EDEMA
INTRODUCTION
•Edema is the abnormal
accumulation of fluid in the
interstitium .
•It also occur in cavities of body
which can cause severe pain.
•It is a palpable swelling produce
by the expansion of interstitial
fluid volume .
DEFINITION
• Edema is the medical
term for swelling. Edema
is the observable swelling
from fluid accumulation
in body tissues.
CLASSIFICATION
• According to the location:
Localized edema
Generalized edema
• According to the clinical
finding:
Pitting edema
Non-pitting edema
• According to the
pathophysiological
mechanism:
Transudate edema
Exudate edema
• Other types of edema:
Peripheral edema
Pulmonary edema
Cerebral edema
• Generalized • Localized
edema: edema:
• It includes • Confined to a
puffiness ,water particular
retention in part/organ of
various body the body
parts.
• Pitting • Non-pitting
edema:
edema:
• When after
applying pressure • When the
on the edemic indentation
area, the does not
indentation persists persists after
after releasing of releasing of
pressure.
pressure.
• Transudate • Exudate
edema: edema:
• Accumulation of • Accumulation of
fluid due to fluid due to inc.
hydrostatic vascular
imbalance b/w permeability.
intravascular & • High protein
extravascular content.
compartment. • Fluid is generally
• Low protein opaque.
content.
Peripheral edema
• Mainly occurs in legs , feet and
ankles.
• Very common type of edema .
• Cause swelling in the lower
extremities.
• Occurs usually on long time sitting or
standing.
Pulmonary edema
• Accumulation of fluids in the lungs due to
blockage of pulmonary veins.
Blood pressure rises
Fluid enter into the lungs
Pulmonary edema
Cerebral edema
• Fluid accumulates in the
intracellular and extracellular
spaces of brain.
• Caused by metabolic
abnormalities.
ETIOLOGICAL FACTORS
1. Standing or sitting for long time.
2. Physical inactivity
3. Excessive salt intake
4. Pregnancy
5. Malnutrition
6. Renal disease
7. Heart failure
8. Liver disease
9. Arthritis
10. Allergic reactions
11. Low albumin
12. Blood clot
13. Burns
14. Trauma
15. Certain medications
RISK FACTORS
1. Heart failure
2. Cirrhosis
3. Renal disease
4. Deep vein thrombosis
5. Lymph edema
PATHOPHYSIOLOGY
Increase capillary permeability
Filtration of more protein from capillary to interstitium
Decrease plasma colloid osmotic pressure
Increase formation of interstitial fluid
When fluid is greater than lymphatic
compensatory return
EDEMA
CLINICAL MANIFESTATIONS
• Swelling
• Stretching of skin
• Shiny skin
• Indentation
• Aching
• Puffiness
• Tacycardia
• Hypertention
• Ascites
• Weight gain
• Chest pain
• Difficulty in breathing
• Shortness of breath
DIAGNOSTIC EVALUATION
• Physical examination
• Medical history
• Lab investigations: urinalysis
blood test
LFT
RFT
• Chest X-ray
• Abdominal ultrasound
• Ultrasound of legs
• Heart function test
COMPLICATIONS
Painfull swelling
Walking difficulty
stiffness
Skin can become stretched,itchy
Poor blood circulation
Ulceration of skin
Swollen area more prone to infection
Medical management
Diuretics : e.g- Furosemide
Use blood thinner : e.g- Aspirin
Warfarin
Treat allergic reactions : use
Antihistamine
Corticosteroid
Maintaining a sodium restricted diet
Use Angiotensin Converting Enzyme
(ACE) inhibitor and Angiotensin
receptor blockers (ARB) = reduce the
loss of protein in urine
surgery , chemotherapy , radiation
are done to remove the tumor
NURSING MANAGEMENT
o Instruct the patient to put a pillow
under legs when lying down.
o Keep legs elevate above the level of
heart for atleast 30 min. , 3-4 times a
day.
o Encourage the patient do not sit or
stand for long period time without
moving.
oinstruct the patient to limit the salt
intake .
oMassage and stroking the affected
area towards heart using firm but
not painful.
oEncourage the patient to protect any
swollen area from additional
pressure and injury .
oProtect from sun burn.
oAvoid exposure to
temperature extremes
oEncourage patient to follow
up.
NURSING DIAGNOSIS
Acute pain related to edema as
evidence by verbal response / pain
rating scale/ facial expression.
Risk of impaired skin integrity related to
edema as evidenced by physical
examination.
Fluid volume excess related to sodium
retention as manifested by edema .
Physical inability related to tightening
of skin due to edema .
Altered sleep pattern related to pain/
fatigue.
Anxiety related to disease condition/
hospitalization .
Knowledge deficient related to disease
condition as evidence by queries of
patient.
SUMMARIZATION
Definition of edema
Classification of edema
Causes of edema
Etiology
Risk factor of edema
Pathophysiology
Clinical manifestation of edema
Diagnostic evaluation
Complications
Management of edema
Nursing diagnosis
RECAPTULIZATION
• Define edema
• Enlist the types of edema
• What are the causes of edema
• Enlist the sign and symptoms of
edema
• Discus nursing management
BIBLIOGRAPHY
Text book of Medical Surgical Nursing-
1part
Author = Javed Ansari & Davinder Kaur
Page no.= 213-219
https:// en.m. wikipedia . org > wiki >
Edema
