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

Malaise is more associated with systemic conditions, such as upper urinary tract infections or generalized illness, rather than isolated lower urinary tract infections. Lower UTIs tend to present with localized urinary symptoms rather than systemic effects.

Choice B rationale

Chills suggest systemic involvement and are characteristic of pyelonephritis or upper urinary tract infections. Lower UTIs typically do not produce systemic signs like chills, as the infection is confined to the bladder and urethra.

Choice C rationale

Dysuria is a classic symptom of lower UTIs. It results from inflammation of the bladder mucosa due to the presence of pathogenic organisms. The irritation of the urinary tract leads to painful or difficult urination, confirming the diagnosis of lower UTI.

Choice D rationale

High fever, like chills, is indicative of upper urinary tract infections, such as pyelonephritis. Lower UTIs are generally afebrile, presenting more with localized urinary symptoms rather than systemic manifestations.

Choice E rationale

Urinary frequency is another hallmark symptom of lower UTIs, caused by bladder irritation. The infection leads to an increased urge to urinate, even when little urine is produced. This symptom is specific to lower UTIs and supports the diagnosis when present.

Choice A rationale

Constant erythema and warmth are more characteristic of venous insufficiency or inflammation, rather than peripheral artery disease. PAD is associated with reduced blood flow and tissue perfusion, leading to symptoms like pallor, coolness, and pain rather than persistent redness and warmth in affected areas.

Choice B rationale

Elevating the legs worsens ischemic pain in PAD by further reducing blood flow. Symptoms typically improve when the legs are in a dependent position due to gravity aiding perfusion. This is a key distinguishing feature in PAD compared to other vascular conditions like venous insufficiency.

Choice C rationale

Discomfort in the legs during exercise relieved by rest, known as intermittent claudication, is a hallmark of PAD. It occurs due to inadequate blood supply during increased activity. Rest restores perfusion and alleviates ischemic pain. This symptom reflects underlying arterial obstruction, a core pathophysiological feature of PAD.

Choice D rationale

Peripheral pulses in PAD are diminished or absent due to arterial obstruction. Bounding pulses in dependent positions suggest venous issues or high cardiac output, not arterial insufficiency. Accurate pulse assessment helps differentiate PAD from other vascular conditions. Normal pulse documentation is critical to diagnosis.