ACKNOWLEDGEMENTS

First of all, praise and gratitude is to God, the lord of the universe and
blessing.
We would like to express my gratefulness and my deepest appreciation to
our major advisor, Assist. Prof. Dr. Jaruwan. M and my course coordinator Dr.
Hathairat Sangchan for their guidance, enthusiasm, spirit, patience, and support
throughout our paper completion.
I much appreciate the librarians Faculty of Nursing PSU to very helpful
us in getting many books, as our based source to complete our paper.
Finally, we are also would like to thanks for my classmates for being
participants in our presentation who gave us chance, suggestion and amazing
experience which have been very beneficial for us.
Aira Putri Mardela & Ni Komang Sukra Andini

PREFACE

Hepatic failure is a frequent event in clinical practice. It ranks eighth as the

cause of death and is the most common reason for hospital admission in
gastroenterology or liver unit. Liver failure refers to a variety of clinical
manifestation those results for many type of liver disease. Chronic liver failure is
probably the most complex clinical syndrome in human pathology. In addition to
problem associated with the impairment with hepatic function. There are
complication related to portal hypertension and to the strategic situation of the
liver between the intestine and systemic circulation
General risk of liver failure with impairment hepatic function is alcohol
induced liver disease. The spectrum of alcoholic liver disease includes fatty liver
disease, alcoholic hepatitis, and cirrhosis. Alcohol is absorbed readily from
gastrointestinal tract its one of the substance that can be absorbed from the
stomach.
Survival of patients with liver failure has improves due to meticulous to
the details of good supportive care combined with better knowledge of the most
important function lost when the liver cell fails.

TABLE OF CONTENT

Acknowledgement...

ii

Preface.

iii

Table of content...

iv

Table of figure.

Table of table...

vi

CASE ANALYSIS.....................

I.

II.

Sign and symptoms of hepatic failure and pathophysiology of each sign

and symptoms based on the case.............

Pathophysiology of hepatic failure based on the case................

10

Abnormal laboratory values and the effects that would have been on
this case of liver failure...

12

Pharmacokinetics and pharmacodynamics of medications.

16

SUMMARY.

21

References

22

III.

TABLE OF FIGURE

Figure 1 Anatomy of portal circulation

Figure 2 Mechanism of portal hypertension..

TABLE OF TABLE

Table 1 Liver function test.....

12

Table 2 Blood chemistry and electrolyte test.

14

Table 3 Hematology and blood clotting test.

15

Table 4 Ascitic fluid culture..

15