Introduction[edit | edit source] Show
Right foot and ankle edema- 2 weeks post-surgery Oedema is defined as a palpable swelling produced by an accumulation of fluid in the intercellular tissue that results from an abnormal expansion in interstitial fluid volume.
The rapid development of generalized pitting edema associated with the systemic disease requires prompt diagnosis and management. [1] Assessment of Oedema[edit | edit source]History - Should include:
Physical Examination - In physical examination, pitting, tenderness, skin changes, and temperature are evaluated.[1]
Methods to Quantitatively Assess Peripheral Oedema[edit | edit source]There are various methods used in research to assess peripheral edema.[3] The most commonly used tools to measure edema are:
Water displacement and ankle circumference had shown a high inter-examiner agreement (intraclass correlation coefficient 0.93, 0.96 right; 0.97, 0.97 left).
The volumeter:
Advantage - It is the gold standard tool for the measurement of edema.[5] Disadvantages - There are various disadvantages to these methods in a clinical setting.
[6] 2. Girth measurements (with a tape measure)
The circumferential method is one of the girth measurement techniques. For consistent measurements, each upper extremity or lower extremity is marked with a semi-permanent marker at a certain part with reference to the bony prominences,[3]
It is also one of the girth measurement techniques. It is more reliable than the circumferential method as it covers a bigger area. A tension-controlled measuring tape is preferred to wrap around the ankle/foot or hand for the measurement of edema than standard tape.[5][3] A figure of 8 method is usually preferred in ankle and hand swelling. It has its own specific points across for consistency.
[7]
[8] 3. Pitting edema Assessment - Press firmly with your thumb for at least 2 seconds on each extremity
Pit depth and the time needed for the skin to return to its original appearance (recovery time) are recorded. The grading of edema is determined by pit depth (measured visually) and recovery time from grade 0-4. The scale is used to rate the severity and the scores are as follows:
Conclusion[edit | edit source]
Pitting Oedema
Focus assessment on: symmetry of swelling, pain, edema change with dependence, skin findings (hyperpigmentation, stasis dermatitis, lipodermatosclerosis, atrophie blanche, ulcerations), and history of venous thromboembolism[9] References[edit | edit source]
What are reliable methods for assessing fluid volume increase?The most reliable method for measuring body water or fluid volume increase is by assessing: tissue turgor. intake and output.
Which of the following is a major cause in acute primary respiratory acidosis?The major cause of respiratory acidosis is alveolar hypoventilation. The expected physiologic response is an increased . The increase in concentration of bicarbonate ions (HCO3) in plasma ( ) is tiny in patients with acute respiratory acidosis, but is much larger in patients with chronic respiratory acidosis.
Which of the following physiologic mechanisms contributes to edema quizlet?The physiologic mechanisms that contribute to edema formation include factors that (1) increase capillary filtration (hydrostatic) pressure, (2) decrease the capillary colloid osmotic pressure, (3) increase capillary permeability, or (4) produce obstruction to lymph flow.
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