1. The client/caregiver has a basic knowledge of the anatomy and physiology of the vascular system.
   1. Arteries carry blood away from the heart, while veins carry blood to the heart.
   2. Veins have a series of valves that allow blood to be carried against gravity and prevent a backflow of blood.
2. The client/caregiver can define varicose veins.
   1. Varicose veins are abnormally dilated veins that may twist and turn.
   2. They are caused by valves in the veins that stretch and weaken, causing blood to pool in the lower extremities.
   3. Varicose veins can occur in the legs, esophagus, or rectal area.
3. The client/caregiver can list factors that may increase risk.
   1. Congenital weakness of vein structure
   2. Obesity
   3. Pregnancy
   4. Constrictive clothing
   5. Prolonged periods of sitting
   6. Venous obstruction (blood clots, tumors, etc.)
   7. Advanced age
4. The client/caregiver can recognize signs and symptoms.
   1. Enlarged, twisted veins that appear under the skin as dark blue or purple
   2. Leg pain, especially after long periods of sitting
   3. Swelling of feet, ankles, and legs
   4. Complaint of legs feeling heavy or tired
   5. Area with impaired circulation may appear darker than surrounding skin
5. The client/caregiver can list measures to prevent or manage varicose veins.
   1. Avoid sitting or standing for long periods of time. Do not cross your legs at the knee.
   2. Avoid injury to extremities.
   3. Avoid constrictive clothing.
   4. Have frequent rest periods with feet elevated.
   5. Exercise regularly, such as swimming or walking.
   6. Wear an elastic support hose. Demonstrate how to apply and remove the support hose.
   7. Proper foot and nail care. Report any open areas.
   8. Lose weight if overweight (refer to weight-reduction diet teaching guide).
   9. Avoid smoking (refer to tobacco abuse teaching guide).
6. The client/caregiver can list treatments available if the above measures are not sufficient.
   1. Surgery includes vein ligation or vein stripping.
   2. Sclerotherapy uses a clotting solution, which is injected into a vein, which closes it off.
   3. Endovenous ablation therapy uses laser energy to cauterize the vein.
7. The client/caregiver is aware of possible complications.
   1. Superficial thrombophlebitis
   2. Rupture
   3. Venous stasis ulcers
   4. Cellulitis

Resources

Registered dietician

Certified nurse wound specialist

Podiatrist

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com