Varicose veins are dilated superficial veins caused by venous hypertension.

The superficial venous system can become incompetent due to family history, pregnancy, aging, deep vein thrombosis, oral contraceptives or obesity. Treatment options include compression stockings and bandages, sclerotherapy using chemicals to obliterate veins, and high ligation and stripping surgery to remove veins. Nursing care focuses on leg elevation, walking exercises, and wearing compression stockings after treatment.

1. VARICOSE VEINS PRESENTED BY:Sidra Bibi And Sawaira Saleem

2. INTRODUCTION Varicose veins are abnormally dilated,tortuous,sperficial veins caused by incompetentvenous valves. Most commonly this condition occur in the lower extremities,the saphenous veins,or the lower trunk,but it can occur elsewhere in the body,such as the esophagus (esophageal varices ).

3. INTRODUCTION The condition is most common in people whose occupations require prolonged standing,such as salespeople,hairstylists,teachers,nurses,ancillary medical personnel,and construction workers. A hereditary weakness of the veins wall may contribute to the development of vericosities . Pregnancy may cause vericosities because of hormonal effects related to decreased venous outputflow,increased pressure by gravid uterus,and increase blood volume.

4. PATHOPHYSIOLOGY Varicose veins may be primary(without involvement of deep veins)or secondary(resulting obstruction of deep veins). A reflux of venous blood results in venous stasis. If only the superficial veins are affected,the person may have no symptoms but may be troubled by their aapearance .

5. CLINICAL MANIFESTATIONS

6. Assessment And Diagnostic Findings Duplex ultrasound scan,which documents the anatomic site of reflux and provide the quantitative measure oth severity of valvular reflux. These scans are typically performed in a reverse Trendelenburg positionor with the patient standing.

7. X-ray studies by injecting radiopaque contrast agent in the leg veins so that the vein anatomycan be visualized. CT scan venography can be helpful,especially if the pelvic venous structures are involved.

8. PREVENTION The patient should avoid activities that cause venous stasis,such as wearing socks that are too tight at the top or that leave marks on the skin. Changing position frequently,when legs are tired.

9. MEDICAL MANAGEMENT The most common treatment options are… Ligation and Stripping Thermal Ablation Sclerotherapy

10. LIGATION AND STRIPPING

11. PHLEBECTOMY The procedure involves removal of a superficial varicosity using anywhere from 1 to 20 small incisions. There can be extensive bruising and risk of infection.

12. THERMAL ABLATION The catheter is introduced into the saphenous vein. The device is then activated and withdrawn,sealing the vein. Small bandages and stocking are applied after the procedure. The patient is asked not to removed the stockinf for at least 24 hours and then to rewrap the leg and wear the stocking.

13. This is also associated with quality of life improvement such as decreased leg swelling,pain,skin changes,healing of ulcerations,because all symptomatic veins may be traeted at one time.

14. CYANOACRYLATE During this procedure,catheter is advanced to the the proximal saphenous vein and injections of cyanoacrylate are given,followed by local compression,then repeated injection with repeated compression until the entire length of the target vein is treated. Cyanoacrylate embolization hs been associated with less procedural ecchymosis because heat is not needed in this procedure.

15. SCLEROTHERAPY Sclerotherapy  is a medical procedure used to eliminate  varicose veins  and  spider veins .  Sclerotherapy  involves an injection of a solution (generally a salt solution) directly into the  vein . The solution irritates the lining of the blood vessel, causing it to collapse and stick together and the blood to clot.

16. NURSING MANAGEMENT Bed rest is discouraged,and the patient is encouraged to become ambulatory as soon as sedation has wornoff . In first 24 hours,walk for 5 to 10 minutes in every hour. Compression stocking are worn continously for about 1 week after stripping.

17. Promoting comfort and understanding… Analgesic agents are precribed . Nurse is alert for reported sensations of PINS AND NEEDLES. Hypersensitivity to touch in the involved extremity indicated temproary and peramant nerve injury during surgery,should be reported to primary provider.

18. After shower,dry the incision well using a patting techique rather than rubbing. Application of skin lotion is avoided. Long term venous compression is essential after discharge,use compression stocking. Exercise of the leg is necessary.