Page 1717 - Saunders Comprehensive Review For NCLEX-RN

to protect healthy tissue.
c. Administer antibiotics as prescribed if
infection or cellulitis occurs.
E. Varicose veins
1. Description
a. Distended, protruding veins that
appear darkened and tortuous.
b. Vein walls weaken and dilate, and
valves become incompetent.

2. Assessment

a. Pain in the legs with dull aching after
standing
b. A feeling of fullness in the legs
c. Ankle edema

3. Trendelenburg’s test

a. Place the client in a supine position
with the legs elevated.
b. When the client sits up, if varicosities
are present, veins fill from the
proximal end; veins normally fill from
the distal end.
4. Interventions
a. Emphasize the importance of
antiembolism stockings as prescribed.
b. Instruct the client to elevate the legs as
much as possible.
c. Instruct the client to avoid constrictive
clothing and pressure on the legs.
d. Prepare the client for sclerotherapy or
vein stripping as prescribed.
5. Sclerotherapy
a. A solution is injected into the vein,
followed by the application of a
pressure dressing.
b. Incision and drainage of the trapped
blood in the sclerosed vein is
performed 14 to 21 days after the
injection, followed by the application
of a pressure dressing for 12 to 18
hours.
6. Laser therapy: A laser fiber is used to heat and close
the main vessel contributing to the varicosity.
7. Vein stripping: Varicose veins may be removed if they
are larger than 4 mm in diameter or if they are in
clusters; other treatments are usually tried before vein

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