Medical Surgical Peripheral Vascular Disease #2

Question

The nurse is assessing a client who reports pain to the left lower extremity, especially while ambulating. The discomfort is relieved with rest. Assessment findings confirm left lower leg mottling and hairlessness. Which health problem will the nurse most likely include in the planning of the client’s care?

Answers

  1. Coronary artery disease (CAD)
    • Rationale:

      This answer is not correct because coronary artery disease symptoms can range from absence of symptoms to angina/chest pain, to myocardial infarction/heart attack. Pain and symptoms associated with the lower extremities is related to peripheral arterial disease, not coronary artery disease.

  2. Intermittent claudication
    • Rationale:

      This answer is correct because claudication occurs when blood flow is narrowed to peripheral circulation. It may occur during exercise or movement, depending on where the arterial narrowing is located. Signs include lower extremity mottling, hairlessness, and pain relieved by ceasing the activity (intermittent pain). Peripheral artery disease (PAD) is linked with intermittent claudication instead of CAD.

  3. Arterial embolism
    • Rationale:

      This answer is not correct because although arterial embolism can occur in the leg and cause acute pain, the symptoms of lower extremity mottling, hairlessness, and pain relieved by ceasing the activity (intermittent pain) indicates chronic peripheral artery disease, not an acute arterial embolism. Arterial embolism causes sudden, unrelieved pain.

  4. Raynaud's disease
    • Rationale:

      This answer is not correct because Raynaud’s disease affects the fingers and toes. It is associated with narrowing of blood vessels when a person is stressed or cold. Intermittent claudication signs include lower extremity mottling, hairlessness, and pain relieved by ceasing the activity (intermittent pain).

Overview

Intermittent claudication is a characteristic symptom consistent with peripheral artery disease. Signs include lower extremity mottling, hairlessness, and pain relieved by ceasing the activity (intermittent pain).

Explanation

Learning Outcomes

Claudication occurs when blood flow is narrowed to peripheral circulation. It may occur during exercise or movement, depending on where the arterial narrowing is located. Signs include lower extremity mottling, hairlessness, and pain relieved by ceasing the activity (intermittent pain). In advanced stages pain occurs at rest; discolored skin or ulcerations from reduced blood flow (and cool to touch); and achy or burning sensation. Peripheral artery disease (PAD) is linked with intermittent claudication instead of CAD.

Test Taking Tip

When arteries are blocked partially or completely, oxygen and perfusion are reduced or eliminated and pain occurs. It can be in the chest (coronary arteries) or peripheral arteries will have pain where the blockage is, for example the lower extremity can experience claudication.

Video Rationale