Abnormal findings. / GREEN: Medications. / BLUE: PP and admiting dx