Role of nurse in educating patients with varicose patients (2nd part) / دور الممرضة في تثقيف المرضى الذين يعانون من الدوالي ( الجزء الثاني ) ( بالانجليزية والعربية)
Role of nurse in educating patients with varicose patients
Nursing care for patients with varicose veins focuses on preventing complications, assessing patients' prognosis, and educating patients. Educating patients involves providing information that includes an explanation of what varicose veins are, possible causes of varicose veins, and the likelihood of progression and complications such as leg ulcers, skin changes, deep vein thrombosis, bleeding, and thrombophlebitis. Address any misconceptions the individual may have regarding the likelihood of developing complications. Also, provide guidance on treatment alternatives such as symptom relief, an explanation of interventional treatments, and the importance of compression. Discuss the anticipated benefits and drawbacks of each treatment option, the possibility of requiring more than one therapy session, as well as the fact that recurrent varicose veins are more likely to reoccur after treatment than original varicose veins. Patients are also taught about health behaviours such as modifications to their lifestyle. Lifestyle changes are essential for achieving the most thorough and long-lasting treatment response possible, including:
Wearing compression stockings are usually suggested as the first step in varicose vein care. It can help blood that has accumulated in the leg, ankle, or foot flow in the appropriate direction. They use various pressures on different regions of the legs and feet to keep blood flowing through the veins. They are useful in relieving discomfort and oedema. Increasing compression strength is used to treat larger varicosities, more severe symptoms, and chronic venous insufficiency.
Patients should be instructed to do the following:
- Put on compression stockings in the morning before getting out of bed, and remove them at night
before going to bed.
- The length of the compression stockings should be sufficient to cover all varicose veins.
- Put on socks or leggings first, then cover with compression stockings.
- Fold the top over or pull it up on the knee.
- Wear support stockings while pregnant.
- For easier donning allow at least 20 minutes of rest before putting on a support stocking.
- Change the support stockings every day. Stockings must be washed after each wear to keep the shape
and compression, or follow the manufacturer's instructions for washing and caring for them.
- Purchase new stockings when compression stockings lose their support (feeling less tight while
Putting them on).
- Do not be measured for support stockings late in the day.
Elevate the legs. Elevating legs when the person in sitting can take pressure off the veins in the legs and increase blood flow. Consider raising them with a footstool. Elevation of the feet should be to at least heart level for 30 minutes at least 4 times a day. This helps to reduce blood pooling in the veins.
Exercise regularly. Exercise is one of the most effective ways to prevent worsening of varicose veins and maintain a healthy weight. The necessity for lower extremity activities to help the calf muscles return blood to the heart. Walking (slightly uphill if possible), tiptoe movements (standing and rising on the tips of the toes while hanging onto a bar or other kind of support), and dorsiflexion and plantar flexion of the feet several times each day are all possible leg workouts. Also, aim for at least 30 minutes of moderate activity, such as walking, cycling, or swimming, five days a week. Avoid certain sorts of exercise, such as lifting weights, distance running, and yoga, as these might stress the veins and cause a backup of the blood.
Tiptoe movements
Change the position frequently. Long durations of standing or sitting can cause blood to pool in leg veins, which can worsen varicose vein symptoms. So, the patients should follow the following instructions:
- Avoid prolonged standing and sitting to relax the lower extremity veins and reduce discomfort.
- Encourage frequent breaks from sitting or standing to move the legs and promote blood flow in the
proper direction.
- Shift the weight frequently and stretch or walk every 30 minutes.
Healthy diet. A fibre-rich, low-sodium, low-fat diet can assist maintain healthy veins. Salt can cause the body to retain water. Excess fluid in the legs can cause oedema and pressure on the veins resulting in exacerbation of varicose veins. Eating plenty of fruits, vegetables, and whole grains will boost the general health and help to avoid obesity, which is a risk factor for worsening of varicose veins.
Maintain a healthy body weight. Being overweight or obese places pressure on the pelvic and leg veins, So, losing weight is a critical step in slowing progression and preventing recurrence.
Avoid wearing tight clothing. Wearing tight clothing—girdles, body shapers, elastic knee socks, and even snug belts—can reduce blood flow from the legs to the heart, causing it to pool and contribute to the progression of varicose veins.
Avoid wearing high heels. Wearing high-heeled shoes for extended periods of time can increase pressure in the veins, reduce blood flow in the legs and aggravate varicose veins. Choose a shorter heel to improve circulation, promote healthy blood flow and keep varicose veins from worsening.
Moisturize the skin as prescribed by doctor. Keep the skin clean and apply daily moisturizer can heal dry or cracked skin resulting in improvement of the leg health.
Smoking cessation should be emphasized in patients with varicose veins.
Cold compress, as prescribed by the doctor. Using a cold compress on the legs can help minimise swelling and discomfort. Simply wrap a cold pack or bag of frozen vegetables in a towel and place it on the legs for 15-20 minutes at a time.
Warm water soak, as prescribed by doctor. Soaking the legs in warm water might assist improve circulation and minimise swelling. Soak the legs in warm water for 15-20 minutes at a time.
Massage. Gentle massage might assist with improving circulation and decrease swelling in the legs. Massage the legs in a circular motion, starting at the ankle and moving up to the thigh.
Follow-up care is a key part of the treatment and safety. Be sure to make and go to all appointments
Seek medical help for varicose veins. Some symptoms may suggest a need for medical intervention. Here are some varicose vein symptoms to look out for:
- Leg pain or discomfort, particularly after long periods of sitting or standing.
- Inflammation or swelling in the legs
- Alterations in the skin, including redness, itching, and discoloration.
- Ulcers or open sores on the legs
- Varicose vein-related bleeding
Other instructions include the following
- Care for wounds if the patient has any infections or open sores.
- Engage in light to moderate physical activity.
- Avoid actions that may cause leg or foot injury, such as walking barefoot.
- Wash the lower legs and feet daily with mild soap and water.
- When shaving the legs, be very careful to avoid the thin-walled veins that are easily cut.
- Keep the blood pressure under control. Work with the doctor.
- Avoid crossing the legs.
دور الممرضة في تثقيف المرضى الذين يعانون من الدوالي
تركز الرعاية التمريضية للمرضى الذين يعانون من الدوالي على منع المضاعفات، وتقييم مدى تطور الحالة، وتثقيف المرضى. يتضمن تثقيف المرضى تقديم معلومات تتضمن شرحًا عن ما هي الدوالي، والأسباب المحتملة للدوالي، واحتمالية تطورها ومضاعفاتها مثل تقرحات الساق، وتغيرات الجلد، وتجلط الأوردة العميقة، والنزيف، والتهاب الوريد الخثاري. ويجب معالجة أي مفاهيم خاطئة قد تكون لدى الفرد فيما يتعلق باحتمالية حدوث مضاعفات. قم أيضًا بتقديم إرشادات حول بدائل العلاج مثل علاج لتخفيف الأعراض، وشرح العلاجات التداخلية، وأهمية الجوارب الضاغطة أو الداعمة. ناقش المزايا والعيوب المتوقعة لكل خيار علاجي، وإمكانية الحاجة إلى أكثر من جلسة علاجية واحدة، بالإضافة إلى حقيقة أن الدوالي المتكررة من المرجح أن تتكرر بعد العلاج أكثر من الدوالي الأصلية. كما يتم تعليم المرضى أيضًا عن السلوكيات الصحية مثل التعديلات على نمط حياتهم. حيث تعد تغييرات نمط الحياة ضرورية لتحقيق الاستجابة العلاجية الأكثر شمولاً وطويلة الأمد، بما في ذلك:
ارتداء الجوارب الضاغطة. عادةً ما يُقترح استخدام الجوارب الضاغطة كخطوة أولى في علاج الدوالي. حيث يمكن أن يساعد الدم المتراكم في الساق أو الكاحل أو القدم على التدفق في الاتجاه المناسب. حيث يستخدمون ضغوطًا مختلفة على مناطق مختلفة من الساقين والقدمين للحفاظ على تدفق الدم عبر الأوردة. ان ارتداء الجوارب الضاغطة مفيدة في تخفيف الانزعاج والألم والتورم. تُستخدم زيادة قوة الضغط لعلاج الدوالي الكبيرة والأعراض الأكثر خطورة والقصور الوريدي المزمن. لذا يجب توجيه المرضى للقيام بما يلي:
- ارتداء الجوارب الضاغطة في الصباح قبل النهوض من السرير، ونزعها ليلاً قبل الذهاب إلى السرير.
- يجب أن يكون طول الجوارب الضاغطة كافياً لتغطية جميع الدوالي.
- ارتدي الجوارب أو السراويل الضيقة أولًا، ثم غطيها بالجوارب الضاغطة.
- قم بطي الجزء العلوي أو اسحبه للأعلى على الركبة.
- ارتداء الجوارب الداعمة أثناء الحمل.
- لتسهيل الارتداء للجوارب الضاغطة، اسمح ب 20 دقيقة من الراحة على الأقل قبل ارتداء الجورب الداعم.
- قم بتغيير الجوارب الداعمة كل يوم. يجب غسل الجوارب بعد كل لبس للحفاظ على شكلها والضغط، أو اتبع تعليمات الشركة المصنعة
لغسلها والعناية بها.
- شراء جوارب جديدة عندما تفقد الجوارب الضاغطة دعمها (الشعور بضيق أقل أثناء وضعهم عليها).
- لا يتم قياس الجوارب الضاغطة في اخر اليوم
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