Case Summary
Amanda, an 18-year-old diagnosed with anorexia nervosa, was admitted to an eating disorders clinic with a BMI of 13.9. Although admitted voluntarily, she was hesitant to participate in treatment and believed she was overweight, noting that her clothes felt tight and that her hands and feet appeared “fat.” A nurse explained that her symptoms were related to a low blood protein level and reassured her that returning to a balanced, healthy diet would help reduce the swelling in her extremities.
Case Analysis
Overview
The girl was diagnosed with anorexia nervosa and was a voluntary patient who did not accept medical treatment. The patient was convinced she was fat, even in her arms and fingers. The nurse assumed the girl’s blood protein level was low and that a healthy diet would improve it. The low albumin level caused edema, and the patient’s moving in the wheelchair might lead to dependent edema.
Role of Blood Proteins in the Development of Edema
A low albumin level in the blood might cause edema. The nurses stated that there was a lack of protein in Amanda’s blood, resulting in edema. In this case, albumin may cause edema because it can quickly leave the vascular bed and enter interstitial tissues. This process leads to edema or increases availability (Andrey, 2019).
In addition, when albumin levels in the blood are low, fluid is retained, and the legs, ankles, and feet are at risk of edema (Andrey, 2019). Due to increased hydrostatic pressure, another variant of the transformation of albumin into edema can create a risk of interstitial edema. In both situations, the background of increased vascular permeability should be presented. Considering these opportunities, the nurse might assume that the albumin level was low in the blood and that edema occurred.
Physiological Differences Between Pitting and Nonpitting Edema
There are two types of edema: pitting and non-pitting. The main physical difference between them is the lack or presence of a pit in the skin. Physical contact with edema is required to assess the pit’s availability. Pitting edema would leave a pit in the skin when pressed (The Scientific World, 2020). Problems with the kidneys, heart, liver, or veins in the hurt area cause this.
On the contrary, after pressing on the swollen skin, there is no pit – it is non-pitting edema. In this case, when the pressure is removed, the skin returns to its shape without creating an indentation (The Scientific World, 2020). This edema is easily diagnosed and caused by myxedema, lipedema, and lymphedema. Therefore, the absence of pitting after pressure is the primary physical difference between pitting and non-pitting edema.
Effects of Reduced Mobility on Edematous Tissues
If the patient with edema is not moving for an extended period, it might lead to dependent edema. Because of Amanda’s weakened condition, the girl was transported in a wheelchair, and as a result, her legs were swelling. In this case, using a wheelchair is essential, as the patient is weak, but such a transformation should not last long. When legs are less mobile and unused, gravity pulls the fluid downward (Flint Rehab, 2022).
In addition, fluid remains in the leg and is not being pumped back. This process leads to dependent edema and harms the healing process and rehabilitation. To avoid the negative consequences of wheelchair use, it is necessary to maintain muscle strength. In Amanda’s case, this practice will help reduce her edematous tissue.
Summary
To sum up, Amanda’s edema was possibly caused by the lack of albumin in the patient’s blood. Albumin is a protein whose characteristics prove this statement. In addition, there are two types of edema: pitting and non-pitting, which differ in the presence or absence of a pit. Lastly, the absence of muscle movement and prolonged wheelchair use negatively affect edematous tissues.
References
Andrey, B. (2019). What clinicians should know about the use of albumin. Haematology International Journal. 3(1).
Flint Rehab. (2022). Leg swelling after spinal cord injury: Why it happens & how to effectively treat i.
The Scientific World. (2020). Difference between pitting edema and non-pitting edema.