One of the major health problems that a health care provider could encounter

is cerebrovascular accident. Despite of the great efforts made worldwide to fight

against it, it is still prevalent. A cerebrovascular accident (CVA), an ischemic stroke
or “brain attack” is the sudden death of some brain cells due to lack of oxygen when
the blood flow to the brain is impaired by blockage or rupture of an artery too the
brain. A CVA is a functional abnormality of the central nervous system and is also
referred to as “stroke”.
Symptoms of a stroke depend on the area of the brain affected. The most
common symptom is weakness or paralysis of one side of the body with partial or
complete loss of voluntary movement or sensation in a leg or arm. There can be
speech problems and weak face muscles, causing drooling. Numbness or tingling is
very common. A stroke involving the base of the brain can affect balance, vision, and
swallowing, breathing and even unconsciousness.
A stroke is a medical emergency. Anyone suspected of having stroke should
be taken immediately to medical facility for diagnosis and treatment.
The causes of stroke could be: An artery to the brain may be blocked by a clot
(thrombosis) which typically occurs in a blood vessel that has previously been
narrowed due to atherosclerosis (“hardening of the artery”). When a blood clot or a
piece atherosclerotic plaque (a cholesterol and calcium deposit on the wall of the
artery) breaks loose, it can travel through the circulation and lodge in an artery of the
brain, plugging it up and stopping the flow of blood; this is referred to as an embolic
stroke. A blood clot can form in a chamber of the heart when the heart beats
irregularly, as in atrial fibrillation; such clots usually stay attached to the inner lining
of the heart but they make break off, travel through the blood stream, form a plug
(embolus) in a brain artery and cause a stroke. A cerebral haemorrhage (bleeding in
the brain), as from an aneurysm (a widening and weakening) of a blood vessel in the
brain, also causes stroke.
Other causes are known to be called as cryptogenic strokes which have no
known cause, and other strokes result from causes such as illicit drug use,
coagulopathies, migraine, and spontaneous dissection of the carotid or vertebral
arteries. (medicinenet, 2017).

Strokes could be classified as Ischemic stroke and Hemorrhagic stroke.

Ischemic stroke is the loss of function in the brain as a result of a disrupted blood
supply while Hemorrhagic strokes are caused by bleeding into the brain tissue, the
ventricles, or the subarachnoid space. (nurselabs, 2016).

STATISTICS (GLOBAL AND LOCAL)

According to the World Health Organization, 15 million people suffer stroke

worldwide each year. Of these, 5 million die and another 5 million are permanently
disabled. High blood pressure contributes to more than 12.7 million strokes
worldwide. In Europe, approximately 650,000 stroke deaths each year.
In developed countries, the incidence of stroke is declining, largely due to
efforts to lower blood pressure and reduce smoking. However, the overall rate of
stroke remains high due to the aging of the population. (strokecenter.org, 2017).

Globally, stroke is the second leading cause of death above the age of 60
years, and the fifth leading cause of death in people aged 15 to 59 years old. Stroke
is less common in people under 40 years, although it does happen. In young people
the most common causes are high blood pressure or sickle cell disease. (World
heart federation, 2017).
According to the American Heart Association, Stroke is the 5 th cause of death
in the United States, killing nearly 130,000 people a year and that someone in the
United States has a stroke every 40 seconds. It was also found out that 87% of
strokes are classified as ischemic. African-Americans are more impacted by stroke
than any other racial group within the American population.
On the other hand, the World Health Organization reported that stroke is the
Philippines second leading cause of death. A data published by WHO in May 2014
reported that stroke deaths in the Philippines reached 63,261 or 12.14% of total
deaths. Stroke afflicts 400,000 Filipinos yearly (Manila bulletin, 13 September 2008)
making it one of the leading causes of death together with vascular diseases.

REASON FOR CHOOSING THE CASE

We, the researchers have chosen this case as our topic because we want to
broaden our knowledge and management of the disease. The acquisition of
cognitive knowledge regarding the topic would enable the researchers’ in providing
optimum care for clients suffering such disease and in delivering appropriate
interventions that would promote health and wellness for the client. We strongly
believe that this case study will be very helpful in our career someday as future
registered nurses.

NURSING OBJECTIVES

GENERAL OBJECTIVES

The purpose of the presentation is to know related information and

knowledge about the aforementioned disease condition. This presentation will
serve as a guideline for student nurses in assessing and providing proper nursing
care to patients with the same problem or disease.

SPECIFIC OBJECTIVES

· Cognitive
- Acquire knowledge regarding Cerebrovascular accident through
research.
- Know the nursing history, personal data, health history and physical
assessment of the patient.
- List the diagnostic tests that are done for the patient.
- Review the concepts about the anatomy and physiology with regards
to the condition.
- Review the disease process: the causes, effects, management,
treatment and possible preventions.
- Determine the pathophysiology of the condition with their rationale for
occurrence of each manifestation.
- Determine certain management and medications given and provided
for the condition.

· Psychomotor
- Conduct a cephalocaudal assessment of the patient.
- Create a book-based and client centred Pathophysiology using
multiple sources.
- Discuss the medications taken by the client, its action, side effects
and nursing responsibilities.
- Provide health teachings to the patient about certain interventions in
the maintenance of health care.

· Affective
- Develop understanding and appreciation with the client’s condition.
- Establish rapport and therapeutic interaction with the patient and to
obtain necessary information and positive compliance to care being provided.