Venous Insufficiency

Causes:

Impaired venous return

• Venous obstruction (DVT)
• Venous valvular insufficiency
• Decreased muscle contractions

Venous Insufficiency

S/S:

• Discomfort
• Edema
• Venous Hypertension
• Skin color change - reddish, brown
• Ulcers (Venous stasis)

Venous Insufficiency

Diagnostics/ Treatment

Diagnosed by ultrasonography

Tx:

• Elevation (3 x per day for 30 min)
• Sequential pneumatic devices
• Wound care
• Duoderm (hydrocolloid; 3-5 days)
• Unna boot
• Hardens
• Changed weekly
• Notify HCP of pain (over compression)
• Surgery
• Teaching - no crossing legs, antiembolic stocking when you get up

Varicose Veins

S/S:

• Superficial pain
• Pressure
• Bcome more visible
• Fatigue possible
• Diagnosis by physical exam

Varicose Veins

Treatment:

• Compression stockings
• Sclerotherapy - injection to prevent thrombosis from occluding vein
• Surgery - strip saphenous veins; ST relief
• Radiofrequency - heats, damages inside wall causing it to collapse
• Laser - heats and seals veins

Varicose Veins

Post-op Care:

• Pressure bandages (6-8 weeks)
• Elevate legs
• ROM immediately
• Assess site for infection
• Peripheral pulses
• Color
• Edema
• At home:
• Avoid sitting or standing for lengthy amt of time
• Good nutrition and foot care
• Exercise (3-5 X week, 30 min)
• Compression stockings

Varicose Veins

NDx

• Chronic pain
• Ineffective tissue perfusion
• Impaired skin integrity
• Risk for neurovascular dysfunction

DVT

Tx:

• Inferior vena cava filter
• Thrombolytic meds:
• Streptokinase
• Urokinase
• Alteplase

DVT

Post-op Care:

• Monitor hypotension
• Petechiae
• Ecchymosis
• Peripheral pulses
• Elevate extremities

DVT

Teaching

No crossing legs

Use electric razor

Inform healthcare workers on use of anticoagulants