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 inflamma- tion  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   dorsi- flexion  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  throm- bophlebitis, 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   sup- port  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. 2-16