Impaired Liver function

Failure to convert ammonia to urea

Obstruction of blood flow from the hepatic vein Venous return Cardiac output Infection Activation of RAAS Impaired filtering of hepatocytes Phagocytosis

Unable to convert bilirubin

Recirculation of amonnia Penetration to blood brain barrier NEUROTOXICITY

Jaundice

Hypertension HEPATIC ENCEPALOPATHY Na and fluid retention EDEMA

Fibrosis or Scarring

Impaired Liver function

Impaired bile production

Obstruction of blood flow from the hepatic vein PORTAL HYPERTENSION Redirection of blood flow to the esophageal veins ESOPHAGEAL VARICES Rupture

Unable to aid in the maturity of RBC ANEMIA Weakness

Impaired protein synthesis Globulin Immunoglobulin Immunity

Impaired glucose synthesis Albumin Hypoalbuminemia Weakness Oncotic pressure EDEMA/ ASCITES Hypoglycemia

Impaired fat synthesis Cholesterol

Hormonal imbalance

Absorption of Fat soluble vitamins Vit. K Clotting factor Bleeding

Bleeding SHOCK