1. What is Edema? What are Ulcers? How can Edematous Limbs be treated?

3.   A Condition in which a collection of fluid between tissues causes extreme swelling.  AKA – Swelling  Edema results whenever small blood vessels, usually veins, become "leaky" and release fluid into nearby tissues. The extra fluid accumulates, causing the tissue to swell. Edema

4.   Low albumin (hypoalbuminemia): Albumin is a protein in the blood that acts like sponges to keep fluid in the blood vessels. (isn't usually the sole cause.)  Anaphylaxis: In response to the allergic exposure, the body allows nearby blood vessels to leak fluid into the affected area.  Obstruction of flow (Gangrene)  Critical illness: Burns and infections (Streptococcal Pyogenes)  Edema and Congestive Heart Failure: When the heart weakens and pumps blood less effectively, fluid can slowly build up, creating leg edema. If fluid buildup occurs rapidly, fluid in the lungs (pulmonary edema) can develop. If there is heart failure of the right side of the heart, oftentimes edema can develop in the abdomen, as well.  Edema and Renal Failure: A Kidney condition called nephrotic Syndrome can result in severe leg edema (Lot’s of vascular patients looking to receive dialysis access) Causes of Edema

7.   Can anyone give me some example of symptoms of Edema in Extremities, in particular? Symptoms

8.  Case Studies Case 1 Case 2  Sex: F Age: 67  BP: 125/66 HR: 72  Room #: 19  Complaint: Patient believes poor circulation in both legs is due to penicillin intake (injection)  Diagnosis: Dermatologist initially diagnosed toe fungus; Vascular Surgeon diagnosis Varicose Veins  Treatment: Compression Stocking are being prescribed by Vascular Doctor Ordered Studies: Bilateral Venous Duplex (Legs) for insufficiency  Other: N/A Patient D Sex: F Age: 72 BP: 212/107 HR: 93 Room #: 21 Complaint: Swollen Arm; Follow-Up Diagnosis: COPD; Edema (Left Upper Extremity); clots in veins (Left Upper Extremity); Stage III Breast Cancer; Right AV Graft (looks great) Treatment: blood thinners; compression wrap placed on Left Upper Extremity (gelocast); Possible Surgery (Balloon and Stenting of Veins) Ordered Studies: CT Scan (To see what the Veins up to) Other: Follow-Up appointment on July 23, 2015; compression wrap maybe done again for another week long period

10.  A diabetic foot ulcer is an open sore that occurs within 15% of all diabetes patients. Cause(s): a higher use of insulin, being overweight, uncontrolled alcohol and tobacco usage, Vascular Disease (inability or hindering of the wound healing process can impose foot ulcers. Symptoms: significant odor, oozing of liquid, redness and swelling of foot Treatment: preventative medicine and management of foot ulcer (“off load” methodology applied to relieve pain of foot in relation to the ulcer. Surgery: surgical care to remove pressure on the affected area include the shaving or excision of bone(s) and the correction of various deformities, such as hammertoes, bunions, or bony “bumps.” Diabetic Venous Ulcers

13.   Diuretics (Lasix)  Blood Thinners to dissolve Blood Clots (Xarelto)  Unna-Boot Compression Wrap  Compression Pumps (Lower Extremities)  Compression Stockings (Lower Extremities)  Xeroform w/ Petroleum Jelly Treatments of Edema in Limbs & Ulcers

16.  Any Questions?