Total body water
2/3
intra- cellular
1/3 extra- cellular
3/4
interstitial fluid
1/4 plasma
Body Water
Movement of
fluid from the
vascular to
the interstitial space
Movement of
fluid from the
interstitial
space to the
vascular compartment
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
Edema
Pitting Non-pitting
Generalized Heart, kidney, liver,
nutrition
Localized DVT, varicose vein
Lymphedema Angioema
Myxedema
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
“INHOMESSS”
Immobility
Nutrition
Housing
Other people
Medication
Examination
Safety
Spiritual health
Service system