a. Varicosities refer to dilated, tortuous veins that result from incompetent values within those veins.

The valves close incompetently or not at all. Blood is thus permitted to seep backward rather than being propelled always toward the heart. This seepage causes further congestion of the part with venous blood and further distention of the veins.

b. Factors associated with varicosities include the following.

(1) The saphenous veins of the legs are commonly affected with varicosities. It can also occur in the external genitalia (vulva or labia), the pelvis, and the perianal area (hemorrhoids).

(2) Some people have familial tendency toward varicosities.

(3) Weight gain associated with the enlarging uterus impairs venous return.

(4) Prolonged sitting (to include with legs crossed at knees) and standing can contribute to development of varicosities.

(5) Wearing of constrictive clothing may also cause varicosities.

(6) Relaxation of smooth muscles, which is due to hormonal changes during pregnancy, is also thought to contribute to the development of varicosities.

(7) Varicosities are seen as dark blue or purplish swellings.

(8) The patient may complain of heavy and tired feelings in the legs or a burning, cramping sensation.

c. Nursing implications include the following.

(1) Encourage the patient to lie down with her hips/legs elevated periodically throughout the day.

(2) Inform the patient that elastic stockings applied before rising may lessen discomfort.

(3) Inform the patient of proper nutritional habits to avoid constipation.

(4) Inform the patient not to bear down with bowel movements.

(5) Inform the patient to avoid prolonged sitting or standing greater than 15 minutes without a change of position.

(6) Inform the patient not to massage her legs.

(7) Inform the patient to discuss possible surgical treatment of varicosities if persistent after pregnancy.