Edema.

[megananne7]

I'm a new nurse and I've seen a lot of nurses chart the pt has edema (usually "mild" generalized of LE non pitting edema) when, to me, they seem to be just overweight. How exactly can you tell if someone who is overweight really has edema? I have pts who have moderate to severe edema and are obese (You're typical obese CHF-er) and I can definitely tell then, but what about an obese pt with mild edema?

Also, I've seen pts (and been told that even myself) who have the "sock ring" around their ankles/lower legs and described as having edema. Just b/c the sock leaves a ring around their ankles, does that mean the pt is edematous or just a normal "side effect" of wearing socks?! Maybe a dumb question, but even my nurse-friend told me I have LE edema b/c of this.

[canoehead, BSN, RN]

We should have an edema contest. After a 12 hour shift I have pretibial pitting over a centimeter. I've never timed the pitting time. I remember on my first job I had swelling but not pitting. I guess I'm lucky we don't have to wear skirts and hose anymore.

[netglow, ASN, RN]

Aww, nobody ever answered the OP long ago. Pitting edema is fluid leaking into the interstitial tissue spaces, lots of time it has to do with bad veins and you know the big three as well (heart, liver, kidney) or combo of all and you know what that pathophys does to fluid balance, etc.

[Katie5]

Pitting edema is just that, when you press against the tibia (or other boney area) it pits and doesn't return immediately. The rating of +1-+4 is how long it takes to return to normal.

Expantiate pls.

[JaneyW]

There is a tightness to the skin--and maybe a shiny appearance that you don't have with obesity. I try to teach that to students, but i think it takes some time and experience to get good at it.

[netglow, ASN, RN]

Take your students over to ICU, they will see the worst examples there. But, it will be clear as a bell in their heads.