Question

a nurse is assessing a client who has chronic peripheral arterial disease (pad). which of the following findings should the nurse expect?
a edema around the ankles and feet
b ulceration around the medial malleoli
c scaling eczema of the lower legs with stasis dermatitis
d pallor on elevation of the limbs, and rubor when the limbs are dependent

Explanation:

• Option A: Edema around ankles and feet is more typical of venous disorders (like chronic venous insufficiency) rather than peripheral arterial disease (PAD). In PAD, there is arterial blood flow reduction, not venous stasis that causes significant edema.
• Option B: Ulceration around the medial malleoli is often associated with venous ulcers. Venous ulcers occur due to poor venous return, increased venous pressure, and subsequent tissue damage. PAD - related ulcers are more likely to be on the toes, heels, or lateral aspects of the feet (arterial supply areas).
• Option C: Scaling eczema of the lower legs with stasis dermatitis is a sign of venous problems. Stasis dermatitis occurs because of venous hypertension, leading to skin changes. In PAD, skin changes are due to reduced arterial perfusion (not venous stasis).
• Option D: In chronic PAD, when the limbs are elevated, there is pallor (blanching) because of reduced arterial blood flow. When the limbs are in a dependent position, there is rubor (dusky red - blue color) due to reactive hyperemia (attempt of the tissues to get more blood flow, but the arteries are diseased). This is a classic finding in PAD.

Answer:

D. Pallor on elevation of the limbs, and rubor when the limbs are dependent