Peripheral Artery Disease (PAD) is a chronic circulatory condition that significantly increases the risk of limb ischemia, infection, and cardiovascular events. Effective nursing care focuses on early detection, symptom management, and patient education. For every nurse, especially a registered nurse (RN nurse) preparing for the NCLEX, understanding PAD is essential for safe clinical practice.
This article reviews PAD, nursing assessment priorities, and evidence-based interventions.
What Is Peripheral Artery Disease?
Peripheral Artery Disease occurs when atherosclerotic plaque narrows peripheral arteries, most commonly in the lower extremities. Reduced blood flow leads to ischemia, pain, and impaired wound healing.
Common risk factors include:
- Smoking
- Diabetes
- Hypertension
- Hyperlipidemia
- Advanced age
📌 NCLEX focus: PAD is caused by decreased arterial blood flow, not venous obstruction.
Key Signs and Symptoms of PAD
A registered nurse should recognize classic PAD symptoms.
Common findings include:
- Intermittent claudication
- Leg pain at rest (advanced disease)
- Cool, pale extremities
- Diminished or absent pulses
- Shiny, hairless skin
- Thickened toenails
These findings reflect poor arterial circulation.
Nursing Assessment Priorities
1. Peripheral Vascular Assessment
RN nurse assessment includes:
- Palpating peripheral pulses
- Comparing bilateral extremities
- Assessing capillary refill
- Checking skin color and temperature
Doppler devices may be used when pulses are difficult to palpate.
2. Pain Assessment
PAD pain typically worsens with activity and improves with rest.
Nursing considerations:
- Assess pain location and triggers
- Monitor for rest pain (severe ischemia)
📌 NCLEX tip: Elevation worsens PAD pain, while dangling the legs may provide relief.
3. Skin and Wound Assessment
Impaired circulation increases risk for ulcers.
Nurses should inspect:
- Feet and toes daily
- Any open wounds or ulcers
- Signs of infection
Early detection prevents limb-threatening complications.
Nursing Interventions for PAD
Promoting Circulation
Nursing strategies include:
- Encourage walking programs
- Avoid crossing legs
- Keep extremities warm
- Position legs in a dependent position when needed
These interventions improve blood flow and reduce ischemic pain.
Medication Management
Common medications include:
- Antiplatelet agents
- Statins
- Antihypertensives
RN nurse responsibilities:
- Monitor for bleeding
- Educate patients on adherence
- Assess therapeutic response
Medication education is emphasized in many nursing bundle resources.
Smoking Cessation and Lifestyle Education
Smoking is the most significant modifiable risk factor.
Nursing education includes:
- Smoking cessation support
- Foot care teaching
- Blood glucose control (if diabetic)
Patient education reduces disease progression.
Preventing Complications
Nurses must monitor for:
- Non-healing wounds
- Infection
- Gangrene
- Acute limb ischemia
Immediate provider notification is required if symptoms worsen.
NCLEX Tips: Peripheral Artery Disease
- PAD causes decreased arterial blood flow
- Pain worsens with elevation
- Skin is cool, pale, and shiny
- Pulses are diminished or absent
- Nurses focus on circulation and education
These points are frequently tested on the NCLEX.
Role of Nursing Bundles in PAD Care
Comprehensive nursing bundles often include:
- Peripheral vascular assessment checklists
- PAD vs venous disease comparison charts
- Foot care guides
- NCLEX practice questions
These tools help nurses deliver consistent, safe care.
Final Thoughts for Nurses
Caring for patients with Peripheral Artery Disease requires vigilant assessment, thoughtful interventions, and ongoing education. By prioritizing circulation, skin integrity, and lifestyle modification, every nurse and registered nurse can improve outcomes and prevent serious complications.
Mastering PAD care strengthens clinical judgment, enhances patient safety, and supports success on the NCLEX and in everyday nursing practice.