Queue appearance of massive swelling of the skin
What are the main mechanisms of edema development?
Edema - fluid accumulation in cavities and tissuesas a result of the disturbance of water exchange. In the development of edema, the main role is played by increased diffusion of fluid from blood vessels into the tissue and fluid retention by tissue.
The edema fluid is characterized by low relative density and low protein content.
How does the latent period of fluid retention manifest?
Appearance of obvious edema is preceded by a latent period of fluid retention, which is manifested by a decrease in the amount of urine released and the increase in body weight (determined by daily weighing).
How can one recognize the occurrence of edema in a patient?
When pressing on the skin in places of edema remains a long-terminating fossa. Skin creases appear on the skin.
What are the manifestations of edema?
The edema fluid usually accumulates in the mostlow-lying parts of the body. With the vertical position of the body, edema appears on the legs and increases toward evening. In bedridden patients, edema first of all appears in the lumbar region. Renal edema occurs on the face under the eyes due to the friability of the subcutaneous tissue.
In severe cases, massive swelling of the feetand trunk. The skin becomes dry, smooth, pale, flaky, insensitive to heat. Therefore, giving the patient a warming-up, we must ensure that there are no burns.
What are the characteristics of care for patients with edema?
Patients with edema have a tendency tothe formation of bedsores, so they need to change their position more often in bed (it is best to give the patient a semi-sitting position). There should be no wrinkles or crumbs on the sheet. Under the buttocks and the rump are put an inflatable rubber circle covered with a diaper. The contiguous surfaces of the skin (under the mammary glands of women, in the inguinal folds) are powdered with talc or pierced by gauze between them. The patient's skin is wiped with an aqueous solution of alcohol, cologne or other disinfectants.
The protective properties of the skin with swelling are reduced. Therefore, if after the injection there is a hole in the skin from which the edematous fluid seeps, you need to lubricate it with iodine and apply a sterile gauze pad to prevent infection and suppuration.
How is it monitored to remove fluid from the patient's body?
A patient with swelling should be weighed daily andto measure its daily water balance, i.e., the ratio between liquid drunk per day and the amount of urine extracted. Soaking liquid includes and liquid dishes (soup, kissel). Daily urine is collected in a separate tray, which is located in the toilet room (most often a three-liter bottle). Measure the amount of urine with a volumetric flask. In the morning the night sister sums up and brings it into the medical history. The daily records of these data and the daily weighing of patients allow us to judge the dynamics of edema-their decrease or increase.
All patients with edema should be under the supervision of a doctor who prescribes a diet with restriction of table salt and liquid.