Vascular Disorders Cheat Sheet
PAD vs CVI, the 6 Ps of limb ischemia, aortic aneurysm safety, and Raynaud vs Buerger disease — the high-yield vascular facts for the NCLEX-RN.
What's in this cheat sheet
Arterial and venous disorders both affect the legs but are nearly opposite in cause, findings and treatment. This cheat sheet contrasts peripheral artery disease (PAD) with chronic venous insufficiency (CVI), covers the 6 Ps of acute limb ischemia, the critical "never palpate" rule for aortic aneurysm, and the cold-triggered vs smoking-triggered presentations of Raynaud and Buerger disease.
Arterial vs Venous
The big picture and a side-by-side of PAD and CVI findings, pulses, ulcers and leg positioning.
PAD & Limb Ischemia
PAD assessment, the 6 Ps of acute limb ischemia, and interventions that keep legs dependent and promote perfusion.
CVI & Aortic Aneurysm
Elevation and compression for CVI, plus the never-palpate rule and rupture signs for aortic aneurysm.
Raynaud, Buerger & Diagnostics
Vasospasm vs vessel inflammation, plus ABI, Doppler and angiography diagnostics.
Key Takeaways
High-yield facts most likely to appear on the NCLEX-RN.
PAD = Poor Arterial Delivery (dry, pale, painful, dependent); CVI = Congested Veins Inside (wet, swollen, brown, elevate).
In PAD keep legs dependent (down) to use gravity for arterial flow; in CVI elevate legs above the heart to drain venous pooling.
PAD ulcers are pale with smooth edges on toes/heels; CVI ulcers are pink with irregular edges on the ankles/lower legs.
The 6 Ps of acute limb ischemia: Pain, Paresthesias, Poikilothermia, Pulselessness, Pallor, Paralysis — act immediately.
NEVER palpate a suspected abdominal aortic aneurysm — palpation can trigger rupture; watch for tearing pain and hypotension.
Raynaud = cold/stress vasospasm, treat with warmth and calcium channel blockers; Buerger = smoking-related, treat with smoking cessation first.
1. Arterial vs Venous Insufficiency
PAD vs CVI — side by side
| Feature | PAD | CVI |
|---|---|---|
| Cause | Arterial narrowing | Impaired venous return |
| Pain | Intermittent claudication | Aching, heaviness |
| Skin | Cool, pale, shiny, hairless | Warm, brown discoloration |
| Pulses | Diminished/absent | Normal |
| Edema | Usually absent | Present, prominent |
| Ulcer site | Toes, heels (pale, smooth edges) | Ankles, lower legs (pink, irregular) |
| Leg position | Keep dependent (down) | Elevate |
2. Peripheral Artery Disease (PAD)
Narrowing of peripheral arteries (usually legs) from atherosclerosis; major risks are smoking and diabetes.
Assessment findings
- Intermittent claudication — leg pain with activity that resolves with rest
- Cool, pale extremities with diminished/absent pulses (use Doppler if needed)
- Hair loss; thin, shiny skin
- Ulcers on toes or heels — pale with smooth, well-defined edges
Nursing interventions
- Smoking cessation is critical — nicotine is a potent vasoconstrictor
- Walk to the point of claudication, rest, then resume — builds collateral circulation
- Keep legs dependent — do NOT elevate above heart level
- Avoid crossing legs and constrictive clothing; give antiplatelets (aspirin, clopidogrel)
- Daily foot assessment; well-fitting shoes; avoid temperature extremes
3. CVI & Aortic Aneurysm
Chronic venous insufficiency (CVI)
- Impaired venous return from damaged valves; risks include varicose veins and DVT
- Edema, heavy aching legs, brown discoloration (stasis dermatitis), ankle/lower-leg ulcers
- Elevate legs above heart level; wear compression stockings daily (never roll them down)
- Avoid prolonged sitting/standing; do ankle pumps; moisturize to prevent cracking
Aortic aneurysm
- Abnormal dilation of the aorta (TAA or AAA), often from hypertension or atherosclerosis
- Often asymptomatic; AAA may show a pulsatile abdominal mass and back/abdominal pain
- Control BP (IV esmolol) — uncontrolled HTN increases rupture risk; anticipate stent graft
- Post-op: monitor peripheral pulses hourly, watch for hypotension/back pain (graft leak)
4. Raynaud, Buerger & Diagnostics
Raynaud phenomenon
Vasospasm of small arteries (fingers/toes) triggered by cold or stress → color changes, numbness. Avoid cold, give calcium channel blockers (nifedipine).
Buerger disease
Vessel inflammation strongly linked to smoking → claudication, ischemic ulcers, gangrene risk. Smoking cessation is essential; give vasodilators.
Diagnostic tests
- Ankle-brachial index (ABI) — compares ankle and arm BP; low ratio indicates PAD
- Doppler ultrasound — assesses flow when pulses aren't palpable
- Venous duplex ultrasound — detects DVT and evaluates venous valves
- CT/MRI angiography and abdominal ultrasound — confirm and monitor aortic aneurysm
Vascular disorders at a glance
| Disorder | Hallmark sign | Key intervention |
|---|---|---|
| PAD | Intermittent claudication | Legs dependent; exercise; smoking cessation |
| CVI | Edema, brown skin | Elevate legs; compression stockings |
| Aortic aneurysm | Pulsatile mass; tearing pain | BP control; never palpate |
| Raynaud | Color changes in digits | Warmth; calcium channel blockers |
| Buerger | Claudication, ulcers | Smoking cessation |
Vascular Disorders Self-Test
6 quick questions — answers reveal after you submit.
Q1. A client with peripheral artery disease asks how to position the legs for comfort and circulation. What does the nurse recommend?
Q2. Which ulcer description is most consistent with chronic venous insufficiency?
Q3. A client's leg suddenly becomes painful, pale, pulseless, and cool. What is the nurse's priority action?
Q4. A client has a suspected abdominal aortic aneurysm. Which action must the nurse avoid?
Q5. What is the priority intervention for a client newly diagnosed with Buerger disease?
Q6. A client with Raynaud phenomenon asks how to prevent attacks. Which instruction is most appropriate?
Answered 0 / 6 — unanswered count as incorrect.