A client comes to the outpatient clinic and tells the nurse that he has had leg pains that begin when he walks but cease when he stops walking. Which of the following conditions would the nurse assess for?
A. An acute obstruction in the vessels of the legs.
B. Peripheral vascular problems in both legs.
C. Diabetes
D. Calcium deficiency
Correct Answer: B. Peripheral vascular problems in both legs.
Intermittent claudication is a condition that indicates vascular deficiencies in the peripheral vascular system. Intermittent claudication (IC) typically refers to lower extremity skeletal muscle pain that occurs during exercise. IC presents when there is insufficient oxygen delivery to meet the metabolic requirements of the skeletal muscles. Pain within these muscle groups is reproducibly induced by walking and relieved with rest.
Option A: If an obstruction were present, the leg pain would persist when the client stops walking. The key feature of intermittent claudication is that the muscle discomfort is reproducible. The pain usually comes on during physical activity and subsides after a period of rest. The key reason for the pain is inadequate blood flow.
Option C: Intermittent claudication is a very common problem seen in patients with diabetes mellitus and people who smoke. Intermittent claudication is a common manifestation of peripheral arterial disease (PAD), which includes atherosclerotic stenosis of arteries in the extremities. IC is commonly localized to the thigh, hip, buttock, and calf muscles.
Option D: Low calcium levels may cause leg cramps but would not necessarily be related to walking. The typical presentation of intermittent claudication is lower extremity pain during ambulation that is relieved with rest. The progression of symptoms is gradual. The pain may be localized to the buttocks or the lower leg, depending on the site of occlusion. Patients with aortoiliac disease frequently develop buttock pain.
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