GRAND CASE

PRESENTATION

GROUP THREE
PRESENTATION
OPENING PRAYER
 “Education must award self-
confidence the courage to
depend on one’s own strength”
CEREBROVASCULAR ACCIDENT
Learning Objectives:
1. Describe the incidence and social
impact of CVA.
2. Identify the risk factors of CVA and
related measures for prevention.
3. Relate the principle of nursing
management to the care of the patient to
an acute stage of ischemic stroke.
4. Use the nursing process as framework for
a care of a patient recovering from an
ischemic stroke.
 CONTENTS
INTRODUCTION
DEMOGRAPHIC DATA
PATIENT’S HISTORY
ANATOMY AND PHYSIOLOGY
PATHOPHYSIOLOGY
PHYSICAL ASSESSMENT
DEVELOPMENTAL TASK
LEVEL OF COMPETENCIES
LEVEL OF FUNCTIONING
MEDICAL MANAGEMENT
TEST AND DIAGNOSTIC PROCEDURES
ONGOING APPRAISAL
DRUG STUDY
NCP
 INTRODUCTION

“The true measure of a man is how he treats someone

who does him absolutely no good true beauty lies in the
heart”
 CEREBROVASCULAR ACCIDENT
 “Cerebrovascular disorders” is an umbrella term
for that refers to any functional abnormality of the
central nervous system (CNS) that occurs when the
normal blood supply to the brain is disruptured.

A sudden, non-convulsive loss of neurologic

function due to an ischemic or hemorrhagic
intracranial vascular event.
 MODIFIABLE RISK FACTORS
Hypertension
Cardiovascular disease
Coronary artery disease
Atrial fibrillation
Heart failure
Left ventricular hypertrophy
Rheumatic heart disease
High cholesterol levels
Obesity
Diabetes mellitus
Smoking
Excessive alcohol consumption
Drug abuse
 NON-MODIFIABLE RISK
FACTORS
Advanced age
Gender
Race
GENERAL MANIFESTATION
TWO MAJOR CATEGORIES
 INCIDENCE RATE

Ischemic- 80-85%
Mortality: 20%
Hemorrhagic- 15-20%
Mortality: 80%
CVA: Ischemic Stroke
There is disruption of the
cerebral blood flow due to
obstruction by embolus or
thrombus
 ETIOLOGY:
Large artery thrombosis
Small penetrating artery thrombosis
Cardiogenic embolic
Cryptogenic (Unknown)
Others (cocaine use, migraine,
coagulopathies, spontaneous dissection
of the carotid or vertebral arteries)
CLINICAL MANIFESTATION
Motor loss
Communication loss
Perceptual disturbances
Sensory loss
Cognitive impairment
CVA: Hemorrhagic Stroke
Normal brain metabolism is impaired
by interruption of blood supply,
compression and increased ICP
Usually due to rupture of intracranial
aneurysm, AV malformation,
Subarachnoid hemorrhage
 ETIOLOGY

Subarachnoid or
intracerebral hemorrhage
Intracranial aneurysm or
rupturing of vessel
CLINICAL MANIFESTATION
Sudden and severe headache
Same neurologic deficits as
ischemic stroke
Loss of consciousness
Meningeal irritation
Visual disturbances
 OBJECTIVE OF
TREATMENT
To promote normal functioning of
the individual
Prevent current symptoms
Prevent severe attack
Prevent further complications and
improve quality of life
MEDICAL MANAGEMENT
Thrombolytic theraphy
Anticoagulant
Anti-platelet Drugs
Administer Oxygen
Anti-hypertensive drugs
 SURGICAL
MANAGEMENT
a. Carotid endarterectomy
b. Carotid Artery Stenosis Stenting
c. Ventriculostomy
d. Mechanical thrombectomy
e. Aneurysm clipping
f. Embolization of Cerebral Aneurysm
g. Stereotactic radiosurgery
g. Stereotactic radiosurgery
 TEST AND DIAGNOSTIC
PROCEDURE

BLOOD TEST

PHYSICAL EXAMINATION

MRI

CT SCAN

CAROTID ULTRASOUND

ARTERIOGRAPHY

ECHOCARDIOGRAM

ECG
 PREVENTION
Take your high blood pressure medicine regularly.
Monitor blood pressure regularly.
Do not smoke or drink too much alcohol.
If you have atrial fibrillation (an irregular or fast heart
beat), you may need to take antithrombotic medicine.
Having a recent heart attack may also require you to take
antithrombotics.
Keep your blood cholesterol level in a normal range.
Eat foods low in fat to decrease the risk of developing
plaque (fatty deposits) in your blood vessels.
Healthy lifestyle.
Monitor and control your blood sugar level if you have
diabetes.
Health educating the patients and community people
about recognition and prevention of stroke.
 DEMOGRAPHIC DATA AND
HISTORY

“The ultimate measure of man in

moments of comfort, but where he stands
in time of challenge and controversy”
 ANATOMY AND PHYSIOL
OGY

“We must all suffer from one of two pain of

regret- the different is discipline weighs
ounces…while regret weighs ton’s”
Anatomy Physiology
 PATHOPHYSIOLOGY
GENERAL SPECIFIC
 PHYSICAL
ASSESSMENT

“The nursing profession, must be capable

from within, ensuring competence and
continuously protecting the art and science
of ‘caring’ as life-long journey, a never
ending process.”
DEVELOPMENTAL TASK

“Happiness begins at the point of

fulfilling task in positive way and
involved personality strength”
 LEVEL OF
COMPETENCIES

“Smile at each other, smile at your friends, smile at

your partner, smile at strangers- it does not matter
who is it- This help you to grow up in greater love
for each other”
 LEVEL BEFORE DURING ANALYSIS
HOSPITALIZATION HOSPITALIZATION

PHYSICAL

MENTAL

EMOTIONAL

SOCIAL

SPIRITUAL
 LEVEL OF FUNCTIONING

“What makes life exciting is when God gave you strength

and courage to fight a losing battle in fact all you want to
do is surrender”
PATTERN BEFORE DURING ANALYSIS
HOSPITALIZTION HOSPITALIZTION

EATING

DRINKING

SLEEPING

BATHING

URINARY

BOWEL
 MEDICAL
MANAGEMENT
“When caring counts, count on us”
“Caring patients is not just a job, a
heartfelt profession”
 ONGOING
APPRAISAL
PIX KUYA WILMAR

“Improvement of the health condition of a client is the

responsibility of the people in the of health care
professionals”
 DRUG STUDY

“From time to time, we may learn, but time without

maximizing experiences- knowledge might burn.”
THANK YOU…….