Nursing Care Plans for Deep Vein Thrombosis. 1,2 Chronic venous ulcers significantly impact quality of life and are a financial burden for both the patient and the health care system. Casey G (2004) Causes and management of leg and foot ulcers. Stage I Ulcer – Reddened area with intact skin surface. However, she does have contributing factors placing her at risk for developing a pressure ulcer. Beebe-Dimmer JL et al (2005) The epidemiology of chronic venous insufficiency and varicose veins. Venous ulcers are further caused by poor circulation “such as venous insufficiency” (Michigan Medicine, n.d.). This causes blood to collect and pool in the vein, leading to swelling in the lower leg. This happens when the walls or valves in the veins of the lower extremities don’t work effectively. Yes, it’s the integumentary system, specifically, our skin, cornea, subcutaneous tissues, and mucous membranes are our first line of defense against threats from the external environment. Nursing Standard; 18: 45, 57-64. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. The Braden scale identifies an individual's risk for developing pressure ulcers. Nursing Diagnosis: Ineffective Tissue Perfusion (Peripheral) related to venous stasis of the left leg as evidenced by calf pain upon palpation, unilateral left leg edema, increased leg warmth and tenderness Pressure Ulcers – are lesions caused by the primary barrier of the body against the outside environment – the skin. Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Pressure ulcers develop from … Deep vein thrombosis (DVT) in leg, 2015 (leg side not indicated)- DVT occurs “in areas with decreased or mechanically altered blood flow” (Stone et al., 2017). Venous ulcers are non-healing or slow-healing wounds that form as a result of blood pooling in the legs and feet. SN explained that the Chronic venous insufficiency ( CVI ) can’t be cured, but you can control leg swelling to reduce the likelihood of ulcers ( sores ). The most common type of chronic lower extremity wound is the venous ulcer, affecting 1% to 3% of the U.S. population. Signs and causes of venous ulcers. Venous ulcers are more common in women and older people. This is called venous insufficiency. You can use this guide to help you develop your nursing care plan and nursing interventions for impaired tissue integrity.. What constitutes our body’s protection against external threats? By the WoundSource Editors. Josephine Morrow has a venous stasis ulcer, which is not a pressure ulcer. Venous ulcers, also referred to as venous stasis ulcers (VSUs), are perceived to be the most common cause of ulcerations affecting the lower extremities and can be severe and debilitating in nature. WBC: 10.5 normal range 4-11*10 9 /L (Taylor et al., 2019) 1. Annals of Epidemiology; 15: 3, 175-184. Recognizing the symptoms Be aware of the following: If you stand or sit with your feet down for long periods, your legs may ache or feel heavy. Chronic venous insufficiency Teaching 2182. Venous ulcers, also known as venous stasis ulcers are open sores in the skin that occur where the valves in the veins don’t work properly and there is ongoing high pressure in the veins. The reduction of blood flow in the area leads to skin breakdown. It is common in bony prominences in the body wherein friction usually occurs. 1-3 VSUs affect an estimated 1% of the U.S. population and are responsible for more than 80% of lower extremity ulcerations.