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Quickly determine the location and severity of edema, including the degree of pitting. (See Edema: Pitting or nonpitting?page 240.) If the patient has severe edema, promptly take his vital signs, and check for jugular vein distention and cyanotic lips. Auscultate the lungs and heart. Be alert for signs of cardiac failure or pulmonary congestion, such as crackles, muffled heart sounds, or a ventricular gallop. Unless the patient is hypotensive, place him in Fowler's position to promote lung expansion. Prepare to administer oxygen and an I.V. diuretic. Have emergency resuscitation equipment nearby.
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Quickly determine the location and severity of edema, including the degree of pitting. (See Edema: Pitting or nonpitting? page 292.) If the patient has severe edema, promptly take his vital signs, and check for jugular vein distention and cyanotic lips. Auscultate the lungs and heart. Be alert for signs of heart failure or pulmonary congestion, such as crackles, muffled heart sounds, or ventricular gallop. Unless the patient is hypotensive, place him in Fowler’s position to promote lung expansion. Prepare to administer oxygen and an I.V. diuretic. Have emergency resuscitation equipment nearby.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Position the patient with his limbs above heart level to promote drainage unless positioning increases respiratory difficulty. Reposition him to avoid pressure ulcers at least every 2 hours. If the patient develops dyspnea, lower his limbs, elevate the head of the bed, and administer oxygen. Massage reddened areas, especially where dependent edema has formed (for example, the back, sacrum, hips, buttocks). Prevent skin breakdown in these areas by placing a pressure mattress, air mattress, or flotation ring on the patient’s bed. Restrict fluids and sodium, and administer a diuretic or I.V. albumin.
Monitor intake and output and daily weight. Also monitor serum electrolyte lev-els — especially sodium and albumin. Prepare the patient for blood and urine tests, X-rays, echocardiography, or an electrocardiogram.
Teach the patient with known heart failure or renal failure and the patient’s caregivers to watch for edema; explain that it’s an important sign of decompensation that indicates the need for immediate adjustment of therapy. Discuss foods and fluids he should avoid. Provide information related to medications prescribed and the importance of medication, diet, and activity compliance.
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Quickly determine the location and severity of edema, including the degree of pitting. (See Differentiating between pitting and nonpitting edema, page 245.) If the patient has severe edema, promptly take his vital signs, and check for jugular vein distention and cyanotic lips. Auscultate the lungs and heart. Be alert for signs of heart failure or pulmonary congestion, such as crackles, muffled heart sounds, or ventricular gallop. Unless the patient is hyposensitive, place him in Fowler’s position to promote lung expansion. Prepare to administer oxygen and an I.V. diuretic. Have emergency resuscitation equipment nearby.
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
▪ Position the patient with his limbs above heart level to promote drainage, if the patient can tolerate it.
▪ Periodically reposition him to avoid pressure ulcers.
▪ If the patient develops dyspnea, lower his limbs, elevate the head of the bed, and administer oxygen.
▪ Prevent skin breakdown by placing a pressure mattress on the patient's bed.
▪ Restrict fluids and sodium, and administer a diuretic.
▪ Monitor the patient's intake and output and daily weight.
▪ Monitor serum electrolyte levels—especially sodium and albumin.
▪ Prepare the patient for blood and urine tests, X-rays, echocardiography, or an electrocardiogram.
▪ Explain signs and symptoms of edema that the patient should report.
▪ Discuss food or fluid restrictions.
▪ Explain the underlying cause of the patient's edema and its treatment.
Source: Nursing: Interpreting Signs and Symptoms, 2007
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