Presented by:

Stephanie Seidel
Quennie Valeryn Quiman
What is Stroke??
A stroke, also known as a cerebrovascular accident
or CVA is when part of the brain loses its blood
supply and the part of the body that the blood-
deprived brain cells control stops working. This loss
of blood supply can be ischemic because of lack of
blood flow, or hemorrhagic because of bleeding into
brain tissue.

The sudden death of brain cells due to lack of

oxygen, caused by blockage of blood flow or rupture
of an artery to the brain. Sudden loss of speech,
weakness, or paralysis of one side of the body can be
symptoms.
A stroke is a medical emergency because strokes can
lead to death or permanent disability. There are
opportunities to treat ischemic strokes but that
treatment needs to be started in the first few hours
after the signs of a stroke begin.
Ischemic Stroke
(clot)

Ischemic strokes occur

when the arteries to your
brain become narrowed
or blocked, causing
severely reduced blood
flow (ischemia).
Occurs when a blood
vessel supplying blood
to the brain is obstructed.
It accounts for 87
percent of all strokes.
Hemorrhagic stroke (Bleeds)
When blood from an artery begins bleeding into the brain. This
happens when a weakened blood vessel bursts and bleeds into the
surrounding brain. Pressure from the leaked blood damages
brains cells, and, as a result, the damaged area is unable to
function properly. Occurs when a weakened blood vessel
ruptures.
TIA (Transient Ischemic
Attack)

is a stroke that lasts only

a few minutes. It happens
when the blood supply to
part of the brain is briefly
blocked.
Called a “mini stroke,”
it’s caused by a
serious temporary clot.
This is a warning stroke
and should be taken
seriously.
• High Blood
pressure
• (hypertension)
• High Cholesterol
• Diabetes
• Smoking
• Obesity
• Alcohol use
• Sedentary
lifestyle
• Stress
 Signs and Symptoms

 Sudden NUMBNESS or weakness of face, arm,

or leg, especially on one side of the body
 Sudden CONFUSION, trouble speaking or
understanding speech
 Sudden TROUBLE SEEING in one or both eyes
 Sudden TROUBLE WALKING, dizziness, loss of
balance or coordination
 Sudden SEVERE HEADACHE with no known
cause
PATHOPHYSIOLOGY
OF STROKE
 NURSING DIAGNOSES
 Ischemic Stroke
 Impaired physical mobility related to hemiparesis , loss of
balance and coordination, spasticity, brain injury
INTERVENTIONS:
 -Improving mobility and preventing joint deformities
 A pt. with hemiplegia has unilateral paralysis (one sided)
 -correct positioning is important to prevent contractures;
measures to relieve pressure; assist in maintaining good
body alignment
 Preventing Shoulder adduction to prevent adduction of the
affected shoulder while the pt. is in bed, a pillow is placed in
the axilla when there is limited external rotation; this keeps
away arm from the chest.
 Self-care deficits (bathing, hygiene, toileting, dressing,
and feeding) related to stroke sequelae (-prvs. dse. or injury)
INTERVENTIONS:
 -Enhancing self care
As soon as the pt. can sit up, he/she is encouraged to participate
in personal hygiene activities
 The pt. is helped to set up realistic goals: to carry out self-
activities on the unaffected side (i.e. combing hair, brushing
the teeth, shaving w/ electric razor, bathing, eating – w/ 1 hand
& should be encouraged) Although the pt. may feel awkward
at first, these motor skills can be learned by repetition, and the
unaffected side will become stronger with use.
 Hemorrhagic Stroke

*Risk for ineffective tissue perfusion (cerebral) related

to bleeding or vasospasm
INTERVENTION/S:
OPTIMIZING CEREBRAL TISSUE PERFUSION
The pt. is closely monitored for neurologic
deterioration resulting from recurrent bleeding,
increasing ICP, or vasospasm. A neurologic flow record-
is maintained – BP, PR, LOC (an indicator of cerebral
perfusion), pupillary responses, and motor function/s
are checked hourly.

*Anxiety related to illness and /or medically imposed
restrictions (aneurysm precautions)
 INTERVENTION/S:
IMPLEMENTING ANEURYSM PRECAUTION
Cerebral Aneurysm Precautions are implemented
for the pt. w/ a dx of aneurysm to provide a
nonstimulating env’t, prevent increases in ICP, and
prevent further bleeding.
Pt. is placed on bed rest, nonstressful env’t –
because activity, pain. & anxiety are thought to
elevate BP, w/c may increase the risk for bleeding.
Visitors may be restricted (AANN,2009;Hickey, 2014)
 Antiplatelet drugs

 ASA, also called acetylsalicylic acid or aspirin

(Aspirin®, Asaphen®, Entrophen®, Novasen®)
 Clopidogrel (Plavix®)
 Prasugrel (Effient®)
 Ticagrelor (Brilinta®)
 Anticoagulants

 Heparin
 Warfarin
 Antihypertensives

 ACE (Angiotensin-Converting Enzyme) Inhib

itors
 ARB’s (Angiotensin Receptor Antagonists)
 Beta-blockers
 Calcium channel blockers
 Diuretics
Cholesterol lowering medications

 Cholesterol absorption inhibitors (ezetimibe)

 Fibrates (Fibric Acid Derivatives)
 Niacin
 Resins
 Statins
 Prevention

 eating a healthy diet

 maintaining a healthy weight
 exercising regularly
 not smoking tobacco
 avoiding alcohol or drinking moderately
 keeping blood pressure under control
 managing diabetes
 treating obstructive sleep apnea
 Alternative Therapies for Stroke

 Acupuncture
 Yoga
 Tai Chi
 Massage Therapy
 Aromatherapy
 Herbal Supplements
 POTENTIAL COMPLICATIONS
 VASOSPASM
 SEIZURES
 REBLEEDING
 HYPONATREMIA
 HYDROCEPHALUS

PLANNING & GOALS:

Improve cerebral tissue perfusion, relief of anxiety,
and the absence of complications
 1. The part of the brain loses its blood supply and
the part of the body that the blood-deprived brain
cells control stops working.
 2-4. What are the 3 types of stroke?

5. It is a type of stroke where blood clot lodges in

cerebral artery causing stroke
 6.Type of stroke when blood from an artery begins
bleeding into the brain
 7. Type of stroke that lasts only a few minutes.
 8-10. give 3 risk factors of stroke.

 11-12. Give only 2 preventions (out of 8)

 13-14. Give 2 Alternative Therapies (out of 6)

 15. Give 1 Anticoagulant (out of 2 “rin”)

THANK YOU
FOR
LISTENING…