A stroke, or cerebrovascular accident (CVA), is caused by disrupted blood flow to the brain resulting in ischemia or hemorrhage. Risk factors include advanced age, male gender, family history, hypertension, heart disease, hyperlipidemia, obesity, smoking, and diabetes. Strokes are classified as ischemic (caused by blood clots) or hemorrhagic (caused by ruptured blood vessels). Symptoms include numbness, confusion, speech problems, vision issues, and headaches. Diagnostic tests include CT scans, MRIs, and angiograms. Medical management focuses on thrombolysis for ischemic strokes and anticoagulation therapy. Nursing assessments evaluate risk factors, symptoms, and management of

1. Stroke
Cerebrovascular Accident (CVA)
• Definition:
• A cerebrovascular accident (CVA), an ischemic
stroke or “brain attack,” is a sudden loss of
brain function resulting from a disruption of
the blood supply to a part of the brain. This
disturbance is due to either ischemia (lack of
blood flow) or hemorrhage.

2. Risk Factors
• Nonmodifiable
• Advanced age (older than 55 years)
• Gender (Male)
• Family history
• Modifiable
• Hypertension
• Heart disease, Atrial fibrillation
• Hyperlipidemia
• Obesity, Smoking
• Diabetes
•

3. Classification:
I- Ischemic: resulting from thrombosis
(obstruction of a blood vessel by a blood clot)
, Embolism
II- Hemorrhagic: resulting from hypertension,
a ruptured aneurysm,

4. Clinical Manifestations
–numbness or weakness of face, arm, or leg
(especially on one side of body);
– confusion or change in mental status;
–trouble speaking or speech;
– visual disturbances; loss of balance, dizziness,
difficulty walking; or sudden severe headache.
– Motor Loss

5. Diagnostic Studies
• CT scan, MRI, Cerebral angiography, Lumbar
puncture (LP), X ray
• Complications of CVA
• Decreased cerebral blood flow due to
increased ICP
• Inadequate oxygen delivery to the brain
• Pneumonia

6. Medical Management
• I- Ischemic:
• Thromolysis with Recombinant tissue
plasminogen activator (tPA)
• Anticoagulation therapy

7. Nursing Assessment
Acute Phase Assessment
• History:
- Age,
-History: coronary artery disease,
- , previous (transient ischemic attake)TIA/stroke,
- diabetes mellitus
- seizure/epilepsy
Change in level of consciousness or
, ability to speak, and orientation

8. Nursing Diagnoses
• Impaired physical mobility related to
hemiparesis , brain injury
• Acute pain related to hemiplegia( (‫نصفي‬ ‫شلل‬
• Deficit self-care ( feeding) related to stroke
process
• Disturbed sensory perception related to
sensory reception.
• Impaired swallowing
• Impaired urinary elimination related
to confusion,

9. Acute Nursing management
• Maintain a patent airway to promote oxygenation
• Administer oxygen therapy with possible intubation
and mechanical ventilation to tissue perfusion
• Maintain bed rest to minimize metabolic
• Provide I.V. fluids to support blood pressure
• Administer anticoagulants and antiplatelet drugs for
thrombotic
• Administer sedatives,
• Assess level of consciousness change on Glasgow coma scale.