At the end of the class, students will gain in depth knowledge regarding ECT, develop positive attitude and skill in providing care to clients undergoing ECT
3. 3
Course : DGNM
Subject : Medical Surgical Nursing
Unit : XII-Nursing management of patients with neurological disorders
Topic : Cerebrovascular Accident
Level of students : II DGNM
No. of students : 17
Venue : Classroom
Date and time :
Duration of class : 1 Hour
Methods of teaching : Lecture cum discussion
Audio visual aids : Power point slides, Black board, Chart
Review of previous knowledge : Students may have acquired some knowledge about medical
surgical nursing and develops skills to provide care to the
patient.
4. 4
Central Objective
At the end of the class students will gain in-depth knowledge regarding
CVA, develop positive attitude and skill in providing care to stroke patients
Specific Learning Objectives
At the end of the class, students will be able to:
• define CVA
• explain the etiology and risk factors of CVA
• describe the pathophysiology of CVA
• list out the clinical manifestation
• describe the diagnostic evaluation
• explain the management of CVA
5. 5
INTRODUCTION
Cerebro vascular accident is otherwise called stroke or brain attack. It occurs when there is
ischemia that is inadequate blood supply to a part of brain or haemorrhage into the brain that results in death
of brain cells.
6. 6
SLO Time Content Teacher’s
Activity
Learner’s
Activity
Evaluation
Define
CVA
5 DEFINITION
Cerebrovascular accident or brain attack is a term used
to describe neurologic changes caused by an
interruption in the blood supply to a part of the brain.
Explain
with the
help of
blackboard
Listening and
taking notes
What is CVA
List
the
etiolog
y of
CVA
5 ETIOLOGY
• Ischemia
• Thrombosis
• Embolism
• Haemorrhage
Other causes
• Irritation
• Protein c and Protein s deficiency
• Tumor
• Large blood clot
• Brain abscess
Explain
with the
help of
blackboard
Listening and
taking notes
What are
the
etiological
factors
7. 7
SLO Time Content Teacher’s
Activity
Learner’s
Activity
Evaluation
List
the
risk
factors
of
CVA
10 RISK FACTORS
Non modifiable risk factors
Age
Gender
Race
Family history
Modifiable risk factors
Hypertension
Heart disease
Smoking
Excessive alcohol consumption
Obesity
Sleep apnoea
Lack of physical exercise
Poor diet
Drug abuse
Explain
with the
help of PPT
Listening and
taking notes
List down
the risk
factors
8. 8
SLO Time Content Teacher’s
Activity
Learner’s
Activity
Evaluation
Descri
be the
pathop
hysiolo
gy of
CVA
10 PATHOPHYSIOLOGY
Ischemia
Energy failure
Acidosis
Decreased intra cellular calcium
Cell membranes and proteins break down formation of
free radicals, protein production decreased
Cell injury and death
Explain
with the
help of PPT
Listening and
taking notes
Explain
about the
pathophysio
logy
List
down
the
types
of
stroke
5 TYPES OF STROKE
• Ischemic stroke
• Non ischemic stroke
• Haemorrhagic
• Thrombotic stroke
• Intracerebral haemorrhage
Explain
with the
help of
blackboard
Listening and
taking notes
List down
the types of
stroke
9. 9
SLO Time Content Teacher’s
Activity
Learner’s
Activity
Evaluation
List
down
the
clinical
manife
station
s of
CVA
5 CLINICAL MANIFESTATION
Right brain damage
Left side brain damage
Motor function
Communication
Intellectual function
Elimination
Explain
with the
help of
blackboard
Listening and
taking notes
List down
the clinical
manifestatio
n
Descri
be the
diagno
stic
evaluat
ion of
CVA
10 DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• CT scan
• Computed tomographic angiography
• MRI
• Magnetic resonance spedrography
• PET
• SPECT
• Cerebral angiography
Explain
with the
help of
blackboard
Listening and
taking notes
Describe the
diagnostic
evaluation
10. 10
SLO Time Content Teacher’s
Activity
Learner’s
Activity
Evaluation
• X Rays
• Brain scan
• EEG
• Lumbar puncture
Explai
n the
manag
ement
and
compli
cation
of
CVA
10 MANAGEMENT
Medical management
• Identify stroke early
• Maintain cerebral oxygenation
• Restore cerebral blood flow
SIDE EFFECTS
Intracranial bleeding
PREVENT COMPLICATION
o Bleeding
o Cerebral oedema
o Aspiration
Explain
with the
help of
blackboard
Listening and
taking notes
Explain in
detail about
the
managemen
t of CVA
11. 11
SLO Time Content Teacher’s
Activity
Learner’s
Activity
Evaluation
SURGICAL MANAGEMENT
Aneurism and haemorrhage; surgical interventions for
stroke include immediate evaluation of aneurism
induced hematomas larger than 3cm.
14. Insert pictures of AV aids used
Audio Visual Aids used
Power point slides, Black board, Chart
14
15. Assignment
Prepare a nursing care plan for stroke patients.
Date and time of submission: 10/05/2022 at
10:00am
Place of submission: Department of Medical
Surgical Nursing
Evaluation(Assessment of Knowledge)
Short answer (5X2=10)
1. Define CVA
2. List any three types of shock
3. Describe the pathophysiology of CVA
4. List any 3 clinical manifestations
5. State any 3 possible nursing diagnosis of stroke
patient
15
16. 16
Summary
Till this time we have discussed about definition, etiology, risk factors,
pathophysiology, clinical manifestation, diagnostic evaluation and management of. I think you
have thorough about this disease condition.
Conclusion
Cerebro vascular accident is the third leading cause of death. In US 1.5-4 million
individual have a history of stroke. So this disease condition is very helpful to know about
etiology, clinical manifestation, and management. While following this management we can
prevent cerebro vascular accident.
17. 17
References
• LINTON: The text book of MEDICAL SURGICAL NURSING 11th edition, Elsevier
publishers, page no.: 1065- 1067
• LEWIS, HEITKEMPER, DRIKSON: The textbook of MEDICAL SURGICAL NURSING
7th edition, mosby publishers, page no.: 1360-1367
• BLACK M JOYCE: The text book of MEDICAL SURGICAL NURSING 7th edition,
mosby publishers, page no.: 1143-1147