Varicose Vein

Varicose Vein

The lower extremities and trunk are where varicose veins most frequently develop because of dilated veins. Vein pooling or edema results from the valve becoming strained and ineffective as the veins enlarge. Between the ages of 30 and 50, it tends to be more prevalent in women than in men.

Heredity, congenital weak points, pregnancy, obesity, menopause, aging, prolonged standing, leg injuries, abdominal strains, etc. are all risk factors. Pain after prolonged standing (relieved by elevation) and swollen, dilated, tortuous skin veins are signs and symptoms. Deep vein thrombosis, pulmonary embolism, and infection are symptoms of varicose veins.

Diagnosis

• Trendelenburg test: varicose vein distends very quickly (less than 35 sec).
• Doppler ultrasound.

Management

Conservative management at first, if not managed by conservative management then surgical intervention may be necessary.

Conservative Management:

The symptoms of varicose veins can be controlled to an extent with the following: 

• Elevating the legs often symptomatic relief.
• Advice about regular exercise.
• The wearing of graduated compression stockings with variable pressure gradients
• The wearing of intermittent pneumatic compression devices has been shown to reduce swelling and increase circulation
• Topical gel and oil application, helps in managing symptoms related to varicose veins such as inflammation, pain, swelling, itching and dryness.

Surgical Management

• Stripping: removal of all or part the saphenous vein (great/long or lesser/short) main trunk.
• Ambulatory phlebectomy.
• Vein ligation.
• Cryosurgery.

Nursing Management

• Elevate the leg above the heart level.
• Measure the circumference of ankle and calf daily.
• Apply knee-length elastic stocking.
• Provide adequate rest Prepare the patient for vein ligation, if necessary.
• Provide routine post-op care.
  • Keep affected extremity elevated above the level of the heart to prevent edema.
  • Apply elastic bandages and stocking, which should be removed every 8 hours for short periods and reapplied.
  • Assist out of bed within 24 hours, ensuring that elastic stocking are applied.
  • Assess for increased bleeding specially in the groin area.
• Provide teaching about self care:
• Elevate the legs as much as possible. If the person can take half-hour breaks during the day to rest, do it. It is important to raise the legs up above the level of the heart to get the maximum effect, and to do this for about a half-hour each time.
• Wear compression stockings; put them on in the morning before walking around and before the veins become more swollen. If a person tries them and experiences worsening pain, especially after walking, remove them and see a health care professional.
• If the patient is overweight, try to lose weight. A healthy diet high in fiber and low in fat and salt can help.
• Avoid alcohol, which can cause the veins in the legs to dilate.
• If he / she has problems such as chronic constipation, urinary retention, or chronic cough, relieving conditions that are causes of straining may help with the varicose veins.
• Avoid wearing tight clothing such as girdles or belts.
• Do not cross the legs when sitting.
• Walking is good exercise. It can help the muscles force the blood out of the deeper vein system.
• If the person is driving on a trip, traveling by air for a long period of time, or working at a desk all day, try to get up and walk around every hour or so to allow the muscles to pump the blood out of the veins.