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  1. 1. STROKE Presented By: Nhelia B. Perez RN. MSN Norteastern College – Nursing Dept. Santiago City, Philippines
  2. 2. Nakaka stroke ang dating!!!!
  3. 3. Stroke <ul><li>A stroke is a medical emergency in which the blood supply to any portion of the brain is interrupted or reduced. </li></ul><ul><li>Alternative names: Cerebrovascular accident/ disease (CVA), Cerebral infarction, Cerebral hemorrhage. </li></ul>
  4. 4. Epidemiology <ul><li>Stroke is the third leading cause of death in the United States. </li></ul><ul><li>Every year 600,000 people will suffer a new or recurrent stroke, and of those, 160,000 will die. </li></ul><ul><li>In the Philippines alone, there are about 500 cases of stroke for every 100,000 individuals every year. It is also estimated that about 400,000 Filipinos have lived through a first stroke with the fear of suffering a second attack, which could finally end their lives. </li></ul>
  5. 5. The symptoms of a stroke are dependant on what portion of the brain is damage.
  6. 6. SYMPTOMS <ul><li>Paralysis or weakness in the face, arms and/or legs. </li></ul><ul><li>Confusion. </li></ul><ul><li>Personality changes. </li></ul><ul><li>Sudden change in eyesight. </li></ul><ul><li>Decreased motor skills. </li></ul><ul><li>Severe headaches </li></ul><ul><li>A sudden development of one or more of the following symptoms usually indicates a stroke. </li></ul>
  7. 7. Types of stroke:
  8. 8. Tests <ul><li>Computed Tomography (CT) </li></ul><ul><li>Magnetic Resonance Imaging (MRI) </li></ul><ul><li>Cerebral Angiography: identify responsible blood vessel </li></ul><ul><li>Electrocardiogram (ECG): underlying heart conditions </li></ul><ul><li>Echocardiogram: blood clot from heart </li></ul><ul><li>Carotid Duplex: carotid artery stenosis </li></ul><ul><li>Heart monitors, blood work and many more tests!! </li></ul>
  9. 9. Ischemic Stroke: <ul><li>A blood vessel becomes blocked and the blood supply to that part of your brain is blocked. </li></ul><ul><li>Types of Ischemic strokes: </li></ul><ul><ul><li>Thrombotic Stroke </li></ul></ul><ul><ul><li>Embolic Stroke </li></ul></ul>
  10. 10. Treatments <ul><li>Tissue plasminogen activator (tPA) can be given within three hours from the onset of symptoms. </li></ul><ul><li>In addition to being used to treat strokes, the following can also be used as preventative measures. </li></ul><ul><ul><li>Anticoagulants/Antiplatelets </li></ul></ul><ul><ul><li>Carotid Endarterectomy </li></ul></ul><ul><ul><li>Angioplasty/Stents </li></ul></ul>
  11. 11. Ischemic Stroke
  12. 12. CT MRI <ul><li> </li></ul>
  13. 13. Hemorrhagic Stroke: <ul><li>A small blood vessel in the brain becomes weak and ruptures. </li></ul><ul><li>Types of hemorrhagic stroke: </li></ul><ul><ul><li>Intracerebral hemorrhage (ICH) </li></ul></ul><ul><ul><li>Subarachnoid hemorrhage </li></ul></ul>
  14. 14. Treatment <ul><li>Surgery is often required to remove pooled blood from the brain and to repair damaged blood vessels. </li></ul><ul><li>Prevention: </li></ul><ul><li>An obstruction is introduced to prevent rupture and bleeding of aneurysms and arteriovenous malformations (AVM). </li></ul><ul><ul><li>Surgical Intervention </li></ul></ul><ul><ul><li>Endovascular Procedures </li></ul></ul>
  15. 15. Hemorrhagic Stroke
  16. 16. Transient Ischemic Attack (TIA) <ul><li>Blood supply to the brain is only briefly interrupted </li></ul><ul><li>Symptoms do not last long </li></ul><ul><li>Warning Stroke- steps should be taken to prevent future stroke. </li></ul>
  17. 17. RISKS <ul><li>TIA </li></ul><ul><li>CAD </li></ul><ul><li>High Blood Pressure </li></ul><ul><li>High Cholesterol </li></ul><ul><li>Smoking </li></ul><ul><li>Heart Disease </li></ul><ul><li>Diabetes </li></ul><ul><li>Excessive alcohol consumption </li></ul><ul><li>Family History </li></ul><ul><li>Age </li></ul><ul><li>Sex </li></ul><ul><li>Race </li></ul><ul><li>Obesity </li></ul>
  18. 18. Prevention <ul><li>Control high Blood Pressure </li></ul><ul><li>Lower cholesterol </li></ul><ul><li>Quit smoking </li></ul><ul><li>Control diabetes </li></ul><ul><li>Maintain healthy weight </li></ul><ul><li>Exercise </li></ul><ul><li>Manage stress </li></ul><ul><li>Eat a healthy diet </li></ul>
  19. 19. Prognosis <ul><li>The results of a stroke vary depending on the size and location, the presence of any associated medical problems, and the likelihood of recurring strokes. </li></ul><ul><li>Dysfunctions correspond to the area in the brain that had been damaged. </li></ul>
  20. 20. Nursing Management <ul><li>During the Acute phase, maintain a patent airway and oxygenation. </li></ul><ul><li>Watch out for ballooning of the cheek on the affected side with respiration. </li></ul><ul><li>If the patient is unconscious, position him on his side to allow secretions to drain and prevent aspiration. If necessary suction the secretions. </li></ul>
  21. 21. <ul><li>Maintain fluid and electrolyte balance. </li></ul><ul><li>Offer the urinal or bedpan every 2 hours. </li></ul><ul><li>Ensure adequate nutrition. </li></ul><ul><li>Manage GI problems. </li></ul><ul><li>Provide careful mouth care. </li></ul><ul><li>Provide meticulous eye care. </li></ul><ul><li>Position the patient and align his extremities correctly. </li></ul><ul><li>Assist the patient with exercise. </li></ul>
  22. 22. <ul><li>Give medications as ordered and watch for and report adverse reactions. </li></ul><ul><li>Establish and maintain communication with the patient. </li></ul><ul><li>Provide psychological support. </li></ul><ul><li>Protect from injury. </li></ul>