What findings can a nurse expect when assessing a client with peripheral arterial disease?

When assessing a client with peripheral arterial disease (PAD), the absence of hair on the toes is a notable finding. This condition is characterized by decreased blood flow due to narrowed arteries, which affects the skin and hair follicles, particularly in the legs and feet. Hair loss in these areas occurs because the reduced circulation hampers the growth and maintenance of hair.

This symptom can often be one of the first signs of PAD, as the lack of adequate blood supply leads to a non-viable environment for hair growth. The absence of hair is indicative of more pronounced ischemia, or restricted blood supply, which can further help in assessing the severity of the disease.

In contrast, swelling in the lower extremities, presence of ulcers on the feet, and increased skin temperature are findings that might indicate other conditions such as venous insufficiency or inflammatory processes, rather than characteristics typical of peripheral arterial disease. In PAD, skin temperature is typically cooler due to reduced blood flow, and while ulcers can develop, they are usually associated with more severe arterial insufficiency or comorbid conditions. Therefore, the absence of hair on the toes aligns well with the pathophysiology of peripheral arterial disease.