Cva

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Cva

  1. 1. CEREBROVASCULAR DISORDERS A Nursing Approach in the Management of BY: DAVE JAY S. MANRIQUEZ BSN,RN.
  2. 2. CEREBROVASCULAR DISORDERS An umbrella term that refers to any functional abnormality of the central nervous system that occurs when the normal blood supply to the brain is disrupted.
  3. 4. STROKE a sudden neurological event which results in the new onset of neurological symptoms.
  4. 5. TYPES of STROKE
  5. 7. ISCHEMIC STROKE “ BRAIN ATTACK”
  6. 23. <ul><li>MOTOR LOSS </li></ul><ul><li>-disturbance of voluntary motor control on the side of the body opposite the location of the stroke lesion </li></ul><ul><li>Hemiplegia </li></ul><ul><li>Hemiparesis </li></ul>
  7. 24. <ul><li>COMMUNICATION LOSS </li></ul><ul><li>Dysarthria </li></ul><ul><li>Apraxia </li></ul><ul><li>Agnosia </li></ul><ul><li>Dysphasia or Aphasia </li></ul>
  8. 27. <ul><li>PERCEPTUAL DISTURBANCES </li></ul><ul><li>Homonymous Hemianopsia </li></ul><ul><li>Disturbance in Visual-Spatial Relations </li></ul><ul><ul><li>- Unilateral Neglect </li></ul></ul><ul><li>Loss of Peripheral Vision </li></ul><ul><li>Night Blindness </li></ul><ul><li>Diplopia </li></ul><ul><li>Horner’s Syndrome </li></ul>
  9. 33. <ul><li>SENSORY LOSS </li></ul><ul><li>Slight Impairment of Touch </li></ul><ul><li>Loss of Proprioception </li></ul><ul><li>Difficulty in interpreting visual, tactile, and auditory stimuli </li></ul>
  10. 34. COGNITIVE IMPAIRMENT & PSYCHOLOGICAL EFFECTS
  11. 35. ASSESSMENT & DIAGNOSTICS <ul><li>Patient History </li></ul><ul><li>Complete Physical and Neurologic Examination </li></ul><ul><li>Initial Assessment: Airway Patency, Cardiovascular Status, Gross Neurologic Losses </li></ul><ul><li>Stroke Time Course Classification </li></ul>
  12. 36. STROKE TIME COURSE CLASSIFICATION Stage 1: Transient Ischemic Attack Stage 2: Reversible Ischemic Neurologic Deficits Stage 3: Stroke in Evolution Stage 4: Completed Stroke
  13. 37. DIAGNOSTIC TESTS <ul><li>CT Scan </li></ul><ul><li>12-Lead ECG </li></ul><ul><li>Carotid ultrasound </li></ul><ul><li>Cerebral Angiography </li></ul><ul><li>Transcranial Doppler Flow Studies </li></ul><ul><li>Transthoracic or Transesophageal Echocardiography </li></ul><ul><li>MRI of the brain and/or neck </li></ul><ul><li>Xenon CT </li></ul><ul><li>Single Photon Emission CT </li></ul>
  14. 46. MEDICAL MANAGEMENT <ul><li>Treatment of TIA from atrial fibrillation or suspected embolic or thrombotic causes </li></ul><ul><li>Thrombolytic Therapy for Ischemic Stroke </li></ul><ul><li>Therapy for Patients with Ischemic Stroke NOT Receiving Thrombolytic Therapy </li></ul><ul><li>Managing Potential Complications </li></ul>
  15. 48. SURGICAL MANAGEMENT CAROTID ENDARTERECTOMY - Main surgical procedure for the management of TIAs and small stroke - Indicated for patients with symptoms of TIA or mild stroke found to be due to carotid stenosis - Complications : stroke, cranial nerve injuries, infection, hematoma at the incision site, carotid artery disruption
  16. 52. NURSING MANAGEMENT <ul><li>Improving Mobility and Preventing Joint Deformities </li></ul><ul><li>Managing Sensory-Perceptual Difficulties </li></ul><ul><li>Attaining Bowel and Bladder Control </li></ul><ul><li>Improving Thought Processes </li></ul><ul><li>Improving Communication </li></ul><ul><li>Maintaining Skin Integrity </li></ul><ul><li>Improving Family Coping </li></ul><ul><li>Helping the Patient Cope with Sexual Dysfunction </li></ul>
  17. 55. HEMMORHAGIC STROKE CEREBRAL ANEURYSM SUBARACHNOID HEMORRHAGE

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