To test for pitting edema, the examiner presses his or her fingers into a dependent area, such as the patient's shin, for 2 to 3 seconds. If pitting edema is present, the fingers sink into the tissue,
and when the fingers are removed, the impression of the fingers remains. This technique is demonstrated in Figure 14-33.
Pitting edema is usually quantified from 1+ to 4+, depending on how long the indentation persists. The most noticeable is 4+. In patients who are bedridden, the dependent area is usually the sacrum and not the shins. The examiner should evaluate for edema over the sacrum in these patients. Figure 14-34 illustrates 4+ sacral edema in a bedridden patient.
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