THE CLIENT WITH CHRONIC VENOUS INSUFFICIENCY

a disorder of inadequate venous return over a prolonged period; deep vein thrombosis is the more frequent cause of
chronic venous insufficiency

PATHOPHYSIOLOGY

following a dvt, large veins may remain occluded, increase the pressure in other veins of the extremity, this increased
pressure distends the veins, separating valve leaflets and impairing their ability to close, dvt also damages valve
leaflets, causing them to thicken and contract.

MANIFESTATIONS

lower extremity edema that worsens with standing, itching, dull lef discomfort or pain that increases with standing, thin
shiny atrophic skin, cyanosis and brow skin pigmentation of lower leg and foot, weeping dermatitis, thick fibrous
subcutaneous tissue, recurrent ulcerations of medial or anterior ankle.

INTERDISCIPLINARY CARE

focus on relieving symptoms, promoting adequate circulation and healing and preventing tissue damage. history of dvt
is major factor, no specific diagnostic tests, reduce edema and treat ulcerations, prolonged standing or sitting is
discouraged, ted hose, elevation,

NURSING CARE

educational and supportive; elevation, walk, don’t cross legs, nothing that pinches your leg, elastic hose, skin care,
disturbed body image r/t edema and stasis ulcers, ineffective health maintenance r/r lack of knowledge, risk for
infection r/r ulceration, impaired physical mobility r/t pain and edema, impaired skin integrity related to presence of
stasis ulcers, ineffective tissue profusion