NCLEX-RN Case Study: Peripheral Arterial
Disease (Acute Limb Ischemia)
Client Scenario: A 65-year-old male with a history of heavy tobacco use and Type 2 Diabetes
presents with sudden, excruciating pain in his left leg. He states, "My foot went numb and
cold about an hour ago."
Initial Assessment:
Left Lower Extremity: Pale/white color, cold to the touch. Absent pedal and
posterior tibial pulses (even with Doppler).
Right Lower Extremity: Warm, pink, 2+ pulses.
Vitals: BP 158/94, HR 92.
Item 1: Recognizing Cues (Select All That Apply)
Question: Which findings suggest Acute Arterial Occlusion (The 6 Ps)?
1. ✅Pain (sudden and severe)
2. ✅Pallor (pale skin)
3. ✅Pulselessness
4. ✅Paresthesia (numbness)
5. ✅Pitting Edema
Rationale: Acute arterial occlusion blocks blood from entering the limb, causing the "6 Ps":
Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia (cold). Edema is a sign
of venous issues (blood can't get out).
Item 2: Analyzing Cues (Matching)
Question: Match the pathophysiology to the clinical finding.
Numbness/Tingling ➔ ✅Nerve Ischemia