Conservative Management
Lifestyle Changes. Patients who have varicose veins can manage and prevent symptoms with the use of lifestyle changes, and the NP's role in patients' education is paramount in helping patients understand the importance of lifestyle changes. Education should be given regarding daily skin care, the types of clothing to avoid, the need to elevate the legs, and the need for lower extremity exercises. Recommended daily skin care should involve the use of a mild soap and lukewarm water followed by the application of a petrolatum-based moisturizer.[13] Patients should also be educated on the need to avoid wearing constrictive clothing, such as knee-high or panty hose stockings, that can restrict the flow of blood in the lower extremities.[13] The NP should educate patients on the need to elevate the legs above the level of the heart for about 30 minutes 4 times each day.[13] Patients can be told to avoid having the legs in the dependent position for prolonged periods of time to avoid the pooling of blood in the legs.[13]The NP should also teach the patient about different leg exercises that can be performed to aid the calf muscles in the return of blood to the heart. Leg exercises that can be done include walking (slightly uphill if possible), tiptoe movements that involve standing and rising up on the tips of the toes while holding onto a bar or other form of support, and dorsiflexion and plantar flexion of the feet several times each day.[13] Patients can also be educated on the use of compression stockings to help with blood return from the legs to the heart.