| SETTING: Community Health Centre |
| PATIENT: You are 66 years old and are concerned about the varicose veins on your left leg, which have become increasingly itchy. You would like some advice. The nurse has just examined your leg. TASK: When asked, say you’re generally well and you don’t have any underlying health conditions. Say the itching started a few months ago. In the past couple of weeks, some of the veins have become much itchier. When you scratch, your skin is becoming red, and there are scabs forming. Your veins are just a bit swollen, but they don’t hurt. Say you haven’t used any medicated creams. You have occasionally used moisturisers, but they didn’t seem to help. Say you’ll try an emollient cream and compression stockings. Say it’s very hard to stop scratching as they’re very itchy. Say you’ll do what the nurse has suggested and make a doctor’s appointment if there’s no improvement. |
| SETTING: Community Health Centre |
| NURSE: You see a 66-year-old patient who is concerned about the varicose veins on his/her left leg, which have become increasingly itchy. He/she would like some advice. You have just examined his/her leg. TASK: Confirm inflammation of varicose veins. Find out relevant patient details (general health, underlying health conditions, etc.). Find out more details about symptoms: (onset, intensity of itching, any swelling, feeling of heat, etc). Explain venous stasis dermatitis is the reason for itchiness (chronic inflammatory skin disease; blood build-up in damaged vessels, eventual leakage/oozing of blood into skin, etc.). Find out about any remedies tried (e.g., medicated creams, moisturizing lotions, etc.). Make recommendations to ease itchiness (moisturize; at least twice a day, thick emollient without fragrance/dye; compression stockings, etc.). Emphasize importance of not scratching (e.g., worsens itch, leads to cuts, infection, etc.). Advise need for doctor appointment if symptoms get worse. Remind patient of varicose vein management and self-care (e.g., keep active; use loose clothing, avoid standing/sitting for long periods, elevate legs when sitting, etc.). |