The nurse checks the skin of a client with edema by placing a finger on the client's skin and applying slight pressure. The nurse notes that the skin returns to normal in a second or so. How would the nurse document this finding?
A) No edema present
B) +1 pitting edema
C) +2 pitting edema
D) Nonpitting edema present
B
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Pitting edema is the descriptive term used to describe serious observable edema that dents under slight finger pressure. The healthcare provider can indicate the extent of pitting edema by using a finger to press against the area of swelling. Generally, a scale of +1 to +4 is used to describe the intensity of the edema. If the dent remains for only a second or so, the nurse would record plus one (+1) pitting edema. When a dent remains for 2, 3, or 4 or more seconds, the observation is charted as +2, +3, or +4 pitting edema, respectively. Nonpitting edema, which can also be severe, refers to swelling that does not indent when slight pressure is applied.
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