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 FEMALE QUESTIONNAIRE - PAGE 5(d) 

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This section deals with edema (swelling/puffiness caused by fluid retention).
519.  Do you have edema of the feet? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
520.  Do you have edema of the ankles or lower legs? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
521.  Do you have edema of the knees? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
522.  Do you have edema of the hands? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
523.  Do you have edema of the eyelids?
Don't know
No
Slightly
Very much
524.  Do you have edema of the abdomen?
Don't know
No
Slightly
Very much

Add any additional information here for the questions above:

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GLOSSARY

Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.

Edema
Abnormal accumulation of fluids within tissues resulting in swelling.





























 
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