TREATMENT—General measures consist of absolute bed rest and sedatives or analgesics as necessary. The patient should avoid stress and should reduce sodium intake. Weight reduction is indicated in overweight individuals. Start oxygen therapy and request further treatment orders from a physician. Transfer the patient for hospitalization as soon as possible.
Hypertension
It is blood pressure elevations above the normal range that are caused by abnormal resistance of the arterioles to the flow of blood.
SYMPTOMS—High blood pressure readings, headaches, vertigo, fatigue, and weakness are common. The patient may exhibit insomnia, nervousness, palpation, epistaxis, and tachy - cardia.
TREATMENT—General measures consist of rest, both mental and physical, a low sodium diet, and weight reduction. Refer the patient for evaluation and definitive treatment.
Thrombophlebitis
It is characterized by partial or complete obstruction of the vein with resulting inflammation of the venous walls. It is most frequently found in the deep veins of the lower extremities. Thrombophlebitis occurs spontaneously in pregnancy or in the postpartum period. It also occurs between the 4th to 14th-postoperative day and as a result of trauma or IV therapy.
SYMPTOMS—The primary symptoms are pain and swelling in the involved extremity. The superficial veins may become dilated and the affected extremity is usually warmer at the site than the remainder of the skin. The pedal pulse is diminished in most cases and the patient may complain of a sensation of heaviness in the affected limb. Calves are painful upon dorsiflexion of the foot, and there is usually plantar tenderness.
TREATMENT—General measures consist of moist heat wraps applied to the affected site, strict bed rest with elevation of the affected limb, and Butazolidin®. Anticoagulant therapy is sometimes unnecessary with superficial thrombophlebitis, but is considered definitive in cases involving the deep veins. Elastic bandages are applied to the limb to lend support to the veins. Complications to be alert for are pulmonary embolisms, and in rare circumstances, emboli in other vital organs.
Varicose Veins
Varicose veins are abnormally lengthened, dilated, sacculated, superficial vessels normally found in the lower extremities. These may be asymptomatic. They are caused by incompetence of venous valves, increased distensibility, and in some cases may be an inherited trait. Contributing factors are prolonged standing, pregnancy, obesity, and aging.
SYMPTOMS—They include muscle cramps, tired muscles, and calf muscle soreness. The ankles tend to swell, with spontaneous remission of swelling overnight. An itchy, scaling dermatitis in the region of the affected vein is common. Veins are abnormally visible and palpable and ulceration may occur.
TREATMENT—Elastic stockings and support and elevation of the extremity are definitive. The patient should be instructed to avoid prolonged standing. Surgical correction is often necessary in severe cases.
Septicemia
Septicemia is the presence of bacteria in the circulating blood and is frequently caused by surgery, IV therapy, or indwelling catheters.
SYMPTOMS—Fever, chills, skin eruptions, and shock are common.
TREATMENT—Evacuate the patient to a medical facility immediately.
Hodgkins’s Disease
The cause of this disease remains unknown. It is a chronic, progressive, and often fatal disease manifested by progressive enlargement of the lymph nodes, spleen, liver, lungs, and frequently other organs and tissues.
SYMPTOMS—Normally the initial stages are marked by painless enlargement of the superficial lymph nodes as well as persistent pruritus, fever, and diaphoresis.
