Palpate pulses bilaterally and grade 0–4+ (0 absent, 1+ diminished, 2+ normal, 3+ increased, 4+ bounding); use Doppler if a pulse is not palpable.
Assess capillary refill (under 3 seconds) and compare extremity temperature and color side to side.
Perform elevation-pallor and dependent-rubor assessment when arterial insufficiency is a concern.
Measure and compare calf circumference when unilateral swelling is present.
Assess edema by pressing over a bony prominence about 5 seconds; grade 1+ to 4+ and note the level and symmetry.
Inspect the skin for ulcers (location and characteristics), hyperpigmentation, and varicosities; assess claudication distance; obtain ankle-brachial index per order where available.
