A 56-year-old man with a long history of alcohol use was admitted to the hospital after he had a seizure that was witnessed by his wife. The patient was obtunded, swollen, and jaundiced. Temperature was 36.8°C (98.3°F), pulse rate was 104/min and regular, respirations was 18/min, and blood pressure was 104/62 mmHg. On physical examination, auscultation of the chest showed diminished breath sounds.
Examination of the abdomen showed firmness of the right upper quadrant, palpable hepatomegaly, and protuberance of the umbilicus. Results of laboratory studies of serum include the following: Creatinine 0.8 mg/dL Sodium 108 mEq/L Potassium 3.5 mEq/L Blood urea nitrogen 4 mg/dL Source: nccpa Which could be the most appropriate initial management in this case? *This case is from Docplexus Editorial Team for educative purpose only.
