anasarca

[momandstudent]

I had a patient on med-surg this week with CHF, renal and resp. failure, COPD, and the list goes on. When I went in to do my assessment, she was 4+ edema all extremities. No fluid restricted diet. Later that day, my CI went to do her assessment. When we were talking about the pt later, CI told me that she and the floor nurse said she had anasarca. Is this a medical Dx? Just curious because I am working on my case study for her and wondering where and if I can put this in. It was not in her chart at all just to clarify that point. Thanks you.

[Transgender_n_TN]

Anasarca is extensive subcutaneous edema; an expression of a generalized edema. There is diffuse subcutaneous swelling which is cool to the touch and retains the imprint of a fingertip after pressure is released--hence 'pitting edema'. The principal locations are the intermandibular space and the ventral aspects of the neck and trunk.

It is usually caused by either congestive cardiac failure, liver failure(cirrhosis of the liver) or renal failure/disease and severe malnutrition/protein deficiency.

It can also be created from the administration of exogenous intravenous fluid. Certain plant-derived anticancer chemotherapeutic agents, such as docetaxel, cause anasarca through a poorly understood capillary leak syndrome. This condition is also called leucophlegmatia.

Sorry if this sounds pompous, but I Googled this information and found various sources of information.

[Daytonite, BSN, RN]

Look the definition of this up in your medical dictionary. It is edema that encompasses the entire body. You will see this kind of edema in late stages of cirrhosis, where there is some degree of renal failure and as heart failure gets progressively worse. Much of it has to do with understanding how fluid moves between the different compartments and the effect hydrostatic and osmotic pressures have on the tissues. Circulation of and to the heart, liver and kidneys are major players here which is why chronic and worsening disease in these organs can lead to a development of anasarca. I saw this a lot in our end stage cirrhosis patients. It's not as pronounced in the ESRD patients because they are getting dialysis on a regular basis, but if you assess them thoroughly you will find pitting edema on the day of dialysis just before the treatment in places you would never expect it. Much depends on what kind of diuretics the patient might be getting as well. Once treated, the anasarca may be hard to detect.

[momandstudent]

I don't mean to come off sarcastic by any means but I know what anasarca is, I just don't know if it is a medical diagnosis or not. I guess I should have made that clearer in my question. Sorry about that. I am curious as to whether or not I can put it in with my nursing Dx.

[Daytonite, BSN, RN]

It is a medical diagnosis.