DISCOMFORTS RELATED TO THE CARDIOVASCULAR SYSTEM
a. Supine Hypotension (Vena Cava Syndrome) (See figure 8-2).
Figure 8-2. Supine hypotension (Vena cava syndrome).
(1) Supine hypotension is caused by pressure of the gravid uterus on the
ascending vena cava when the woman is supine which decreases the return of the
(2) Symptoms include nausea, cold and clammy, feels faint, and
hypotensive (decreased blood pressure).
Nursing interventions consist of advising the patient to:
(a) Get up slowly.
(b) Use the side-lying position, preferably on the left side.
b. Varicose Veins.
(1) Varicosity is an enlargement of the lumen of a vein due to thinning and
stretching of its walls.
(2) It is caused by the relaxation of smooth muscle walls of veins, which is
due to increased hormones (progesterone), which causes pelvic vasocongestion. This
condition is aggravated during pregnancy due to the enlarging uterus in the pelvis
causing pressure on the great abdominal veins, which interferes with return blood flow
from the lower extremities. It is also aggravated by gravity and bearing down for bowel
movements. This may also be a hereditary disposition.
(3) Varicosity involves the veins of the lower extremeties (legs), the external
genitalia (vulva or labia), the pelvis, and the perineal area (hemorrhoids).
Nursing intervention consists of advising the patient to:
(a) Avoid obesity.