Varicose veins, or varicosities, are swollen, twisted veins that lie just under the skin. They usually occur in the legs. However, they can appear in other parts of the body as well such as in the form of hemorrhoids in the rectum.

1. P R E S E N T E D B Y – S A M I K S H Y A L I N K H A
VARICOSE VEIN

2. INTRODUCTION
 Varicose veins are
abnormally dilated,
tortuous permanently
distended superficial
veins that develop from
the loss of valvular
competence.
 They appear as twisted
and enlarged veins.

3.  This condition occurs most commonly in the lower
extremities, like the saphenous veins, or the lower
trunk. That’s because standing and walking increase
the pressure in the veins of the lower body.
 However it can occur anywhere in the body with
esophageal varices as the most common example.
 Varicose veins may be caused by weakened valves
within the veins that allow blood to pool in the veins
instead of travelling to the heart.

5. ETIOLOGY
• Congenital weakness of the veins.
• Women are affected more, especially in pregnancy
(hormonal influences, increased pressure by gravid
uterus and also because of increased blood volume).
• People whose occupation require prolonged
standing ike Teachers, Nurses, Guards, Sales
persons etc.

6. • Hereditary and obesity.
• Sitting for a long time without moving.
• Old age (50 to 60 years)
• Trauma, obstruction, DVT or inflammation causes
damage to the valve of the vein.

7. PATHOPHYSIOLOGY
Varicose veins may be primary (without involvement
of deep vein) or secondary (resulting from obstruction
of deep veins)
A reflux of venous blood in veins results in venous
stasis (slow blood flow in the veins)
If only superficial veins are affected, the persons may
have no symptoms but may be troubled by dilated
veins.

8. Deflected valves and weakened wall of veins
Blood flow becomes stagnant or very slow.
Veins become distended.
Varicose Vein

9. CLINICAL MANIFESTATIONS
• Dull aching or feeling of heaviness in affected legs.
• Itching and moderate swelling of legs.
• Nocturnal cramps.
• Bulging, bluish vein or veins.
• Swelling in the legs.
• skin color changes around the vein or veins

10. DIAGNOSTIC PROCEDURE
• Physical examination
In order to detect any visible dilations, or tortuous
skin veins, leg tenderness and also to detect pain on
varicosities.
• History taking
It includes asking about various factors like
symptoms, family history, activity levels, and lifestyle.

11. • Duplex Ultrasound
It involves using high frequency sound waves
to look at the speed of blood flow, and structure of
the leg veins.

12. VENOUS DUPLEX ULTRASOUND

13. NURSING DIAGNOSIS
• Acute pain related to tissue ischemia secondary.
• Impaired skin integrity related to vascular
insufficiency.
• Impaired physical mobility related to activity
limitations due to pain.
• Imbalanced nutrition, less than body requirements
related to increased metabolic needs.
• Disturbed body image related to varicose veins.

14. NURSING MANAGEMENT
• Advise patient to elevate the legs.
• Caution patient to avoid prolonged standing or
sitting.
• Caution patient to avoid knee-length stockings and
constrictive clothing.
• Provide high-fiber foods to prevent constipation.
• Teach simple exercise to promote venous return.
• Apply anti-embolic stockings as directed.
• Avoid massage on the affected area.

15. MEDICAL MANAGEMENT
• Laser treatment
A device is used to send a thin beam of
radiation in the form of light. This closes and shrinks
the varicose vein and causes scar tissue within the
vessel. This seals off the vein. Blood then flows
through other nearby veins instead.

16. • Radiofrequency Ablation (RFA)
It is a procedure using radiofrequency energy
to heat up and damage the wall inside a vein. This
usually closes off a varicose vein in the leg.

17. • Sclerotherapy
It involves injecting a chemical solution directly
into the varicose vein. The solution causes the vein
walls to swell, stick together and seal shut, stopping
the flow of blood.

18. SURGICAL MANAGEMENT
• Vein Ligation and Stripping Procedure
It involves “tying off” a varicose vein to stop
blood from entering it. The vein is then stripped
(removed from your body). After varicose vein
stripping and ligation, your healthy veins take over to
help restore normal blood flow.

19. PREVENTIVE MEASURES
• Maintain a healthy weight.
• Follow a low-salt diet to prevent swelling caused from
water retention.
• Fiber enriched such as oats, apples, flaxseed, carrots,
berries, and barley, are good for fighting against varicose
veins and keeping veins healthy.
• Do not cross your legs while sitting.
• Do not wear tight clothing.
• Choose proper footwear.
• Avoid standing or sitting for long period of time.
• Exercise regularly.