What the eff is Edema?

Before working in the hospital, I never heard of the word "edema."

I thought that maybe it was a rectal suppository when I first heard it.

Well, I really found out what edema was this past clinical day. This man was morbidly obese with 2+ pitting edema on his leg with a weeping wound. This is what edema looks like:

Edema occurs when tiny blood vessels in your body (capillaries) leak fluid. This leakage can result from damage to or increased pressure in the capillaries, or from lowered levels of serum albumin, a protein in your blood. When your body senses the capillaries are leaking, your kidneys begin to retain more sodium and water than normal to compensate for the lost fluid from your blood vessels. This increases the amount of fluid circulating through your body, which causes the capillaries to leak more. The fluid from the capillaries leaks into the surrounding tissue, causing the tissue to swell.

My patient had congestive heart failure, was obese and inactive, and probably ate high sodium foods to cause his edema.

It was interesting working with this patient. I got to change his wound dressing (since he was also positive for strep B with cellulitis and it was "weeping" serous fluid [lymphocytes, or white blood cells]). Apparently this guy was there for 14 days. Lets just say he didn't want to be there at all.

To toot my horn a little, I implemented a few things on this shift. There was no reaction in the computer for his bee allergy which should be discussed with the patient and added to his record (which ended up being hives), so the nurse faxed a document down to pharmacy with the reaction after I told her this. He also had an allergy to warfarin with the same reaction which was newly diagnosed and never communicated with me. Since he does have heart failure, normally this kind of patient would be put on this med. Though he was on heparin, another anticoagulant. I voiced these to my instructor who said that she was never told of the warfarin allergy in hand off report.

My patient was in a much better mood at the end of the night. It actually seemed like he was enjoying himself, not being mad that he hadn't gone home yet.

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