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Description of the Symptom

This chapter describes pathology that may lead to edema. Edema is enlargement of the soft tissues secondary to excess water accumulation. It can be classified as intracellular or extracellular. Intracellular edema develops when there is direct injury to tissues, causing inflammatory insult to the cell or alterations in cellular metabolism and resulting in an increase in intracellular sodium and water. Extracellular edema is an abnormal accumulation of fluid and protein molecules in the intercellular spaces of tissues.1 Edema that develops in the arms or legs, which is the focus of this chapter, is called peripheral edema. Peripheral edema may be due to either a systemic dysfunction such as cardiac or renal insufficiency or an obstruction such as a blood clot or tumor. The development of edema may be associated with loss of skin mobility, loss of joint range of motion, loss of joint shape and definition, loss of muscle strength, pain, and changes in skin color, texture, and temperature.2

Special Concerns

  • Bilateral edema of the hands or feet; may or may not be progressive

  • Sudden onset of edema without traumatic event

  • Edema that occurs simultaneously with fever, sweats, and chills

  • Distal edema with reports of shortness of breath either with exertion or at rest

  • Calf pain and edema after trauma

  • Edematous body part with red streaks

  • Edema involving the face or arm that is present with discoloration of the chest, arm, or face; loss of carotid pulses; dysphagia; wheezing; chest pain; headaches; dizziness; or orthopnea

  • Total body edema or total quadrant edema

CHAPTER PREVIEW: Conditions That May Lead to Edema

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