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Introduction

The subject proponents case study of Mr. N.N. who was admitted at Northern Mindanao Medical Center that was diagnosed with Cerebrovascular Disease, Hemorrhagic, Left Putamen; Hypertensive Cardiovascular Disease; Hypertension Stage. One relatively common cause of brain damage and death is referred to as a stroke. A stroke is similar to a heart attack, only in this case, blood flow to brain, rather than the heart, is blocked. The term "stroke" comes from the once popular idea that someone had received a "stroke of God's hand" and was therefore damaged. Strokes are also called cerebrovascular accidents. CVA's; "cerebrum" is Latin for brain, while "vascular" refers to the blood vessels or "brain attacks" to emphasize the need to call 911 and get immediate medical attention when they occur (mentalhelp 2011).

Stroke is sometimes referred as "brain attack" and with good reason: Similar to a heart attack, a stroke occurs when the blood supply to the brain is blocked. And like a heart attack, the effects of stroke can range from mild to fatal, with a wide range of effect that leave a lasting impact both on the sufferer and his or her family. If someone you care about has had a stroke, you're probably curious to find out why it happened, what comes next, and what you can do to prevent it from occurring again.

Stroke is a leading cause of death in the Philippines and the majority of strokes are from developing countries and among the top five diseases with the greatest burden. Ischemic and hemorrhagic stroke are among the types of stroke. Although two community-based studies have been conducted to determine the prevalence of stroke in the Philippines, the incidence has not been nationally recorded to date. In the Philippines, ischemic stroke is the most common with 70% of cases. Hemorrhagic stroke accounts for 30% of cases in the country.

Common causes include uncontrolled hypertension where one detects high blood pressure but is hesitant to go to the doctor to consult; or where a hypertensive patient isnt taking medicine, or medicine is taken in inadequate amounts. Both types are fatal. Its said that if one experiences a stroke or brain attack, you are in what is known as a 30-30-30 situation. Meaning, 30% die, 30% lucky and can go to back to normal, and 30% left with

disability, explains Dr. Maria Cristina San Jose, a neurologist, and 2nd Vice President of the Stroke Society of the Philippines. Due to the increasing number of stroke cases annually, the government of the Philippines should emphasize primary and secondary prevention strategies.

According to the latest WHO data published in April 2011 stroke deaths in the Philippines reached 40,245 or 9.55% of total deaths (WHO 2011). The age adjusted death rate is 82.77 per 100000 of population ranks Philippines #106 in the world. The number of people who were admitted to hospital following a stroke, who then spent 90% of their time on a stroke unit. The number of Transient Ischaemic Attack (TIA) cases with a higher risk of stroke who are then subsequently treated within 24 hours in an outpatient setting (DOH 2011) The Government's target which aims to reduce the death rate from Stroke, CHD and related diseases in people under 75 by at least 40 percent by 2010 has already been achieved

The brain receives about 25% of the body's oxygen, but it cannot store it. Brain cells require a constant supply of oxygen to stay healthy and function properly. Therefore, blood needs to be supplied continuously to the brain through two main arterial systems

This case study will help us understand the disease process leading to its complications of the patient. This would also help us in identifying the primary needs of the patient with Cerebrovascular Disease, Hemorrhagic. By identifying such needs and health problems, we can now formulate an individualized care plan for the patient that would address these needs and problems effectively. The objectives of this case study are to apply the concept learned regarding cases of perception and coordination, specifically on stroke. And incorporate the values of faith excellence and service in caring for a patient who may run into this condition. As well as enhance our nursing skills in managing patients with this condition; and develop perseverance in the task as a group and establish camaraderie. Analyze the pathophysiology of the disease, be able to identify the medicine given and its indication

readily apply skills and competently could care patient in its condition and be able to apply nursing intervention for the future. This case study provides data and explanations regarding the patients health condition in the past and predicted possible outcomes of our care. A history taking of the patients condition was made to determine all the important events prior to the assessment which may have contributed to the patients current condition. This study is limited to the clients general profile and all considerations regarding her present status.

The scope of this study includes the patients profile, laboratory tests done by the patient, assessment of the physiological and psychological status, Doctors order, Drug study the pharmacologic and non-pharmacologic, pathophysiology, procedures done surgically and adequacy of support systems and care given by the family as well as other health care providers. The source of this information was the wife of the patient, and the patient itself in which the assessment of the patient was done last January 17, 2013 at 4:00 in the afternoon. This is limited in terms of alleviating problems that is beyond the allotted time given and the researchers resources in which an assessment done last January 15, 2013, actual care to client last January 16, 2013, and a hospital visit last January 17, 2013. This study focuses on the chosen client itself. It is a good experience for us, so we can provide extensive and proper nursing care to our client. The proponents of this paper chose the above mentioned case because they believe that the prevention is always better than cure, hence, proper knowledge of this disease condition should be dealt accordingly for proper management.