Nursing Care and External Applications for Edema

Britta Wilde

Last update: 14.08.2019

External applications play an important role in treating edema and can often quickly improve both the patient’s sense of well-being and the symptoms. The quality of touch, application temperatures and the substances used act via the skin’s extensive sensory system and can influence edema-associated complaints, such as dyspnea, the urge to cough, agitation, congestion and tension. The treatment can also calm a person down and promote sleep.

Peripheral edema, lymphedema

  • In case of peripheral edema – due to heart failure, chronic venous insufficiency, lymphedema, anasarca – the patient’s weakened life organization can be strengthened with
    Borage compresses: dissolve 1 tbsp. Borage essential oil WALA in 1 liter water
    Borage has a decongestive, cooling and anti-inflammatory effect. The liquid that has accumulated in the body’s tissues is made to flow again. Patients often report an improvement immediately after the treatment.
    For instructions, see: http://www.pflege-vademecum.de/boragoessenzwickel.php

  • For tired patients
    Citrus compresses: lemon compresses wrapped around the torso, lower legs, forearms – alternating with cool compresses
    The lemon scent alone has an immediate activating effect. In addition, lemon has an astringent and formative effect.
    Instructions: Halve a lemon (of biodynamic quality) and cut into the rind a few times. Place the lemon in a bowl and pour water over it. Squeeze out the lemon, under water, by pressing on it with a glass or cup. Immerse a cotton baby diaper in the lemon water obtained in this way. Wring it out well and place it on the area to be treated. The temperature can be adapted to make it comfortable for the patient. Cover with a cloth, e.g., a towel or duvetyn cloth, and leave on for 15–20 minutes.
    Farmer's cheese (quark) compresses on the lower legs or forearms
    For instructions, see: http://www.pflege-vademecum.de/quarkauflage.php

Cerebral edema

Therapeutic nursing care measures for cerebral edema (e.g., resulting from cerebral metastasis or brain tumors):

An arnica forehead compress or arnica cap with Arnica essence WALA, WELEDA

Arnica harmonizes between dissolving and structuring forces and has a shaping and structuring effect.
For instructions, see: http://www.pflege-vademecum.de/arnika-kopfhaube.php

Pulmonary edema and pleural effusion

  • In pulmonary edema, the air-filled respiratory tract is constricted by liquid. The causes are mainly cardiac, inflammatory or tumor related.
    Farmer’s cheese (quark) chest compress
    During this application, liquids are gently sucked into the compress as the farmer's cheese dries. Farmer's cheese also has an anti-inflammatory and cooling effect. The best results are achieved with low-fat farmer's cheese.
    Instructions: Use a knife or wooden spatula to spread the low-fat farmer's cheese about 3–5 cm thick on an unfolded compress cloth, then cover with a second compress cloth. A cloth size of ca. 15 x 15 cm is usually large enough. Place the compress directly on the skin and fix in place with another cloth (e.g., a cloth diaper). Leave on for 20–45 min. The effect of farmer's cheese unfolds as it dries. 
    The farmer's cheese should not be too cold, apply it approx. 36°C (~97°F) to lukewarm. This temperature can be achieved quickly if the finished farmer's cheese compress is briefly placed on a hot-water bottle (a plastic bag is suitable as protection). The farmer's cheese must also not be heated above 40°C (104°F), otherwise the milk protein will curdle.

  • Helpful when there is an accompanying urge to cough:
    a thorax compress with lavender 10% oil WELEDA, or thyme 5% oil or farmer's cheese
    Lavender has a warming, relaxing, calming, sleep-inducing, antispasmodic effect. Thyme stimulates the patient’s warmth organization, loosens mucus and has a spasmolytic effect, even in patients who suffer from a strong urge to cough at night and cannot fall asleep for fear of coughing. Thyme can also be used to treat patients who have an aversion to lavender. Farmer's cheese compresses have proven reliable in treating bronchial mucus production and terminal respiratory secretion (death rattle).

  • For inflammatory edema due to pneumonia:
    Rhythmical embrocation of the lungs with Plantago Bronchialbalsam WALA, or thyme oil, or eucalyptus oil, or Eucalyptus comp. paste WELEDA.
    Farmer's cheese compress
    During the application, pay attention to the patient’s breathing – “breath along with the patient” – it should gradually slow down. A rhythmical embrocation of the lungs has four phases: 1. Stroke along the back 2. Change direction 3. Stroke forwards 4. Return through the air to the beginning.

  • Rhythmical embrocation of the calves with lavender 10% oil WELEDA, or Cuprum metallicum praep. 0.4% ointment WELEDA, or Red Copper Ointment WALA
    to draw mental states of congestion and tension away from the head and chest and into the patient’s limb system.

Anasarca

Anasarca is multifactorial in origin and is frequently found in advanced tumor diseases. Edema develops in subcutaneous tissue as an expression of the patient’s weakened life organization. More rarely, the patient’s soul body can cause congestion processes with generalized edema formation.
Borage compress: dissolve 1 tbsp. Borage essential oil WALA (also available as Borago Essenz) in 1 liter water. Wrap the compress around the limb from the back of the foot to the calf or groin.

  • For tired patients
    Citrus compresses: lemon compresses wrapped around the torso, lower legs, forearms – alternating with cool compresses
    Borage has a toning effect on the patient’s etheric body, citrus activates the soul body.
    Farmer's cheese (quark) compress: spread the farmer's cheese 0.5 cm thick on the substance cloth and fold in all four ends to form a pack. Place the pack on the patient’s stomach and wrap a towel around the patient. See also: http://www.pflege-vademecum.de/qbw.php 

Ascites

Ascites of different causes can lead to various complaints, for which the following nursing care treatments are recommended.
See also: https://www.anthromedics.org/PRA-0773-DE

  • For abdominal tension and pain:
    Abdominal compress with Oxalis, Folium 20% tincture WELEDA
    Rhythmical embrocation of the abdomen with Oxalis, Folium 10% ointment WELEDA

  • For liver metastases:
    Yarrow liver compress: add 1 heaped tbsp. of yarrow (the whole flowering plant, without the roots) to 1 liter of cold water and cook covered for 5 min., let steep for 10 min. covered. Pour through a sieve to obtain a golden-yellow compress solution.
    For instructions, see: http://www.pflege-vademecum.de/schafgarben_leberwickel.php

  • To stimulate diuresis:
    Equisetum kidney compress: add 1–2 heaped tbsp of Herba Equiseti Arvensis to 1 liter of cold water and cook covered (over a low flame) for 10–15 min., let steep for 10 min. After pouring through a sieve, the water is a dark brown-green color.
    Farmer's cheese (quark) compress: spread the farmer's cheese 0.5 cm thick on the substance cloth and fold in all four ends to form a pack. Place the pack on the patient’s stomach and wrap a towel around the patient. See also: http://www.pflege-vademecum.de/qbw.php">http://www.pflege-vademecum.de/qbw.php

Research news

Phase IV trial: Kalium phosphoricum comp. versus placebo in irritability and nervousness 
In a new clinical study, Kalium phosphoricum comp. (KPC) versus placebo was tested in 77 patients per group. In a post-hoc analysis of intra-individual differences after 6 weeks treatment, a significant advantage of KPC vs. placebo was shown for characteristic symptoms of nervous exhaustion and nervousness (p = 0.020, p = 0.045 respectively). In both groups six adverse events (AE) were assessed as causally related to treatment (severity mild or moderate). No AE resulted in discontinuation in treatment. KPC could therefore be a beneficial treatment option for symptomatic relief of neurasthenia. The study has been published open access in Current Medical Research and Opinion
https://doi.org/10.1080/03007995.2023.2291169.


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