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42 Cards in this Set
- Front
- Back
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Edema |
an abnormal accumulation of fluid in the interstitial space |
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Localized edema |
acute injury, sprain, strain, bee sting |
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Systemic edema |
(generalized/always bilateral) starvation/malnutrition (complete lack of protein) organ problems/failure diseases of the body |
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Acute Edema signs and symptoms |
rapid onset after known injury redness warmth painful to palpation or movement localized (tissue temperatures play a significant role in acute edema) |
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Venous Edema Signs and symptoms |
swelling of legs caused by malfunction or obstruction of veins; chronic-especially elderly; soft pitting; could be local -slowly progressive -moderate warmth -dusky color or brownish staining of skin -achy pain as day progresses -normal contours of leg are lost |
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Lymphatic Edema signs and symptoms |
swelling that occurs in one or both of your arms and legs; lymphatic vein obstruction or removal/damage of lymph nodes; hard pitting; generalized or local -slowly progressive -mild warmth -color changes rare -usually painless -sensation of fullness or heaviness in limb -soft and pitting or hard -asymmetrical in comparison of limbs |
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Systemic Edema signs and symptoms |
Abdominal swelling (ascites) generalized, varying edema (liver disease) bilateral, symmetrical edema |
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Toxic edema signs and symptoms |
acute localized itchy or painful redness nonpitting
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Lymphedema |
chronic or progressive edemas result of venous or lymphatic obstruction high protein content |
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Primary lymphedema |
congenital lack of adequate lymphatic drainage; lymphatic vessels malformed or reduced in number; systemic -Milroys disease- birth -lymphedema preaecox- adolescence -lymphedema tarda- after age 30 |
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Secondary lymphedema |
result of an acquired injury to the venous or lymphatic system; localized -trauma -infection -radiation therapy -paralysis of a limb -surgery -obstruction by tumor -obstruction by parasite -chronic venous insufficiency
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Stages of lymphedema |
stage I: reversible; pitting edema w/pressure stage II: irreversible; minimal pitting to pressure stage III: elephantitis |
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Goals and expected outcomes |
-increased ROM -decreased edema -normal tissue temperature -risk of occurrence reduces thru education -patient/caregiver able to don/doff and care for devices -decreased pain -improved skin integrity -independent management of symptoms -edema control with appropriate device |
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lymphatic system |
removes protein from the interstitial space; if too much protein is removed along with the excess fluid (edema), we would die within 24 hours due to cellular dehydration |
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retrograde massage |
best type of massage to reduce edema |
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transudate |
initial fluid; transparent |
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exudate |
fluid becomes cloudy as more cells and plasma proteins enter due to the onset of infection |
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pus |
fluid becomes white/yellow, thick, odorous; infection state; contains large numbers of leukocytes |
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venous ulcers |
wounds that are thought to occur due to improper functioning of venous valves; shallow, weepy, painless, medial ankle, diabetic ulcer |
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arterial ulcers |
mostly located on lateral surface of the ankle or the distal digits; deep, dry, painful, commonly caused by peripheral artery disease (PAD) |
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Blood flow |
pulmonary arteries shuttle the de-oxygenated blood to lungs then returns oxygenated blood to heart via pulmonary veins; the blood gets pumped through the aorta; then branches into the coronary arteries and out to the body |
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pulmonary edema |
a generalized/systemic condition in which fluid accumulates in the lungs, usually because the hearts left ventricle does not pump adequately; more dangerous than peripheral due to overfilling of lungs (left side congestive heart failure- left ventricle failure) |
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peripheral edema |
a generalized/systemic (right side congestive heart failure) condition in which excessive amounts of fluid are pumped out into the body, especially the extremities, usually because the hearts right ventricle does not pump adequately (right ventricle failure: back flow to right ventricle) |
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examination of patient |
1. timing of symptoms 2. medical/surgical history 3. pain 4. self-treatment 5. medications/tests 6. functional limitations |
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Measuring edema |
measurements should be taken at the same time of day; before and after intervention Circumferential measurement (commonly used) or volumeter (water displacement) |
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RICE Therapy |
1st 24-72 hours after injury rest, ice, compression, elevation |
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Rest |
limits the blood flow to the area during the time period that there is excessive capillary permeability and increased pain with movement |
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Ice |
10-20 min time period (extended application could cause vasodilation or tissue damage) decreases local tissue temperature, inflammation, metabolic rate, circulation through vasoconstriction, and pain |
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Compression |
increases hydrostatic pressure in the tissues, decreasing ultrafiltration out of the damaged capillaries and increasing the absorption of fluid by the veins and fluid and proteins of lymphatic vessels |
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compression bandages |
short stretch: <70% stretch medium stretch 70% to 140% stretch long stretch >140% stretch
the more the stretch of elastic=more strength
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contraindications for compression bandages |
active infection recent thrombophlebitis pulmonary embolus w/o adequate anticoagulation CHF |
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Precautions for compression bandages |
arterial disease diabetes mellitus decreased sensation metastatic disease |
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Elevation |
allows gravity to assist both the veins and the lymphatic vessels to carry excess fluid and proteins away from the area of injury and decreases hydrostatic pressure in the tissues Contraindication: ischemic limb-further reduce arterial flow to the limb |
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Factors to consider choosing a compression garment |
coverage compression class appearance custom-made versus off the shelf material or fabric construction suspension skin condition/sensitivity/ wounds ability of patient to don/doff cost and source of payment |
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Compression Classes |
Class I: 20-30 mmHg- minor varicose veins, minor varicosities of pregnancy, mild lymphedema of the arm Cass II: 30-40 mmHg- Significant varicose veins with edema, post-traumatic swelling, postphlebitis swelling, significant varicosities or pregnancy, lymphedema of the arm Class III: 40-50 mmHg- Chronic venous insufficiency, status postvenous ulcers, lymphedema of the arm or leg Class IV: 50 to 60 mmHg- Lymphedema |
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Pitting edema |
1+ =edema is barely detectable 2+ =a slight indentation is visible when the skin is depressed 3+ =a deeper fingerprint resolves in 5 to 30 seconds 4+ =the limb is swollen to 1.5 to 2 times its normal size |
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Exercise (for edema) |
enhances venous and lymphatic flow and in combination with compression enhances muscle pump action Aerobic exercises are often prescribed for patients with edema |
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Aquatic physical therapy (for edema) |
exerts a gradient compression on a body when immersed |
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Electrical Stimulation (for edema) |
achieve rhythmic contraction of muscles, enhances musculoskeletal pump |
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Massage (for edema) |
reducing swelling (segmental draining- start proximal to distal) |
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Complete Congestive Therapy |
for lymphedema- 2 phases: 1. skin care, manual lymphatic drainage, bandaging, and exercise 2. skin care and exercise |
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Documentation |
measurements before and after interventions settings of device same time of day for every session (edema is a cyclic event) |
