Varicose Veins

  1. General information
    1. 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
    2. Most common between ages 30 and 50
    3. Predisposing factor: congenital weakness of the veins, thrombophlebitis, pregnancy, obesity, heart disease
  2. 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)
  3. Assessment findings
    1. Pain after prolonged standing (relieved by elevation)
    2. Swollen, dilated, tortuous skin veins
    3. Diagnostic tests
      1. Trendelenburg test: varicose veins distend very quickly (less than 35 seconds)
      2. Doppler ultrasound: decreased or no blood flow heard after calf or thigh compression
  4. Nursing interventions
    1. Elevate legs above heart level.
    2. Measure circumference of ankle and calf daily.
    3. Apply knee-length elastic stockings.
    4. Provide adequate rest.
    5. Prepare client for vein ligation, if necessary.
      1. Provide routine pre-op care.
      2. In addition to routine post-op care
        1. keep affected extremity elevated above the level of the heart to prevent edema.
        2. apply elastic bandages and stockings, which should be removed every 8 hours for short periods and reapplied.
        3. assist out of bed within 24 hours, ensuring that elastic stockings are applied.
        4. assess for increased bleeding, particularly in the groin area.
    6. Provide client teaching and discharge planning: same as for thrombophlebitis (see Thrombophlebitis).