Total body water

2/3

intra- cellular

1/3 extra- cellular

3/4

interstitial fluid

1/4 plasma

Body Water

Excessive

accumulation

of fluid in

the tissues

Increased in the interstitial fluid

Starling Forces

Regulate the disposition of fluid

(ECF) between interstitial fluid &

plasma

Movement of

fluid from the

vascular to

the interstitial space

Movement of

fluid from the

interstitial

space to the

vascular compartment

Fluid move

from the

vascular to

the interstitial

space at the

arteriolar end

of the capillaries

Movement of

fluid into the

vascular at

the venous

end of the

capillaries

and

lymphatic

Alterations of the Starling’s forces

Increased flow of fluid from the

vascular system into the interstitium or a body cavity

Increased capillary pressure

Decreased plasma proteins

Increased capillary permeability

Lymphatic blockage

Idiopathic cyclic edema

Pitting Non-pitting

Edema

Pitting Non-pitting

Generalized Localized

Lymphedema, Angioema

Myxedema

Angioedema

Localized non-pitting edema

Lymphedema

Edema

Pitting Non-pitting

Generalized Heart, kidney, liver,

nutrition

Localized DVT, varicose vein

Lymphedema Angioema

Myxedema

Generalized pitting edema

Congestive Heart Failure

Generalized pitting edema

Nephrotic syndrome

Breaking bad news

Step I: Getting the physical context right

Step II: Finding out how much the patient knows

Step III: Finding out how much the patient wants to know

Step IV: Sharing the information

Step V: Responding to the patient’s feelings

Step VI: Planning and follow-through

OR SPIKES model

S=Setting

P=Perception

I=Invitation

K=Knowledge

E=Empathy

S=Summary

“INHOMESSS”

Immobility

Nutrition

Housing

Other people

Medication

Examination

Safety

Spiritual health

Service system

Take home message

What is edema?

Pathogenesis of edema

Clinical approach of cases

Patient-centred

Holistic care

Palliative care & braking bad news

Home care