I.

Introduction The brain is our primary control center, a fantastically complex organ containing billion of nerves that can simultaneously process information from our bodies, operate our internal organs, generate thoughts and opinions, store and recall memories and control our daily movement.

In order to perform its many functions and direct activities throughout the body – from walking to seeing to reasoning – the brain requires a constant amount of energy provided by the oxygen and nutrients that are delivered by the flowing blood. If the blood flow is restricted or out of all any point between the heart and the brain, portions on the brain relying on blood from the obstructed blood vessel become deprived of oxygen. Brain cells are extremely sensitive to such oxygen deprivation and if they are deprived of the oxygen and nutrients for more than four minutes, it could cause irreversible brain damage. (Bare, et al., 2006)

Cerebrovascular Accident (CVA) which is also known as stroke, brain attack or apoplexy is a situation which could result to brain damage. This is cause by an interruption in the blood supply to a part of a brain. A CVA could be ischemic or hemorrhagic. An ischemic stroke is caused by a thrombotic or embolic blockage of blood flow to the brain. While bleeding into the brain tissue causes hemorrhagic stroke. Ischemic strokes occur for about 83% and the remaining 17% are hemorrhagic strokes (Black and Hawks 2009) According to World Health Organization, 15 million worldwide suffer a stroke annually. Of these, 5.5 million (3 million women and 2.5 million men) die and another 5 million were left permanently disabled. Stroke mortalities correspond to 10% of the cause of death worldwide. It is the second leading causes of death above the age 60 years and the fifth leading cause in age 15 to 59 years old. In developed countries, stroke is the third most common causes of death. (Retrieved at http://www.who.int/cardiovascular_diseases/resources/articles/en)

In the Philippines, cardiovascular diseases including CVA ranked second to the leading cause of mortality as of the year 2009. These are a total of 51, 680 Filipinos who died from vascular system disease in

About half of the participants drank three cups of hibiscus tea per day for six weeks. 2010 at 8:30am) Another clinical trial published in February 2009 have found out that a few cups of fruity-tart hibiscus tea may help lower high blood pressure in pre-hypertensive and mildly hypertensive adults as effectively as medications too. technologies to use clot-busting drugs or remove the clot are more readily available today.gov/kp/statistics/leading_mortality ) According to the Results of a Mayo Clinic. study shows the incidence of stroke or mini-stroke related to a coronary angioplasty remained steady over a 15-year period. their verbal memory and focused attention recovered better and they had a more positive mood that patients who did not listened to anything or listened to audio books. classical. Those who drank the actual hibiscus tea saw a 7.the same year. (Retrieved at http://proquest. So doctors made a way on how to solve this problem and they performed the arteryopening procedure on older patients.930 are male and 22. while a control group received a placebo beverage containing artificial hibiscus flavoring and color. Participants followed their usual diets and physical activity regimens. Researchers say this is good news because physicians now are performing the artery-opening procedure on older patients who are sicker and need more complicated treatment. jazz or folk. especially if other forms or rehabilitation are not yet feasible at this stage-by providing an individually targeted. The researchers suggested that everyday music listening during an early stroke recovery offers a valuable addition to the patients’ care.750 are female.umi. This study helps physicians recognize patients who are at higher risk of stroke or TIA. In this research. wherein 28. Another study in October 2009 introduced that listening to music in the early stages after a stroke can improve patients’ recovery. and had their blood pressure measured weekly. easy-toconduct and inexpensive means to facilitate cognitive and emotional recovery. researchers from Finland found that if stroke patients listened to music for a three to six hours a day with genres varying from pop.2 drop in their systolic blood pressure. In here. significantly more than the slightly over 1 point drop seen in the .doh.com/pqdweb? did1536471551&sid=PQD on July 22. it was shown that a lot of people acquiring CVA are almost old and they need a lot of attention. (Retrieved at http://www. And if a patient has a stroke or TIA related to angioplasty treatment. if any. The study’s subject was split into two groups.

The role of nurses establishes his or her deliverance of independent and dependent nursing responsibilities. (Retrieved at http://proquest. A moderator at the conference noted that such antihypertensive results were similar to that delivered by standard blood pressure medications. prevention of acquiring the disease condition and avoiding the complications of the disease. 2010) c. remains to be the main responsible for their own health. knowledge acquisition and improvement in nursing care. as evidenced by the statistical information that was provided in the former part of the introduction.placebo group. CVA was found out to be one of the most common disease conditions that the patients acquire and the reasons of many disabilities and mortalities. This goal is in its sense dynamic and multidimensional as in its advantage . Reasons for choosing the case Locally. the researchers concurred on cerebrovascular accident to subject into the case presentation. Through empowering the people of their responsibility towards their own health and nurses continuing their roles provided in their scope of practice. Aided by the fact it is to expect that various case studies have already been conducted with the disease condition and therefore considerable information had already been disclosed and known. up to providing health teachings to the people on relevant information and practices regarding promoting health.umi. Acting upon this role in society as a health care provider realizes the fact that nurses play a role in helping the people achieve their optimum health for nurses assume the responsibility of bringing to the people their right for health. The researcher cautions that the recent human trial was relatively small and would need validation.com/pqdweb? did=1631975031&sid=3&Fmt=3&clientid=57020&RQT=309&Vname= PQD on July 25. Challenged with this. the people. after they have been provided with the necessary knowledge and attitude to assume this role. The researchers were up to undertake this study with enthusiasm and outlook that there are continuous and never-ending learning entailed with commission of any study in the realm of pathology. throughout the country and worldwide. health for all Filipinos may be achieved. however. but she suggested that incorporating hibiscus tea into the diet may help control blood pressure in people at risk of developing hypertension. latest trends.

Specific Objectives: 1. diet. healthy people means decreased health care cost. be able to provide the best nursing care for the client. . 3. 2. reduced hospital stays and increased power and productivity. 6. analyze and interpret the diagnostic and laboratory procedures ordered to the patient. and impart health teachings regarding the client’s condition in maintaining an optimum level of functioning.economically. Illustrated a complete anatomy and physiology. of all the systems affected by the patient’s present condition. Objectives Student – Nurse Centered At the end of the case study. Identified the demographic data and obstetrical history of the patient. inclusive of visual aids. history of her past illnesses. the student nurses shall have: General Objective: Gained knowledge and deeper understanding of the disease process itself (CVA). Performed a thorough cephalo-caudal physical assessment including cranial nerve assessment. d. 5. Outlined the family health-illness history of the patient. Identified the patient’s lifestyle. Recognized the current trends and statistics regarding the disease condition. 7. socioeconomic and cultural factors and environmental factors that may have contributed to the development of the present condition. 4. Made a list of the indications. ADLs.

Imparted knowledge on fellow students in providing care for clients with the same illness. (b) Range of Motion Exercise to facilitate muscle activity thus preventing complications such as muscle atrophy and confractures. Recognized the modifiable and non-modifiable factors that they may contribute to the development of cerebrovascular accident both book-based and patient centered. Presented a concise discharge planning including the METHOD technique. Presented the actual SOAPIEs used during the actual hospital duty. Identified different interventions such as (a) Nasogastric Tube Feeding to help the patient maintain optimum nutrition. 11. 3. Discussed a comprehensive synthesis of the disease of the patient and a thorough definition the disease experienced by the patient. 15. different drugs. 16. the patient shall have: 1. Demonstrated compliance on the treatment regimen. Acquired knowledge on the importance of compliance to treatment regimen. . 2. Presented a client’s daily progress chart from the day of the patient’s admission up to the last day of the student nurses’ hospital duty. 10. Increased their knowledge and understand the disease process including the risk factors involved. Listed the indications and take note of the patient’s response for the intravenous fluids. types of diet and exercise of the patient. 9. 14. Patient Centered At the end of the nursing assessment. 13. 12. Prepared nursing care plans for the actual and foreseeable problems of the patient. Made a list of the signs and symptoms associated with the present condition of the patient. nasogastric tube feeding.8. 4. inclusive of their rationales.

female. She did not have the chance to continue her studies because of financial crisis. Identified different measures to prevent further aggravation of condition. Precious was born in the year 1953 via home delivery at Balitucan. She had five children namely Emer. Precious had her menarch when she was about 12 years old and she had reached her menopausal stage at the age of 50. Mary Jane. She got pregnant for her first child at age of 18. Precious chose to stay at home and help in household chores instead and she was never enrolled back to school. Precious was able to reach first high school in a public school in Magalang. 2010 at 10:00 am with an admitting diagnosis of Cerebrovascular Accident with Hemorrhage and Stage II Hypertension primary controlled. Pampanga. Pampanga. Participated in the patient’s plan of care. She was admitted with the chief complaint of body weakness in one of the secondary hospitals in Magalang last July 18. NURSING PROCESS This is the case of Fifty-four years old Precious (not her real name). A. During her pregnancy.5. Loida and Analie which they were all born via normal spontaneous delivery. married and a natural born Filipino who lives in Balitucan. Rodel. 6. She is the eldest child in the brood of twelve. ASSESSMENT • PERSONAL HISTORY Demographic Data Precious told the student nurses a gist of her personal history. Socioeconomic and Cultural Factors . she visit the baranggay health center for her regular check-ups. II.

Precious’ husband pay a boundary for the jeep he drives. Environmental Factors Currently. The house has two bed rooms. Now that her children have grown and had their own jobs. Precious prefers bicarbonate drinks and coffee a lot. She would then take her lunch at 11:30 – 12 noon which is usually comprised of rice and meat. Their earning was barely enough for the family. Precious. As a means to earn a living. Jeepney is their mode of transportation. they lived at the house of her husband’s parents who support them. After eating and cleaning the kitchen. This information is based from the interview . Their garbage is disposed properly inside and outside the house by means of trash bags that are collected weekly. she usually goes to bed for a night sleep.m. The house is made up of cement and wood and the interior of the house appeared to be unorganized. she likes pork and fatty parts of it. they usually go to a doctor. Pertinent Family Health Illness History As simplified pedigree reflects the family health illness history of Precious’ family lineage. Upon waking up. Precious could usually consume 3-4 servings per meal. She usually urinates 6-10 times in a 24 hour period and regular bowel elimination. Precious is living in a one storey house. At around 9 o’clock am. she usually rests herself while listening to a. Toilet facility is located outside the house. Precious and her family believe to herbularyos and manghihilots but if the illness or disease was severe. Comes 5:00 pm.When Precious and her husband built a family. The living space of the house is adequate. After which. When it comes to beverages. She also likes the skin of chicken and adding condiments such as soy sauce and salt. Precious is already preparing for dinner and eats at around 6:30 pm. she usually wakes up at 4 o’clock in the morning and starts cleaning the house as well as the backyard. After breakfast of a cup of coffee and bread at around 6 o’clock am. when it comes to food. they are the one who support the needs of the family. she usually takes a nap and watch television until 2:00 pm. There are windows in two bedrooms but they are not sufficient in providing light and ventilation. she would go outside to play cards with her neighbors and buy some merienda. For the activities of the daily living of Precious prior to hospitalization. At around 9:00 pm. Precious then be free to relax as she watch evening programs on the television while drinking a cup of coffee. she would start cooking for lunch. radio.

She went to the market to purchase needed home goods and fresh ingredients to cook for the day. HISTORY OF PAST ILLNESS Precious didn’t experienced major illnesses except when she was in her childhood years. They worried that Precious’ condition was worse so they rushed her to the hospital. . she never did seek medical advice that they had not thought about Precious’ health status. Precious woke-up early to do her usual chores.conducted with the three children of Precious – Mary Jane. However. History of Present Illnesses Precious did not experienced any signs and symptoms directly relating to her disease condition several weeks or days prior to her hospitalization last July 18. She was also put into NPO and hooked IVF PNSS 1L x 30-31 and insertion of NGT. After completing all needed data for the patient’s admission. Upon admission her in the hospital she was seen by the doctor on rounds with the following laboratory procedures such as CBC. They rested Precious in a bench and give her a glass of water. 2010. In the morning of July 18. After breakfast. As stated by her children. etc. mild fever and coughs. she took a cup of coffee and a slice of bread. With that there had been limitations to the activities of Precious that she could normally do such that she would order her children to clean the backyard and pay another person to the laundry for her. O2 via nasal canula @ LPM. they manifest mild hypertension. measles. 2010 when she first had an actual manifestation of body weakness and difficulty of swallowing. her granddaughter saw her lying on the ground. she was admitted with the same diagnosis of CVA hemorrhagic with stage II HPN. Precious had often complained of nervousness and was observed to be easily fatigued. according to the informant. Rodel and Analie. After Precious has arrived at their house around 10:00 am. she was admitted at room 35 with an admitting diagnosis of Cerebrovascular Accident with hemorrhage and stage II hypertension. She had chicken pox. Year 2008. Chest x-ray. Even then.