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

Choice A rationale Excessive stretching of the ventricles and impaired cardiac contraction are hallmarks of heart failure, specifically systolic dysfunction. This relates to the heart's ability to pump blood to the systemic circulation rather than an intrinsic problem within the peripheral arteries themselves. Peripheral arterial disease focuses on the conduit vessels rather than the central pump. Normal ejection fraction ranges from 55. Choice B rationale Peripheral arterial disease is primarily caused by atherosclerosis, where fatty deposits and calcium build up in the arterial walls. This narrowing reduces the diameter of the vessel, limiting the delivery of oxygenated blood to distal tissues, especially during exercise. This mismatch between oxygen supply and demand leads to ischemia and symptoms like intermittent claudication. Clinical findings often include diminished pedal pulses, cool skin temperature, and delayed capillary refill exceeding three seconds in the extremities. Choice C rationale Incompetent valves and increased venous pressure are the underlying mechanisms for chronic venous insufficiency, not arterial disease. In the venous system, valves prevent the backflow of blood as it returns to the heart. When these valves fail, blood moves backward and increases hydrostatic pressure, leading to edema and skin changes. This process involves the return of deoxygenated blood, whereas arterial disease involves the delivery of oxygenated blood to the tissues through the high-pressure system. Choice D rationale Blood pooling in the legs is a characteristic of venous stasis, often resulting from varicose veins or deep vein thrombosis. In arterial disease, the problem is a lack of blood reaching the lower extremities due to proximal obstructions. Pooling causes a dark, ruddy discoloration and significant edema, while arterial insufficiency typically results in pallor when the legs are elevated and rubor when they are dependent. The pathophysiology of pooling is entirely related to the low-pressure venous return system.