PRECIPITATING FACTOR: CONCEPT MAP PREDISPOSING FACTOR:

 Chronic use of OTC drugs  Age ( 63 years old)

 Nutrition Diet (Fast food)  Gender (Male)
Damaged liver cells
 As
Ingestion of Alphatoxins (Root crops)  Race (Asian
 Second hand smoker
 DM type 2 Disease tissue replace normal health tissue Legend:
 Physical inactivity (3 years)
 Manifestation
Liver scarring  Nursing diagnosis
 Medications
 Diagnostic test
Alteration in blood and lymph flow
 Nursing managament:

Liver necrosis

Impaired Increased Impairement

Faulty Faulty Vascular
detoxification arterial loading in bile
hormone protein compression
activity drainage
inactivation synthesis
Increased flow thru
Toxin Increased resistance of hepatic artery Deposition of Bile in
exaggeration Hypoalbuminemia blood flow thru the
Increased bile salts in the intestine
gastrin in liver skin
the blood Increased blood
Increase Albumin: 27.1
volume in sinusoid Light colored
susceptibility (35-41ul/L) Decreased blood flow to and veins Pruritus feces
in infection hepatic
Excessive
stimulation
Risk for infection Increased Diminished fat
of stomach
osmotic Steatorrhea emulsification &
parietal cells
pressure absorption

Portal Hypertension
Oversecretion Fluid Decreased Vitamin K
shifting to Anemia
of acid absorption
ECF
Diversion of bld. to Decreased Clotting
Ulcer formation Increase pressure in
Rapid Hepatic shunting collateral chemical
capillary bed factor
proliferation
  Abdominal pain with the pain Spontaneous Decrease Thrombocytopenia Portal flow General weakness
scale of 6/10 bacterial venous
 DYSPEPSIA peritonitis pattern Excessive RBC lysis
Abdominal vessel
Acute pain congestion Fatigue Activity
Ascites Relese of
Decreased intolerance
blood hemoglobin
 Tramadal 50 mg q8h PRN pressure Caput medusa
 Pantoprazole 40 mg IVTT q12h Increased
Activated partial
Strci
Ceftriaxone bilirubin
Release of thromboplastin time
 Weight loss
renin  Loss of appetite
 Hemolytic Patient: 50.4 seconds
Post endoscopy jaundice (eyes)  CHANGE IN BOWEL Blood in stool Control: 34.6 seconds
diagnosis: Distal Secrete  Tea colored HABITS
esophageal varices and RBC: 3.42(4-6X10 12/L)
aldosterone urine
Portal hypertensive Altered Risk for Hematocrit: 0.33 (0.37-0.57
nutrition Hemoglobin: 112 (110-180g/L)
gastropathy Disturbed body bleeding
Conversion of
image
angiotensin 1 and 2
to 3  LSLF Vitamin K.1 amp.
Tranexamic acid 500 mg
 Offer small
Total Bilirubin: 150.36 frequent meals
Na & H20 (1.7-2ul/L)  Provide  Promote bed
retention B1 or Indirect: 95.40 (1.7- PROTIME:20.2 seconds
attractive meals rest
Fluid volume excess 17.1)
Ineffective B2or direct: 54.96(0-3.4) Control:14.5 seconds
breathing pattern
Activity: 67%
X-RAY of the chest HBA1C: Glycosylated
Impression: Crowding of the Ultrasound-whole abdomen
haemoglobin
lower lung parenchyma due to Urinalysis:
Impression: Moderate 10.2(<7%)HGT:
diaphragmatic elevation  Protein: +
The included upper abdomen was ascites, Liver cirrhosis HEMOGLUCOTEST:
 Mucus:+4
opacified,likely ascites 134(70-110mg%  Bacteria:+2
 Bilirubin: +1

 LSLF URIC ACID: 333.21(155-357umol/L)

 Human albumin 20% vial +20 SGPT : 57.19 (5-35U/L)
 Fluid restriction
mg Furosemide per vial to Alkaline
 Strict monitoring of I AND O CREATININE: 57.6(51-106umol/L)
run for 2hrs q12hr phosphate:
 Bed rest
 Livamin TID 154.19(53-141U/l
 Can use commercial salt
 Aldactone