After a renal angiography via femoral approach, which assessment should the nurse perform to monitor for complications?

• A. Check the client's pedal pulses frequently.
• B. Measure blood pressure every hour.
• C. Assess for hearing loss.
• D. Evaluate for leg muscle strength.

Answer: (A)

Monitoring distal perfusion in the leg used for arterial access is the key focus after a renal angiography via a femoral approach. The femoral artery puncture can lead to complications such as arterial occlusion, hematoma, or compression that reduce blood flow to the lower leg. Palpating and tracking the pedal pulses frequently gives a direct and early indication of whether the limb is still receiving adequate blood supply. If the pulses remain strong and equal, perfusion is preserved; if they weaken or disappear, it signals a potential vascular problem requiring prompt assessment and intervention.

Other assessments are less specific to this risk. While vital signs like blood pressure are important, hourly BP checks don’t directly reveal limb perfusion status. Hearing loss and leg muscle strength testing don’t address the immediate vascular complication risk after femoral access. In addition to pulse checks, also observe color, temperature, capillary refill, and the groin puncture site for bleeding or hematoma, but the most critical early indicator of complications is the status of the distal pulses.