Page 1718 - Saunders Comprehensive Review For NCLEX-RN

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XVII. Arterial Disorders

A. Peripheral arterial disease

1. Description
a. Chronic disorder in which partial or
total arterial occlusion deprives the
lower extremities of oxygen and
nutrients
b. Tissue damage occurs below the level
of the arterial occlusion.
c. Atherosclerosis is the most common
cause of peripheral arterial disease.
2. Assessment

a. Intermittent claudication (pain in the
muscles resulting from an inadequate
blood supply)
b. Rest pain, characterized by numbness,
burning, or aching in the distal portion
of the lower extremities, which
awakens the client at night and is
relieved by placing the extremity in a
dependent position
c. Lower back or buttock discomfort
d. Loss of hair and dry scaly skin on the
lower extremities
e. Thickened toenails
f. Cold and gray-blue color of skin in the
lower extremities
g. Elevational pallor and dependent rubor
in the lower extremities
h. Decreased or absent peripheral pulses
i. Signs of arterial ulcer formation
occurring on or between the toes or on
the upper aspect of the foot that are
characterized as painful
j. BP measurements at the thigh, calf, and
ankle are lower than the brachial
pressure (normally, BP readings in the
thigh and calf are higher than those in
the upper extremities).
3. Interventions

Because swelling in the extremities prevents arterial blood

flow, the client with peripheral arterial disease is instructed to elevate

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