Noted the clinical prcoeedings.
Hep C with liver cirrhosis
with recurring SBP and encephalopathy
with signs of ketoacidosis
indicates that she is in the decompensated phase of end stage liver disease
MELD of 20 which signifies that she has to undergo a liver transplant
The primary problem here is the Liver.
She has to be admitted to an intensive care unit.
First her hemodynamics has to be stabilised.
Infection controlled with appropriate broad spectrum antibiotic.
Ketoacidosis if untreated could be life threatening.
Low platelets corrected.
Cardiac condition optimised - have an echo,ecg done and cardiac mediations taken.
Metabolic parameters corrected if there is any abnormality and Renal function monitored.