A nurse is planning care for a client immediately following a cardiac catheterization who has a vascular closure device in place. Which of the following interventions is the nurse's priority when providing care to the client?

Post–cardiac catheterization care focuses on early detection of vascular compromise, bleeding, and impaired perfusion related to arterial access and closure device placement. A vascular closure device is used to seal the arterial puncture site, but complications such as thrombosis, bleeding, or arterial occlusion can still occur. Cardiac catheterization requires frequent neurovascular assessments of the affected limb to ensure adequate circulation. The priority is maintaining distal perfusion because loss of blood flow can rapidly lead to tissue ischemia and limb-threatening complications. Rationale: A. Monitoring the catheterization site for hematoma formation is important because bleeding and hematoma are common complications after arterial puncture. However, site observation alone does not provide immediate information about limb perfusion. Neurovascular assessment takes priority because it detects both bleeding and vascular compromise affecting distal circulation. B. Palpating distal pulses is the priority because it directly assesses arterial blood flow beyond the catheter insertion site. A weak or absent pulse may indicate arterial occlusion, thrombosis, or compromise from the closure device. Early detection is critical to prevent ischemia and permanent tissue damage in the affected extremity. C. Monitoring the client's pain level is important but is not the priority because pain is a nonspecific symptom that may occur due to local tissue irritation. Although increasing pain can signal complications, it is less immediate than assessing distal perfusion, which provides more direct evidence of vascular integrity. D. Initiating cardiac monitoring is appropriate for clients undergoing cardiac procedures, but post-catheterization complications are more commonly vascular rather than rhythm-related. Continuous cardiac monitoring may already be in place, and it does not address the most immediate risk of limb ischemia at the insertion site.