main problem: turtuous, abnormally dilated, superficial veins due to incompetent venous valves
pathophysiology: reflux of venous blood —> venous statis
(1) primary – no involvement of deep veins
(2) secondary – result from obstruction of deep veins
outstanding signs & symptoms: dilated veins and feeling of heaviness of the legs
signs & symptoms: nocturnal muscle cramps, dull aches, increased fatigue in lower legs and ankle edema
diagnostic tests:
(1) duplex scan – anatomic site & measure severity of reflux
(2) air plethysmography – measures venous blood volume changes
(3) venography – injection of x-ray contrast used to evaluate valvular reflux
medical management:
(1) surgery – ligation and stripping of saphenous vein
(2) sclerotherapy – may be performed after vein ligation or stripping and only for small varicosities
how? – sclerosing agent is injected –> irritates the venous endothelium –> localized phlebitis & fibrosis –> lumen of the vein obliterates
nursing management:
(1) post surgery
(a) bed rest for 24 hours
(b) after 24 hours, patient is encouraged to walk every 2 hours for 5 to 10 minutes
(c) elastic compression bandage is worn for about 1 week
(d) foot of bed elevated
(e) administer analgesics as ordered
(f) inspect dressing for bleeding
(g) encourage patient to report hypersensitivity to touch and and sensation of “pins and needles“
(h) discourage standing still and sitting
(i) instruct patient to dry the incisions well with a clean towel using the patting technique rather than rubbing after shower
(j) avoid applying lotion to incision site to avoid infection
(2) post sclerotherapy – educate patient that a burning sensation in the injected leg may be experienced for 1 to 2 days.
