👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: poor leg vein return · long-term venous stasis · venous stasis disease
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Use this quick-reference guide to spot, treat, and prevent Chronic Venous Insufficiency on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Mech
Venous return impaired
Chronic pooling → ↑ pressure
🩺 Signs
Brown hemosiderin staining
Edema, warm, +pulses
Ulcers at medial malleolus
✅ Do
Elevate legs, compression
Walking, avoid standing
📌 Avoid
Compression if arterial dz
Don't dangle legs
📚 Chronic Venous Insufficiency — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Chronic venous insufficiency is long-standing impaired venous return from the legs due to incompetent valves or prior thrombosis, leading to chronic edema, skin changes, and ulceration. Blood pools in the lower legs, causing increased pressure and tissue damage. Venous (stasis) ulcers typically appear over the medial ankle.
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Key points
Understand these first
Caused by chronic venous valve incompetence or prior DVT, leading to venous hypertension.
Hallmarks: lower-leg edema, brownish hyperpigmentation, and stasis dermatitis.
Venous stasis ulcers occur over the medial malleolus (inner ankle), are shallow with irregular edges and drainage.
Legs are usually warm with present pulses and edema — unlike cool, pulseless arterial disease.
Elevation and compression therapy are mainstays of management.
Distinguish from arterial ulcers, which are deep, painful, punched-out, and on the toes/lateral foot.
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Nursing priorities
What to do, in order
Apply compression therapy (stockings or wraps) as prescribed to promote venous return.
Elevate the legs above heart level frequently to reduce edema.
Provide wound care for venous ulcers and monitor for infection.
Inspect skin and protect it from breakdown and trauma.
Confirm adequate arterial flow (ankle-brachial index) before applying compression.
Compression applied without verifying arterial flow can worsen arterial insufficiency.
Sudden calf pain and swelling may signal a new DVT.
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Labs & values
Numbers to know
Ankle-brachial index (ABI) normal 0.9-1.3 — verify before compression therapy
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Patient teaching
What patients must know
Wear compression stockings daily and elevate the legs whenever resting.
Inspect skin daily, keep it clean and moisturized, and avoid injury.
Avoid prolonged standing or sitting and do not cross the legs.
Report any new sores, increasing swelling, or signs of infection.
❓ Chronic Venous Insufficiency: NCLEX FAQs
What are the priority nursing interventions for Chronic Venous Insufficiency?
Apply compression therapy (stockings or wraps) as prescribed to promote venous return. Elevate the legs above heart level frequently to reduce edema. Provide wound care for venous ulcers and monitor for infection. Inspect skin and protect it from breakdown and trauma.
What are the warning signs of Chronic Venous Insufficiency a nurse must report?
Increasing ulcer size, foul drainage, fever, or surrounding redness indicates infection — report. Compression applied without verifying arterial flow can worsen arterial insufficiency. Sudden calf pain and swelling may signal a new DVT.
What do I need to know about Chronic Venous Insufficiency for the NCLEX?
Caused by chronic venous valve incompetence or prior DVT, leading to venous hypertension. Hallmarks: lower-leg edema, brownish hyperpigmentation, and stasis dermatitis. Venous stasis ulcers occur over the medial malleolus (inner ankle), are shallow with irregular edges and drainage. Legs are usually warm with present pulses and edema — unlike cool, pulseless arterial disease.
What patient teaching is important for Chronic Venous Insufficiency?
Wear compression stockings daily and elevate the legs whenever resting. Inspect skin daily, keep it clean and moisturized, and avoid injury. Avoid prolonged standing or sitting and do not cross the legs. Report any new sores, increasing swelling, or signs of infection.
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Quick Tip
Caused by chronic venous valve incompetence or prior DVT, leading to venous hypertension.