Skip to main content

Swollen legs

 

  • Differential diagnosis

    Usually due to fluid leak from veins or lymphatics. Most are 'pitting' (remains indented after pressing), but hypothyroidism and lymphoedema are 'non-pitting'.

    Bilateral:

    • Venous insufficiency, usually due to age-related venous valvular incompetence.
    • Right heart, liver or renal failure.
    • Dependent oedema: effect of gravity when sitting for a prolonged period.
    • Pregnancy
    • Calcium channel blockers.
    • Hypothyroidism

    Unilateral:

    • Venous insufficiency: can be uni- or bilateral.
    • DVT
    • Cellulitis
    • Lymphoedema e.g. from pelvic mass.

  • Lymphoedema

    Tissue swelling due to fluid leakage from lymphatic vessels.

    Primary lymphoedema

    Congenital lymphoedema (aka Milroy disease):

    • Autosomal dominant disease.
    • Usually bilateral.

    Lymphoedema praecox (aka Meige disease):

    • Onset between birth and 35 years old, usually in puberty. 4 times commoner in women.
    • Commonest cause of primary lymphoedema.
    • Usually unilateral.

    Lymphoedema tarda:

    • Onset >35 years old.
    • Uncommon

    Secondary lymphoedema

    Causes:

    • Cancer
    • Surgery
    • Radiotherapy

    Management

    Compression stockings and elevation.

Comments

Post a Comment

Popular posts from this blog

ROLE OF A NURSE IN EPIDEMIOLOGY

 ROLE OF A NURSE IN EPIDEMIOLOGY Role of a nurse in epidemiology can be explained in 4 aspects. These are: Preventive role Promotive role Curative role Rehabilitative role Role in Prevention Epidemiology is one of the basic sciences applicable to nursing. The nurses working in a community deal with people in various settings and help them solve their health problems. They make the nursing process. They identify and investigate the problem, formulate and test the hypothesis regarding the causal factors, formulate alternative interventions and implement to prevent and control the problem and evaluate effectiveness of intervention. They have an active role in the prevention and control of communicable diseases which include:             - Identify sources of infection and methods of spread of infection.             - Health education of people in general.             - Having an important role in...
Post a Comment
Read more

TYPES OF TOOLS USED FOR EVALUATION

 TYPES OF TOOLS USED FOR EVALUATION There are many tools or instruments used in evaluation process. Some of the tools have been briefly discussed here: Questionnaire Most commonly used method of evaluation is questionnaire in which an individual attempts answers in writing on a paper. It is generally self-administered in  which person goes through the questionnaire and responds as per the instruction. It is considered to be the most cost-effective tool of evaluation in terms of administration. While developing teacher should ensure that it is simple, concise, and clearly stated. Evaluation done with the help of questionnaire is quantitative. Interview  Interview is the second most important technique used for evaluation in which students participating in evaluation are interviewed. Interview can help in getting information both quantitatively and qualitatively. Interview can be conducted in group or individually. It is a time-consuming process; therefore it should be arra...
Post a Comment
Read more

Intramuscular (IM) Administration

  Intramuscular (IM) Administration Here are the steps needed to accomplish administering IM injections. Feel free to read through the steps . You will be needing all these supplies. Prepare the medication to be given, syringe, alcohol prep pad, gauze, band-aid and needle. The needles are usually 21g or 22g, and 1 1/2″ long. Wash your hands. Prepare/Mix the medication accordingly and put it into the syringe. Attach the new needle into the syringe. Medication can be given into the: Ventrogluteal  – Patient may lie on back or side with hip and knee flexed. Vastus lateralis  – Patient may lie on the back or may assume a sitting position. Deltoid  – Patient may sit or lie with arm relaxed. Dorsogluteal  – Patient may lie prone with toes pointing inward or on side with upper leg flexed and placed in front of lower leg. The site should be free of bumps and scars. Clean the site with an alcohol pad. Allow the alcohol to dry. Do not use a blower or fan to quicken the dr...
Post a Comment
Read more