Edema - ANNA Flashcards
Edema
Palpable swelling secondary to expansion of volume within the interstitial fluid
Anasarca
Edema affecting the whole body
-kidney/liver failure
-pregnancy
-protein deficiency
-burns
-malignancy
Peripheral edema
edema affecting the hands and/or feet
-typically toes are spared
Ascites
Edema of the abdomen
-can have protrusion of umbilicus
-dullness to percussion
-full/firm to palpation
-fluid wave test: tap on one side, hand on the other
-#1 cause is cirrhosis
Pulmonary edema
Excess fluid in the lungs
-fuzzy on CXR
-chest pain, dyspnea, orthopnea, SOB
What factors contribute to development of edema associated with pressures?
Increased hydrostatic pressures
Decreased oncotic pressure in BV
Increased oncotic pressure in tissue
Other factors that contribute to development of edema associated with pressures?
Increased blood vessel wall permeability
Obstruction of fluid clearance by lymphatic system
Conditions that increase hydrostatic pressure
Right heart failure
DVT
Iliac vein compression by fibroids or metastatic lymph node disease
Conditions that decrease oncotic pressure
Liver cirrhosis
Nephrotic syndrome
Anything with protein loss
Conditions that increase capillary permeability
Sepsis
Cellulitis
Vasculitis
Conditions that decrease lymphatic drainage
Metastatic lymph node disease
elephantiasis
lyphangectasia
What is localized edema?
limited to a single extremity or part of an extremity
-example: unilateral leg swelling
What is generalized edema
Affects the whole body rather than one particular organ or body area
-bilateral leg and abdominal swelling
-CKD or cirrhosis
-need at minimum 3L additional fluid
Examples of localized edema
Inflammatory causes
Venous obstruction
Lymphatic obstruction
Local trauma
Congenital
Examples of generalized edema
Cardiac
GI
Renal
Poor nutrition
Endocrine
Misc. - medications
What is pitting edema
swelling depresses to pressure
-press over boney surface
-scale is 1+ to 4+
What could chronic pitting edema be a sign of?
Liver, heart, kidney problems or problems with nearly veins
What is non-pitting edema often a sign of?
thyroid or lymphatic system issue
-chronic venous stasis
-chronic inflammation
-Grave’s dermopathy
What is dependent edema
Swelling that falls to gravitational pull
-walking: lower extremities
-bed: back or buttocks or face
-pregnancy
What medications can cause edema
CCBs - amlodipine
NSAIDs
Estrogens
TZDs
Steroids
Gabapentin
Trazadone
What is cyanosis
Bluish coloration of the skin or mucous membranes due to poor circulation or inadequate oxygenation of blood
-Caused by disorders of deoxygenated hemoglobin and abnormal hgb
-can indicated medical emergency
Peripheral cyanosis
Upper or lower extremities
secondary to significant difference in the saturation between the arterial and venous blood
Central cyanosis
Occurs when oxygen sat drops <85%
Bluish hue to the entire body surface and mucosa
Causes of peripheral cyanosis
-Acrocyanosis is bluish coloration of the hands and feet
-May occur when O2 stats are normal
-Caused by peripheral vasoconstriction when not hypoxic
Causes of central cyanosis
Cardiac
Respiratory
Hemorrhage
Shock
