NR283: Week 3 : Edema

Increased Vascular Permeability

"Increased vascular permeability occurs when chemicals and proteins change the size of the vessel walls to allow fluid to travel into or out of the vascular system." Explanation: When blood vessels become "leaky," fluid escapes from them into surrounding tissues, causing swelling. This is common during infections and inflammation, as the body tries to send help to the area.

Localized Edema

"Localized edema is specific to a body part or organ." Explanation: Localized edema only affects a specific area, like a swollen ankle or fluid buildup around the lungs or heart. This is usually due to a localized injury or condition like an infection or organ issue.

Edema in Older Adults

"Older adults are more likely to experience edema due to reduced kidney function and lack of elasticity in veins and arteries." Explanation: As people age, their kidneys don't work as well, and their blood vessels become less flexible, which makes it easier for fluid to build up in their bodies, causing swelling.

Weight Measurement for Edema

"One kilogram of weight gain equates to one liter of fluid accumulation." Explanation: A quick way to measure how much extra fluid someone has is by tracking weight. Gaining 1 kilogram (about 2 pounds) means there's an extra liter of fluid in the body.

Using Gravity for Edema Treatment

"Propping the legs up above the level of the heart will decrease leg swelling by moving excess fluid towards the heart." Explanation: Lifting swollen legs higher than your heart lets gravity help move the fluid back to your heart, reducing swelling in your legs.

Pulmonary Edema

"Pulmonary edema is inside the lung and usually caused by heart failure." Explanation: Pulmonary edema is when fluid builds up in the lungs, which makes it hard to breathe. This is often a sign of heart failure or severe infection.

Pleural Effusion

"A pleural effusion is edema under the lung usually caused by infection or cancer." Explanation: Pleural effusion is when fluid collects between the layers of the tissue lining the lungs, which can make breathing difficult. It's often caused by infections, lung cancer, or heart failure.

Compression for Edema Treatment

"Another way of treating edema is by increasing direct pressure externally on the area. For edema in the legs, this is done using compression stockings." Explanation: Compression stockings or wraps are used to squeeze the swollen area, which helps push the fluid back into the bloodstream, reducing the swelling in the affected area, such as the legs.

Pitting Edema

"Applying pressure to the swollen area causes an indentation that persists for some time." Explanation: In pitting edema, when you press on the swollen area, it leaves a dent (pit) that stays for a few seconds. This is a sign of more severe swelling.

Edema in Abdomen (Ascites)

"As the liver fails, elevated pressure in the portal vein of the liver circulation combined with reductions in protein cause movement of fluid into the abdomen causing ascites (edema)." Explanation: Liver disease can cause pressure to rise in the blood vessels around the liver, pushing fluid into the abdomen and causing swelling known as ascites.

Ascites

"Ascites is edema in the abdomen caused by liver failure." Explanation: Ascites is when fluid builds up in the abdominal cavity, usually because of liver disease, which causes fluid to leak into the abdomen.

Change in Osmotic Pressure

"Change in osmotic pressure occurs when the concentration of the blood or interstitial fluid changes." Explanation: If the concentration of proteins or salts inside the blood vessels is off, it can cause water to move in or out of the blood vessels, leading to swelling (edema).

Environmental Factors and Edema

"Climate differences, including places with higher levels of heat, can cause venous dilation and increases in edema." Explanation: Hot weather can cause veins to expand (dilate), leading to fluid leakage into tissues and swelling. The ingestion of high-sodium foods or drinks on hot days can also worsen edema, as too much salt increases fluid retention in the body.

Cause of Edema: Low Blood Albumin

"Due to low blood albumin, fluid moves out of the vascular space and enters into the interstitial space causing edema." Explanation: When there's not enough albumin (a protein) in the blood, fluid leaks out of the blood vessels and causes swelling in the tissues (edema), often seen in people with liver or kidney disease.

Edema

"Edema is the accumulation of excess fluid in the interstitial spaces." Explanation: Edema means swelling caused by too much fluid collecting in spaces around cells (called interstitial spaces). It can happen all over the body (generalized) or just in one place (localized), like around the lungs or in the abdomen.

Signs and Symptoms of Edema

"Excess fluid retained in tissues, localized swelling, pale, gray, or red skin color, weight gain, slow, bounding pulse, high blood pressure, pulmonary congestion, cough, and rales." Explanation: Swelling (edema) causes puffiness, changes in skin color, weight gain, high blood pressure, and trouble breathing due to fluid in the lungs (pulmonary congestion).

Sodium and Edema

"Excessive sodium levels in the extracellular fluid promote accumulation of fluid in the interstitial compartment." Explanation: Eating too much salt increases the amount of fluid in the spaces around cells (interstitial spaces), causing swelling. This happens because salt draws water into the tissues.

Generalized Edema in Renal Disease

"Failure of the kidneys can cause increased generalized edema as the kidneys are not able to eliminate any excess fluid that has already been metabolized." Explanation: In kidney failure, the body can't get rid of extra fluid, leading to swelling all over the body (generalized edema).

Compression for Edema Treatment

"Flexible bandage wraps are used to compress the extremity." Explanation: Compression wraps or stockings are used to squeeze the swollen area, which helps push the fluid out of the tissues and back into the blood vessels to reduce swelling.

Generalized Edema

"Generalized edema occurs all over the body and can include the arms, legs, trunk, torso, and face." Explanation: This type of edema affects large parts of the body, such as the arms, legs, and face, and is often linked to conditions like heart failure or kidney disease.

X-Ray for Edema

"Hidden edema, like ascites in the abdomen or pulmonary edema in the lungs, can best be seen by x-ray." Explanation: X-rays can reveal swelling in places you can't see or feel, like fluid buildup in the lungs (pulmonary edema) or abdomen (ascites).

Lymphatic Node Dysfunction

"If one or more of the lymph nodes are not able to collect these materials, they get caught in the interstitial areas, causing a type of edema called lymphedema." Explanation: The lymphatic system helps remove fluid and waste from tissues. When lymph nodes don't work properly or are removed, fluid builds up, leading to swelling called lymphedema, often in the arms or legs.

Using Gravity for Edema Treatment

"If someone has edema in the legs, then propping the legs up above the level of the heart will decrease leg swelling by moving excess fluid towards the heart." Explanation: Elevating the swollen part of the body (like the legs) higher than the heart helps gravity move the fluid back into the bloodstream, reducing the amount of fluid pooling in the tissues and decreasing swelling.

Ultrasound for Edema

"In cases where edema is caused by a blood clot, an ultrasound can identify the clot and verify the cause of the edema." Explanation: Ultrasounds are used to check for blood clots in the veins that could be causing swelling, helping doctors figure out what's behind the edema.

Increased Hydrostatic Pressure

"Increased hydrostatic pressure occurs when there is a blockage or backup in the vascular system, causing increased pressure against the vessel walls and the movement of fluid into interstitial spaces." Explanation: If there's a blockage in blood flow (like a clot), pressure builds up in the blood vessels, forcing fluid out into the tissues and causing swelling (edema).

The Leak of Veins (Mnemonic)

"THE: Tumor, Heart failure, Enteropathy (protein-losing). LEAK: Liver failure, Endocrine (hypothyroidism, aldosterones, diabetes), Altitude sickness, Kidney disease (renal failure, nephrotic syndrome). OF: Obstruction of lymphatics, Filariasis. VEINS: Venous thrombosis, Eclampsia/pregnancy, Iatrogenic, Nutritional deficiency, Sepsis/capillary leakages." Explanation: This mnemonic helps remember the common causes of edema. Each letter stands for different conditions that can lead to fluid leaking into tissues (edema). Examples include heart failure, kidney disease, and liver failure, which cause the body to retain too much fluid or lead to fluid leakage into tissues. "Tumor" can mean that a tumor is obstructing fluid flow, "Liver failure" can cause fluid buildup (ascites), "Kidney disease" leads to fluid retention, and "Venous thrombosis" means a blood clot is causing a blockage, leading to swelling in the legs. Each condition affects the body's ability to properly move and balance fluids, leading to swelling in different areas.

Edema in Lower Extremities

"The decreased circulatory pressure caused by a failing heart or vascular blockage leads to increased pressure in the venous system." Explanation: In heart failure or blood clots, blood doesn't circulate properly, which causes pressure to build up in the legs and feet, pushing fluid into the tissues and causing swelling in the lower legs.

Treatment of Edema

"The focus of the treatment of edema is to correct the underlying cause. Strategies, like the administration of medications, are used to assist the body in removing excess fluid. Some medications used include diuretics. These medications cause a change in elimination patterns by moving more fluid into the urinary system for excretion." Explanation: The main way to treat edema is to address the underlying cause, whether it's heart failure, liver issues, or kidney problems. One common treatment is using diuretics, medications that help the body get rid of excess fluid by increasing urine production. Diuretics help reduce swelling by moving the fluid causing the edema out of the body through urination.

Edema Around Wounds

"The immune system draws fluid in and around an injury to send white blood cells and other immune mediators to fight any type of infection." Explanation: When you have a wound, your body sends extra fluid to the area to help with healing and to fight infection, which can cause swelling around the wound.

Lymphedema in Extremities

"The lymph removes fluid and cells that have reached the end of their usefulness. When these lymph nodes stop functioning or are removed, lymphedema occurs." Explanation: When lymph nodes are damaged or removed (often during cancer treatment), they can't remove excess fluid, causing lymphedema, a type of swelling in the arms or legs.

Diuretics for Edema Treatment

"These medications cause a change in elimination patterns by moving more fluid into the urinary system for excretion." Explanation: Diuretics are medicines that help your body get rid of extra fluid by making you pee more. This reduces swelling by removing the fluid causing the edema.

Physical Assessment of Edema

"When an indentation of an object or finger remains in the edema, it is called pitting." Explanation: During an exam, doctors press on swollen areas to check for pitting, which indicates how much fluid is in the tissues. The longer the dent stays, the more severe the edema.