Stroke

Stroke

• 1.
  Stroke Cerebrovascular Accident (CVA) •Definition: • A cerebrovascular accident (CVA), an ischemic stroke or “brain attack,” is a sudden loss of brain function resulting from a disruption of the blood supply to a part of the brain. This disturbance is due to either ischemia (lack of blood flow) or hemorrhage.
• 2.
  Risk Factors • Nonmodifiable •Advanced age (older than 55 years) • Gender (Male) • Family history • Modifiable • Hypertension • Heart disease, Atrial fibrillation • Hyperlipidemia • Obesity, Smoking • Diabetes •
• 3.
  Classification: I- Ischemic: resultingfrom thrombosis (obstruction of a blood vessel by a blood clot) , Embolism II- Hemorrhagic: resulting from hypertension, a ruptured aneurysm,
• 4.
  Clinical Manifestations –numbness orweakness of face, arm, or leg (especially on one side of body); – confusion or change in mental status; –trouble speaking or speech; – visual disturbances; loss of balance, dizziness, difficulty walking; or sudden severe headache. – Motor Loss
• 5.
  Diagnostic Studies • CTscan, MRI, Cerebral angiography, Lumbar puncture (LP), X ray • Complications of CVA • Decreased cerebral blood flow due to increased ICP • Inadequate oxygen delivery to the brain • Pneumonia
• 6.
  Medical Management • I-Ischemic: • Thromolysis with Recombinant tissue plasminogen activator (tPA) • Anticoagulation therapy
• 7.
  Nursing Assessment Acute PhaseAssessment • History: - Age, -History: coronary artery disease, - , previous (transient ischemic attake)TIA/stroke, - diabetes mellitus - seizure/epilepsy Change in level of consciousness or , ability to speak, and orientation
• 8.
  Nursing Diagnoses • Impairedphysical mobility related to hemiparesis , brain injury • Acute pain related to hemiplegia( (‫نصفي‬ ‫شلل‬ • Deficit self-care ( feeding) related to stroke process • Disturbed sensory perception related to sensory reception. • Impaired swallowing • Impaired urinary elimination related to confusion,
• 9.
  Acute Nursing management •Maintain a patent airway to promote oxygenation • Administer oxygen therapy with possible intubation and mechanical ventilation to tissue perfusion • Maintain bed rest to minimize metabolic • Provide I.V. fluids to support blood pressure • Administer anticoagulants and antiplatelet drugs for thrombotic • Administer sedatives, • Assess level of consciousness change on Glasgow coma scale.