A nurse has received report on a client who has a basilar skull fracture. Which of the following findings should the nurse anticipate with this client?

A. Lower back or groin pain: Lower back or groin pain can be an early manifestation of an abdominal aortic aneurysm (AAA). This pain may result from pressure exerted by the enlarging aneurysm on surrounding structures or from irritation of nerves as the aneurysm expands. As the aneurysm enlarges, the pain may become more severe and persistent.

B. Hunger after eating: Hunger after eating is not typically associated with an abdominal aortic aneurysm. This symptom may be indicative of various gastrointestinal issues such as peptic ulcer disease or gastritis, but it is not a characteristic manifestation of AAA.

C. Pain in the chest: While AAA can lead to compression of nearby structures, resulting in referred pain, chest pain is not a common early manifestation of an abdominal aortic aneurysm. Chest pain is more commonly associated with cardiac issues such as angina or myocardial infarction.

D. Presence of Cullen's sign: Cullen's sign refers to periumbilical bruising, which can occur due to retroperitoneal hemorrhage from a ruptured AAA. However, Cullen's sign is not an early manifestation of an AAA; it is typically observed in more advanced cases or after rupture has occurred.

A. "Blood flow is altered and causes blood to pool in the legs." This statement inaccurately describes venous insufficiency rather than peripheral arterial disease (PAD). In PAD, blood flow is reduced or obstructed due to atherosclerosis, leading to inadequate oxygen supply to tissues rather than pooling of blood in the legs.

B. "Blood flow is altered due to atherosclerosis affecting the tissues' ability to receive oxygen-rich blood." This statement correctly explains the underlying pathology of peripheral arterial disease (PAD). Atherosclerosis, characterized by the buildup of plaque in the arteries, narrows or blocks blood flow, impairing the delivery of oxygen-rich blood to the tissues. This can result in symptoms such as pain, cramping, and tissue damage, especially during activity when oxygen demand increases.

C. "Blood flow is altered due to incompetent valves causing increased venous pressure." This statement describes venous insufficiency rather than PAD. In venous insufficiency, faulty valves in the veins result in increased venous pressure, leading to symptoms such as swelling, heaviness, and varicose veins, but it does not involve arterial obstruction as seen in PAD.

D. "Blood flow is altered due to excessive stretching of the ventricles impairing the heart to contract." This statement describes a condition related to the heart's function rather than peripheral arterial disease. Excessive stretching of the ventricles may occur in conditions such as heart failure, but it does not directly affect blood flow in the peripheral arteries as seen in PAD.