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CEREBROVASCULAR

CEREBROVASCULAR

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Published by jayz-cee
An umbrella term that refers to any functional abnormality of the CNS related to disrupted blood supply
An umbrella term that refers to any functional abnormality of the CNS related to disrupted blood supply

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Published by: jayz-cee on Sep 01, 2010
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11/03/2012

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CEREBROVASCULAR ACCIDENTS

JULIUS CEASAR P. SINCO, R.N

CEREBROVASCULAR ACCIDENTS
‡ An umbrella term that refers to any functional abnormality of the CNS related to disrupted blood supply

CEREBROVASCULAR ACCIDENTS
‡ Can be divided into two major categories ‡ 1. Ischemic stroke- caused by thrombus and embolus ‡ 2. Hemorrhagic stroke- caused commonly by hypertensive bleeding

CEREBROVASCULAR ACCIDENTS
The stroke continuum ‡ 1. TIA- transient ischemic attack, temporary neurologic loss less than 24 hours duration ‡ 2. Reversible Neurologic deficits ‡ 3. Stroke in evolution ‡ 4. Completed stroke

General manifestations

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
‡ There is disruption of the cerebral blood flow due to obstruction by embolus or thrombus

RISKS FACTORS
Non-modifiable ‡ Advanced age ‡ Gender ‡ race Modifiable ‡ Hypertension ‡ Cardio disease ‡ Obesity ‡ Smoking ‡ Diabetes mellitus ‡ hypercholesterolemia

Pathophysiology of ischemic stroke
‡ Disruption of blood supply ‡ Anaerobic metabolism ensues ‡ Decreased ATP production leads to impaired membrane function ‡ Cellular injury and death can occur

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
‡ ‡ ‡ ‡ DIAGNOSTIC test 1. CT scan 2. MRI 3. Angiography

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
CLINICAL MANIFESTATIONS ‡ 1. Numbness or weakness ‡ 2. confusion or change of LOC ‡ 3. motor and speech difficulties ‡ 4. Visual disturbance ‡ 5. Severe headache

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
Motor Loss ‡ Hemiplegia ‡ Hemiparesis

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
Communication loss ‡ Dysarthria= difficulty in speaking ‡ Aphasia= Loss of speech ‡ Apraxia= inability to perform a previously learned action

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
Perceptual disturbances ‡ Hemianopsia Sensory loss ‡ paresthesia

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 1. Improve Mobility and prevent joint deformities ‡ Correctly position patient to prevent contractures
± Place pillow under axilla ± Hand is placed in slight supination- C ± Change position every 2 hours

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 2. Enhance self-care ‡ Carry out activities on the unaffected side ‡ Prevent unilateral neglect ‡ Keep environment organized ‡ Use large mirror

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 3. Manage sensory-perceptual difficulties ‡ Approach patient on the Unaffected side ‡ Encourage to turn the head to the affected side to compensate for visual loss

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 4. Manage dysphagia ‡ Place food on the UNAFFECTED side ‡ Provide smaller bolus of food ‡ Manage tube feedings if prescribed

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 5. Help patient attain bowel and bladder control ‡ Intermittent catheterization is done in the acute stage ‡ Offer bedpan on a regular schedule ‡ High fiber diet and prescribed fluid intake

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 6. Improve thought processes ‡ Support patient and capitalize on the remaining strengths

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 7. Improve communication ‡ Anticipate the needs of the patient ‡ Offer support ‡ Provide time to complete the sentence ‡ Provide a written copy of scheduled activities ‡ Use of communication board ‡ Give one instruction at a time

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 8. Maintain skin integrity ‡ Use of specialty bed ‡ Regular turning and positioning ‡ Keep skin dry and massage NON-reddened areas ‡ Provide adequate nutrition

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 9. Promote continuing care ‡ Referral to other health care providers

CEREBROVASCULAR ACCIDENTS: Ischemic Stroke
NURSING INTERVENTIONS 10. Improve family coping 11. Help patient cope with sexual dysfunction

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

CVA: Hemorrhagic Stroke
‡ ‡ ‡ ‡ ‡ Sudden and severe headache Same neurologic deficits as ischemic stroke Loss of consciousness Meningeal irritation Visual disturbances

CVA: Hemorrhagic Stroke
‡ ‡ ‡ ‡ DIAGNOSTIC TESTS 1. CT scan 2. MRI 3. Lumbar puncture (only if with no increased ICP)

CVA: Hemorrhagic Stroke
‡ ‡ ‡ ‡ NURSING INTERVENTIONS 1. Optimize cerebral tissue perfusion 2. relieve Sensory deprivation and anxiety 3. Monitor and manage potential complications

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