A nurse is reinforcing teaching to a client who has peripheral arterial disease. Which of the following statements should the nurse include in the teaching to explain the cause of peripheral arterial disease?

Peripheral arterial disease is a chronic stenotic vascular disorder driven by atherosclerosis, where lipid-rich plaques accumulate within the tunica intima of systemic arteries. This progressive fibro-fatty narrowing restricts the delivery of oxygenated blood to distal appendicular tissues, inducing intermittent claudication. The resulting mismatch between oxygen supply and metabolic demand leads to ischemic tissue hypoxia and potential necrosis. A. "Blood flow is altered and causes blood to pool in the legs.": Hydrostatic blood pooling within the lower extremities occurs during chronic venous insufficiency due to deep vessel dilation and gravity. This venous stagnation elevates capillary pressures but does not reflect structural narrowing within the high-pressure arterial tree. It describes venous, not arterial, breakdown. B. "Blood flow is altered due to excessive stretching of the ventricles impairing the heart to contract.": Ventricular stretching and chamber dilation characterize dilated cardiomyopathy, which causes central systolic heart failure and reduced ejection fraction. While this decreases global perfusion, it is a primary cardiac pump muscle disease rather than localized peripheral arterial narrowing. It is etiologically separate. C. "Blood flow is altered due to atherosclerosis affecting the tissues' ability to receive oxygen-rich blood.": This statement accurately explains that fibro-fatty plaque deposition creates mechanical obstructions within the lumina of large and medium peripheral arteries. This luminal narrowing drops perfusion pressures, starving distal skeletal muscles of the oxygen required for cellular respiration. It defines the core disease mechanism. D. "Blood flow is altered due to incompetent valves causing increased venous pressure.": Valvular incompetence is a pathognomonic feature of peripheral venous disease, where weak leaflets allow retrograde venous reflux and chronic hypertension. Arteries are high-pressure conduits that do not contain internal valves along their continuous pathways. This describes a distinct venous pathology.