Angelite Nurses: Varicose Veins

Varicose Veins

General information

Dilated veins that occur most often in the lower extremities and trunk. As the vessel dilates, the valves become stretched and incompetent with resultant venous pooling/edema
Most common between ages 30 and 50
Predisposing factor: congenital weakness of the veins, thrombophlebitis, pregnancy, obesity, heart disease

Medical management: vein ligation (involves ligating the saphenous vein where it joins the femoral vein and stripping the saphenous vein system from groin to ankle)
Assessment findings

Pain after prolonged standing (relieved by elevation)
Swollen, dilated, tortuous skin veins
Diagnostic tests

Trendelenburg test: varicose veins distend very quickly (less than 35 seconds)
Doppler ultrasound: decreased or no blood flow heard after calf or thigh compression

Nursing interventions

Elevate legs above heart level.
Measure circumference of ankle and calf daily.
Apply knee-length elastic stockings.
Provide adequate rest.
Prepare client for vein ligation, if necessary.

Provide routine pre-op care.
In addition to routine post-op care

keep affected extremity elevated above the level of the heart to prevent edema.
apply elastic bandages and stockings, which should be removed every 8 hours for short periods and reapplied.
assist out of bed within 24 hours, ensuring that elastic stockings are applied.
assess for increased bleeding, particularly in the groin area.

Provide client teaching and discharge planning: same as for thrombophlebitis (see Thrombophlebitis).

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