Being a 54 year old chronic alcoholic, having gastrointestinal bleeding/mental deterioration, and showing signs of cirrhosis, F.C. is in a very dangerous position. It is concerning that he was found to have a .18 BAC because this is a potentially fatal level of alcohol in the blood (Be Responsible About Drinking, 2013). Some common manifestations of alcoholic cirrhosis that F.C. may experience include weight loss, loss of appetite/energy, edema/ascites, mood changes, and jaundice (WebMD 2012). Of these symptoms, ascites and jaundice are both secondary from hepatocellular failure, and weight loss and ascites are also secondary symptoms to portal hypertension (Copstead, pgs. 756-759).
Unfortunately, with cirrhosis and portal hypertension also typically comes gastric or esophageal varices. These varices are pathways that open up when portal pressure becomes too high in order to redirect the blood flow back to the heart. When these pressures rise and these varices open up, it leaves the lining beneath the mucosa very susceptible for rupture, leading to major bleeding. Since F.C. has already had several incidents with GI bleeding, he is at an even greater risk for re-bleeding (Copstead, pg. 761).
F.C’s mental deterioration is most likely caused by a disorder called hepatic encephalopathy. When cirrhosis occurs, the parts of the liver cannot function the way that they are supposed to. Since once of the major jobs of the liver is to clean out, or “detox” the blood, this function can be inhibited or even stopped if cirrhosis becomes too severe. When the blood is not being filtered correctly, these toxins can continue through the blood stream and begin to effect the brain, leading to mental disorders (National Institute of Health, 2014). This is a major problem and must be treated as one. The first steps that must be taken are to stop drinking alcohol, and go to the hospital to have the bleeding stopped and blood in the intestines removed. Antibiotics and diuretics may be prescribed to flush out the body of the toxins and protein will need to be restricted. This is a very serious disorder and should be managed before treatment is no longer an option. The encephalopathy may be treatable, but if it is left alone there is a very good chance that F.C. may go in to a coma or pass away from complications.

References
Be Responsible About Drinking (2013, January 22). BAC Charts. Retrieved May 30, 2014, from http://www.brad21.org/bac_charts.html
Copstead, L. E., & Banasik, J. L. (2010). Liver Diseases. In Pathophysiology (pp. 756-759). St. Louis, Mo: Saunders Elsevier.
Copstead, L. E., & Banasik, J. L. (2010). Liver Diseases. In Pathophysiology (p. 761). St. Louis, Mo: Saunders Elsevier.
Medscape (2005). Medscape: Medscape Access. Retrieved May 30, 2014, from http://www.medscape.com/viewarticle/501977_4
National Institute of Health (2013, October 13). Alcoholic liver disease. Retrieved May 30, 2014, from http://www.nlm.nih.gov/medlineplus/ency/article/000281.htm
National Institute of Health (2014, May 16). Hepatic encephalopathy. Retrieved May 30, 2014, from http://www.nlm.nih.gov/medlineplus/ency/article/000302.htm
WebMD (2012, July 11). Cirrhosis of the Liver Stages, Causes, Symptoms, Treatments. Retrieved May 30, 2014, from http://www.webmd.com/digestive-disorders/cirrhosis-liver?page=2