The nurse is assessing a client suspected of having peripheral artery disease (PAD) in the legs.
Which of the following findings should the nurse expect during the assessment?

Choice A rationale

Lower extremity edema is often associated with right-sided heart failure rather than left ventricular failure. Right-sided failure leads to systemic venous congestion, causing fluid accumulation in peripheral tissues like the legs. Left ventricular failure predominantly affects pulmonary circulation, making edema of the lower extremities a less expected finding.

Choice B rationale

Pulmonary crackles are a hallmark finding in left ventricular failure due to fluid accumulation in the alveoli. This occurs because reduced cardiac output causes blood to back up into pulmonary veins and capillaries, increasing hydrostatic pressure and leading to pulmonary congestion. Crackles indicate the presence of interstitial or alveolar fluid, a direct result of left-sided dysfunction.

Choice C rationale

Ascites results from portal hypertension and systemic venous congestion, typically seen in right-sided heart failure or advanced liver disease. Left ventricular failure impacts the pulmonary system rather than the abdominal cavity, making ascites an unlikely finding during assessment for this condition.

Choice D rationale

Jugular vein distention is indicative of systemic venous congestion caused by right-sided heart failure. In left ventricular failure, pulmonary congestion dominates, and jugular vein distention is not a primary finding. Assessments should focus on symptoms directly linked to pulmonary effects such as crackles or dyspnea.

Choice A rationale

Constant erythema and warmth in the legs are indicative of venous insufficiency due to stagnant blood flow. PAD typically presents with cool, pale extremities as a result of reduced arterial perfusion.

Choice B rationale

Discomfort typically worsens when legs are elevated in PAD because elevation further impairs blood flow, causing ischemic pain. Relief is more commonly achieved when the legs are in a dependent position, aiding perfusion.

Choice C rationale

Pain during exercise, termed intermittent claudication, occurs due to insufficient oxygen delivery to muscles. Rest alleviates symptoms as oxygen demand decreases. This hallmark feature distinguishes PAD from other circulatory disorders.

Choice D rationale

Peripheral pulses in PAD are generally diminished or absent, reflecting compromised arterial blood flow. Bounding pulses would suggest conditions such as aortic regurgitation or hyperdynamic states, not PAD.