CVA class teaching ,b,sc nsg

3. •
INTRODUCTION
Also called “brain attack”, cerebral infarction,
cerebral hemorrhage, ischemic stroke or stroke
A stroke, sometimes called a “brain attack,” occurs
when blood flow to the brain is interrupted.When a
stroke occurs, brain cells in the immediate area begin to
die because they stop getting the oxygen and nutrients
they need to function.

4. •DEFINITION
A stroke is caused by the interruption of the
blood supply to the brain, usually because a blood
vessel bursts or is blocked by a clot.This cuts off
the supply of oxygen and nutrients, causing
damage to the brain tissue.

5. •RISK FACTORS:
Being over age 55
Being an African-American
Having diabetes
 Having a family history of stroke
MEDICAL STROKE RISK
 Previous stroke
 Previous episode of transient ischemic attack (TIA) / ministroke
 High cholesterol
 High blood pressure
Heart disease
 LIFESTYLE STROKE RISK
Smoking Being overweight
Drinking too much alcohol.

6. TYPES

7. )
CVA
ISCHEMIC
STROKE
ATHEROSCLERO-
SIS
EMBOLIC
HEMORRHAGIC
STROKE
INTRACEREBRAL
HEMORRHAGE
(ICH)
SUBARACHNOID
HEMORRHAGE
(SAH)

9. •ISCHEMIC STROKE :-
•Occurs when a clot or a mass clogs a blood vessel,
cutting off the blood flow to brain cells. The underlying
condition for this type of obstruction is the development
of fatty deposits lining the vessel walls.
• This condition is called atherosclerosis.
• Almost 85% of strokes are ischemic

10. •ATHEROSCLEROSIS
•“hardening of the arteries”
• “athero” – gruel or paste
• “sclerosis” – hardness
• It’s the process in which deposits of fatty substances,
cholesterol, cellular waste products, calcium and other
substances build up in the inner lining of an artery. This
buildup is called plaque.
 Occurs when a blood vessel bleeds into the tissue
deep .

11. • HEMORRHAGIC STROKE
Results from a weakened vessel that ruptures and
bleeds into the surrounding brain.The blood
accumulates and compresses the surrounding
brain tissue. – About 15% of all strokes but
responsible for 30% of stroke deaths
INTRACEREBRAL HEMORRHAGE (ICH)
 SUBARACHNOID HEMORRHAGE (SAH)

12. INTRACEREBRAL HEMORRHAGE (ICH)
Occurs when a blood vessel bleeds into the tissue
deep within the brain.
SUBARACHNOID HEMORRHAGE (SAH)
Occurs when a blood vessel on the surface of the
brain ruptures and bleeds into the space between
the brain and the skull .

13. STAGES OF CVA
Transient Ischemic Attack
• sudden and short-lived attack
• Is a "mini stroke" that occurs when a blood clot blocks an
artery for a short time.
Reversible ischemic neurologic deficit (RIND)
similar toTIA, but symptoms can last up to a week
Stroke in evolution (SIE)
• Gradual worsening of symptoms of brain ischemia
Completed stroke (CS)
symptoms of stroke stable over a period and rehab can
begin

15. Signs &
Symptoms

17. DIAGNOSIS
• Physical Examination series of X-rays
•neurological examination
•medical history •CT scan and MRI

18. •ISCHEMIC STROKE

19. HEMORRHAGIC STROKE

20. MANAGMENT

21. Anticoagulants
warfarin
Antiplatelet medicines
Aspirin
ANTI-HYPERTENSIVE
Angiotensin II receptor blockers (ARB
Angiotensin-converting enzyme (ACE) inhibitors
Beta-blockers
Calcium channel blockers.
Diuretics
Antidepressants
bupropion (Wellbutrin)
fluoxetine (Prozac)
Anticonvulsants
Diazepam
Lorazepam
Clopidogrel

22. SURGICAL MANAGEMENT
Cerebral revascularization
Mechanical embolectomy

23. NURSING
MANAGMENT

24. Ineffective Tissue Perfusion related to
Interruption of blood flow evidenced by
Changes in vital signs .
Impaired Physical Mobility related to
cognitive impairment AS evidenced by
decreased muscle strength/control.
Impaired Verbal Communication related
to loss of facial/oral muscle tone/control
evidenced by Inability to modulate speech,

25. Disturbed Sensory Perception related to
Altered sensory reception evidenced
by altered thought processes /bizarre
thinking
Ineffective Coping related to Situational
crises evidenced by Inappropriate use of
defense mechanisms

31. Mechanical embolectomy