Varicose veins are enlarged, twisted veins that bulge just under the skin surface, most commonly in the legs. They occur when valves in the veins weaken, causing blood to pool in the veins. Risk factors include aging, family history, pregnancy, obesity, and prolonged standing or sitting. Varicose veins can cause pain, swelling, skin discoloration, and leg ulcers. Treatment options include compression stockings, sclerotherapy, laser therapy, and surgery to remove or tie off the damaged veins. After vein ligation surgery, nurses monitor for edema and complications while keeping legs elevated and applying compression stockings.

1. DISORDER OF VEINS
Varicose Veins
Prepared by
Nursing Instructor
Mrs. Safoora Qureshi

2. Structure of Vein
Vein is made of three layers of tissues
and fibers
• The tunica adventitia (outer layer)
gives structure and shape to vein.
• The tunica media (middle layer)
contains smooth muscle cells
• The tunica intima (inner most layer)
consists of flat epithelial cells.

3. Veins Disorder
• Some of the more common
disorders include:
• Venous thrombosis
• Chronic venous insufficiency.
• Deep vein thrombosis.
• Phlebitis
• Varicose
• Spider veins/ spider engioma

4. • Chronic venous
insufficiency (CVI) is a
condition that occurs when
the venous wall and/or
valves in the leg veins are
not working effectively.

5. Varicose Veins
• are enlarged, twisted veins
that bulges just under the skin
surface.
• Can happen anywhere in the
body, but are more common in
the legs.
• are not considered a serious
medical condition.
• But can be uncomfortable
• May lead to more serious
problems.

7. Sign and Symptoms
Pain less varicose veins:
• Dark purple or blue
• Appear twisted and bulging, often appearing like cords on the legs
Painful varicose :
• An achy or heavy feeling in the legs
• Burning sensation
• Throbbing pain,
• Muscle cramping and swelling in the lower legs
• Worsened pain after sitting or standing for a long time
• Itching around one or more of the veins
• Changes in skin color around a varicose vein
•

8. Spider Veins
• Spider veins are smaller, red,
purple, and blue vessels that also
twist and turn.
• Visible through the skin,
• Affect the capillaries /the smallest
vessels
• look like a spider’s web or tree
branch.
• Typically visible on the legs and

9. Difference b/w varicose & spider veins
Varicose veins and spider veins are both types of venous
disease, but they look different.
Spider veins are:
• Smaller and thinner than varicose veins.
• Look like red or blue spider webs or branches of a tree,
• Close to the skin’s surface.
• Usually painless.
• Appear, most often behind the knee, on feet or on face.
• Varicose veins usually appear on feet and legs.

10. Pathophysiological mechanism
• Exact cause is unknown
• Weak or damaged valves can lead to varicose veins.
• Muscle contractions in the lower legs act as pumps, and elastic vein
walls help blood return to the heart.
• Tiny valves in the veins open as blood flows toward the heart, then close
to stop blood from flowing backward.
 Weak or damaged valve:
• Cause the blood to;
• flow backward and pool in the veins
• Causing the veins to
• stretch or twist.

11. Risk factors
• Congenital: weakness of the vein structure
• Aging : valves in veins start to damage or weaken over time
• Gravity: put the negative effect on leg veins in standing position
• Family History: history of family members with varicose vein
• Sex: more common in female,
• Hormonal effect: during menopause and pregnancy
• Pregnancy: growing uterus place extra pressure on a person’s veins
• Long Standing
• Sitting down for long time periods
• Being over weight

12. Complications
• Ulcers.
• Blood clots.
• Superficial
thrombophlebitis
• Deep vein thrombosis
(DVT)
• Pulmonary embolism:
• Bleeding.
Prevention
• Avoid long periods of standing:
• Raising your legs when sitting or lying down
• Maintain a healthy weight:
• Quit tobacco use
• Stay active
• Try compression stockings
• Wear clothes that fit properly:
• To encourage blood flow
• Avoiding high heels and tight hosiery
• Changing your sitting or standing position
regularly
• Eating a high-fiber, low-salt diet
• Exercising

13. Diagnosis
• History:
• Physical Examination: in sitting and standing position.
• Ultrasound: To see Detailed images of the veins and check
for complications.
• Ultrasound can show blood clots and how your valves are
working.

14. Treatment
• Relive Pain:
• There isn’t a cure for varicose veins, these treatments can
reduce their appearance and relieve discomfort:
• Elevation: to improve circulation, elevate your legs above
your waist several times throughout the day.
• Elastic stockings: Supportive stockings or socks compress
your veins and reduce discomfort. The compression stops
vein stretching
• Injection therapy (sclerotherapy):
• During sclerotherapy, a solution is injected into the vein,
that causes the vein walls to stick together. Eventually, vein
turns into scar tissue and fades away.

15. Laser therapy:
In a minimally invasive procedure called
• Endogenous thermal ablation
• A catheter (a long, thin tube) and laser is used to close off a
damaged vein.
Vein surgery:
• ligation
• To stop blood from pooling/tying off the varicose vein
• Stripping
• To remove (strip) the vein to prevent varicose veins from
reappearing.

16. Ligation

17. Nursing management
After Vein Ligation surgery
• Encourage deep breathing to promote venous return
• Check the extremities regularly for
• color, movements, sensations, temp, edema and pedal pulses.
• Bruises and discoloration are consider normal
• Keep the legs elevated at 15 degree to prevent edema
• Compression stocking, applied and removed every 8 hrs for short time
and then applied
• Improving circulation
• Relieving discomfort and pain
• Improving cosmetic appearance
• Avoiding complication such superficial thrombophlebitis, and ulceration