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CEREBROVASCULAR ACCIDENT
.
INTRODUCTION
Cerebrovascular accident is the medical term for a
stroke is when blood flow to a part of your brain is
stopped either by a blockage or the rupture of a
blood vessel. There are important signs of a stroke
that you should be aware of and watch out for.
INCIDENTS:
Ages affected:
1. Babies (0-2) years : rare
2. Toddlers (3-5) years : very rare
3. Children (6-13) years: Very rare
4. Teenagers(13-18) years: very rare
5. Young adults(19-23) years : rare
6. Adults ( 41-60) years: common
7. Seniors ( 60+years) : common
Conti......
Every year, more than 7,95,000 people in the
United States have a stroke. About 6,10,000 of these are
first or new strokes. About 18,500 strokes – nearly 1 of 4-
are in people Who have had a previous stroke. Above
87℅of all strokes are ischemic stroke, In which blood flow
to the brain is blocked.
AIMS:
1.Definie a stroke
2.Distinguish between types
3.Explain what goes to wrong
DEFINITION
Cerebrovascular accident: The sudden death of some
brain cells due to lack of oxygen when the blood flow to
the brain is Impaired by blockage or ruptured of an
artery to the brain. A CVA is also referee to as astroke.
STROKE:
A stroke is an acute neurological deficit,
Lasting longer than24 hours.
A transient ischemic attack is an acute
neurological deficit, lasting less than 24
hours
EFFECTS OF STROKE
How much of the brain tissue is affected also determine
the severity of the stroke.
1. Left brain
° paralysis or muscle weekness on the right side of
the body.
° speed/ language problem
° memory loss
° slow cautious behavioral style.
2. Right side of the brain
~ Paralysis or muscle weekness of the right
side of the brain
~ Vision problem
~ Quick behavior style
~ memory loss
TYPES OF STROKE:
1.Ischemic stroke
2.Hemorrhagic stroke
3.Transient ischemic attack
4.Cryptogrnic Stroke
ISCHEMICSTROKE
Ischemic stroke (clots): occurs when a blood
vessel supplying blood to the brain Is
obstructed....
HEMORRHAGIC STROKE
Hemorrhagic stroke(bleeds) occurs when
a weekend blood vessel are ruptures....
Hemorrhagic stroke classified in to two
types:
1. Intracerebral hemorrhage
2. Subarachnoid hemorrhage
hemorrhagic stroke occurs when a
weekend blood vessel rupures. The two
types of weekend blood vessel Cause
hemorrhagic stroke
• Aneurysms
• Arteriovenous malformations (AVMs).
TRANSIENT ISCHEMIC ATTACK
TIAs or minor strokes are same as for major Stroke
but they May last for only a few minutes.
They include anyone or combination of following:
sudden numbness or weakness in face, arms or legs
especially on one side of the body. Sudden trouble
speaking or understanding.
CRYPTOGENIC STROKE
Cryptogenic stroke is defined as an ischemic stroke
that is not attributable to a source of definite
cardioembolism, large artery atherosclerosis, or
small artery disease, despite extensive vascular,
cardiac, and serology evaluation.
SOME OF THE MOST IMPORTANT TREATABLE RISK
FACTORS FOR STROKE ARE:
• High blood pressure or hypertension. Hypertension
is by far the most potent risk factor for stroke.
• Cigarette smoking.....
• Heart disease........
• Warning signs or history of TIA or stroke....
• Diabetes.....
• Cholesterol imbalance.......
• physical inactivity and obesity.....
• Increasing age......
WARNING SIGNS
1.Numbness or weakness in the face, arms or legs,
located on one side of the body........
2.Confusion or trouble understanding........
3.Trouble seeing in one or both eyes.........
4. Sudden dizziness, trouble walking, Loss of
balance or coordination.....
5.Sudden and headache with no obvious cause........
CAUSES:
Chief causes:
1. Thrombosis
2. Heart emboli
3.Atherothromboembolism
4.CNS bleed ( hypertension., trauma, Aneurysm
Rupture).
HOW WOULD YOU KNOW SOMEONE IS HAVING A STROKE:
FAST
• Face
• Arms
• Speech
• Time
OTHER SYMPTOMS:
1.Difficulty swallowing
2.Excessive drooling
3.Choking
4.Difficulty walking
5.Change in vision
6.Eyes fail to move in unison
7.Difficulty with balance
8.Loss of co-ordination
9.Clumsiness
LESS COMMON SYMPTOMS:
1.Headache
2.Dizziness
3.Excessive sleepiness
4.Excessive sslaivation
5.Drooping eye lid
6.Trismus (cannot open mouth)
7.Vertigo
8.Urinary incontinence
CONTINUE.........
9. Memory loss
10. Confusion
11. Delusion
12. Coma
13.Impotence
14. Generalized weekness
15. Fatigue
DIAGNOSTIC EVALUATION
• Baselines : bleeding and clotting time, ESR
• Random glucose: Do they have hyperglycemia
(or) hypoglycemia diabetes????
• Lipid profile : Do they have hyperlipidaemia
• Hyperhomocysteinaemia???
• Hyper viscosity – Polycythaemia???
• Infection : vasculitis???
• Prothrombotic states: Thrombophilia ( blood
clotting disorder)
CONTINUE........
• Physical examination
• Cranial nerve examination
• Neurological examination
CRANIAL NERVE EXAMINATION:
NEUROLOGICAL EXAMINATION:
NURSING CARE INTERVENTION:
1.Motor and functional rehabilitation
2.Medication administration
3.Monitoring of physiological functions
4.Planning for patient discharge
5.Emotional care
6.Skin care
CONTINUE.....
7. Care of prevent complication and trauma
8. Emergency screening
9. Assessment of clinical & neurological elements
10. Care related to self care activities
11. Urinary catheter
12. Nasal oxygen administration
CONTINUE....
13. Oral care
14. Correct positioning of patient in the bed
15. Aspiration prevention care
16. Back massage
17. Right down patient weight
18. Register start time of the symptoms
19. Urinary catheter
NURSING MANAGEMENT
Assess the level of consciousness or responsiveness
as evidenced by movement resistance to changes of
position & response to stimulation oriented to time
place & person.
presence or absence of voluntary or involuntary
movements of the extremities muscle tone body
posture and position of the head.
CONTINUE...........
3. Stiffness or flacidity of the neck
4. Eye opening comparative size of pupils &
Pupillary reactions to light & occular position.
5. Airway management/ ventilator management
6. Assessment and evaluation of neurologic status
to detect patient deterioration.
7. Blood pressure management
8. General supportive care and prevention of
complications like:
• Dysphagia
• Hypertension
• Hyperglycemia
• Dehydration
• Malnurishment
• Fever / fever
• Cerebral edema
• DVT / immobility
• Fall / skin care
• Bowel and bladder dysfunction.
MEDICAL MANAGEMENT
1. Platelet inhibiting medications: aspirin,
Cloopidogrel.
2. Anti thrombolytic : Aspirine 160 to 325 mg
within 48 hours.
3. High dose statin : Atorvastatin 80 mg.
4. Anti coagulation only in cardio embolism stroke.
COMPLICATIONS
• Hyperglycemia
• Hypertension
• Fever
• Infarct extension or bleed
• Cerebral edema
• Herniation
CONTINUE.......
• Coning
• Aspiration
• Pneumonia
• Urinary tract infection
• Cardiac dysarrthmias
• Deep vein thrombosis
• Pulmonary Embolism
COMPLICATION DUE TO IMMOBILITY
• Pressure sores
• DVT / PE
• Painful shoulder
• UTI / Constipation
• Drpression & anxiety
abi.pptx

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abi.pptx

  • 1.
  • 3. INTRODUCTION Cerebrovascular accident is the medical term for a stroke is when blood flow to a part of your brain is stopped either by a blockage or the rupture of a blood vessel. There are important signs of a stroke that you should be aware of and watch out for.
  • 4. INCIDENTS: Ages affected: 1. Babies (0-2) years : rare 2. Toddlers (3-5) years : very rare 3. Children (6-13) years: Very rare 4. Teenagers(13-18) years: very rare 5. Young adults(19-23) years : rare 6. Adults ( 41-60) years: common 7. Seniors ( 60+years) : common
  • 5. Conti...... Every year, more than 7,95,000 people in the United States have a stroke. About 6,10,000 of these are first or new strokes. About 18,500 strokes – nearly 1 of 4- are in people Who have had a previous stroke. Above 87℅of all strokes are ischemic stroke, In which blood flow to the brain is blocked.
  • 6. AIMS: 1.Definie a stroke 2.Distinguish between types 3.Explain what goes to wrong
  • 7. DEFINITION Cerebrovascular accident: The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is Impaired by blockage or ruptured of an artery to the brain. A CVA is also referee to as astroke.
  • 8. STROKE: A stroke is an acute neurological deficit, Lasting longer than24 hours. A transient ischemic attack is an acute neurological deficit, lasting less than 24 hours
  • 9. EFFECTS OF STROKE How much of the brain tissue is affected also determine the severity of the stroke. 1. Left brain ° paralysis or muscle weekness on the right side of the body. ° speed/ language problem ° memory loss ° slow cautious behavioral style.
  • 10. 2. Right side of the brain ~ Paralysis or muscle weekness of the right side of the brain ~ Vision problem ~ Quick behavior style ~ memory loss
  • 11. TYPES OF STROKE: 1.Ischemic stroke 2.Hemorrhagic stroke 3.Transient ischemic attack 4.Cryptogrnic Stroke
  • 12. ISCHEMICSTROKE Ischemic stroke (clots): occurs when a blood vessel supplying blood to the brain Is obstructed....
  • 13. HEMORRHAGIC STROKE Hemorrhagic stroke(bleeds) occurs when a weekend blood vessel are ruptures....
  • 14. Hemorrhagic stroke classified in to two types: 1. Intracerebral hemorrhage 2. Subarachnoid hemorrhage hemorrhagic stroke occurs when a weekend blood vessel rupures. The two types of weekend blood vessel Cause hemorrhagic stroke • Aneurysms • Arteriovenous malformations (AVMs).
  • 15. TRANSIENT ISCHEMIC ATTACK TIAs or minor strokes are same as for major Stroke but they May last for only a few minutes. They include anyone or combination of following: sudden numbness or weakness in face, arms or legs especially on one side of the body. Sudden trouble speaking or understanding.
  • 16. CRYPTOGENIC STROKE Cryptogenic stroke is defined as an ischemic stroke that is not attributable to a source of definite cardioembolism, large artery atherosclerosis, or small artery disease, despite extensive vascular, cardiac, and serology evaluation.
  • 17. SOME OF THE MOST IMPORTANT TREATABLE RISK FACTORS FOR STROKE ARE: • High blood pressure or hypertension. Hypertension is by far the most potent risk factor for stroke. • Cigarette smoking..... • Heart disease........ • Warning signs or history of TIA or stroke.... • Diabetes..... • Cholesterol imbalance....... • physical inactivity and obesity..... • Increasing age......
  • 18. WARNING SIGNS 1.Numbness or weakness in the face, arms or legs, located on one side of the body........ 2.Confusion or trouble understanding........ 3.Trouble seeing in one or both eyes......... 4. Sudden dizziness, trouble walking, Loss of balance or coordination..... 5.Sudden and headache with no obvious cause........
  • 19. CAUSES: Chief causes: 1. Thrombosis 2. Heart emboli 3.Atherothromboembolism 4.CNS bleed ( hypertension., trauma, Aneurysm Rupture).
  • 20. HOW WOULD YOU KNOW SOMEONE IS HAVING A STROKE: FAST • Face • Arms • Speech • Time
  • 21. OTHER SYMPTOMS: 1.Difficulty swallowing 2.Excessive drooling 3.Choking 4.Difficulty walking 5.Change in vision 6.Eyes fail to move in unison 7.Difficulty with balance 8.Loss of co-ordination 9.Clumsiness
  • 22. LESS COMMON SYMPTOMS: 1.Headache 2.Dizziness 3.Excessive sleepiness 4.Excessive sslaivation 5.Drooping eye lid 6.Trismus (cannot open mouth) 7.Vertigo 8.Urinary incontinence
  • 23. CONTINUE......... 9. Memory loss 10. Confusion 11. Delusion 12. Coma 13.Impotence 14. Generalized weekness 15. Fatigue
  • 24. DIAGNOSTIC EVALUATION • Baselines : bleeding and clotting time, ESR • Random glucose: Do they have hyperglycemia (or) hypoglycemia diabetes???? • Lipid profile : Do they have hyperlipidaemia • Hyperhomocysteinaemia??? • Hyper viscosity – Polycythaemia??? • Infection : vasculitis??? • Prothrombotic states: Thrombophilia ( blood clotting disorder)
  • 25. CONTINUE........ • Physical examination • Cranial nerve examination • Neurological examination
  • 28. NURSING CARE INTERVENTION: 1.Motor and functional rehabilitation 2.Medication administration 3.Monitoring of physiological functions 4.Planning for patient discharge 5.Emotional care 6.Skin care
  • 29. CONTINUE..... 7. Care of prevent complication and trauma 8. Emergency screening 9. Assessment of clinical & neurological elements 10. Care related to self care activities 11. Urinary catheter 12. Nasal oxygen administration
  • 30. CONTINUE.... 13. Oral care 14. Correct positioning of patient in the bed 15. Aspiration prevention care 16. Back massage 17. Right down patient weight 18. Register start time of the symptoms 19. Urinary catheter
  • 31. NURSING MANAGEMENT Assess the level of consciousness or responsiveness as evidenced by movement resistance to changes of position & response to stimulation oriented to time place & person. presence or absence of voluntary or involuntary movements of the extremities muscle tone body posture and position of the head.
  • 32. CONTINUE........... 3. Stiffness or flacidity of the neck 4. Eye opening comparative size of pupils & Pupillary reactions to light & occular position. 5. Airway management/ ventilator management 6. Assessment and evaluation of neurologic status to detect patient deterioration. 7. Blood pressure management 8. General supportive care and prevention of complications like:
  • 33. • Dysphagia • Hypertension • Hyperglycemia • Dehydration • Malnurishment • Fever / fever • Cerebral edema • DVT / immobility • Fall / skin care • Bowel and bladder dysfunction.
  • 34. MEDICAL MANAGEMENT 1. Platelet inhibiting medications: aspirin, Cloopidogrel. 2. Anti thrombolytic : Aspirine 160 to 325 mg within 48 hours. 3. High dose statin : Atorvastatin 80 mg. 4. Anti coagulation only in cardio embolism stroke.
  • 35. COMPLICATIONS • Hyperglycemia • Hypertension • Fever • Infarct extension or bleed • Cerebral edema • Herniation
  • 36. CONTINUE....... • Coning • Aspiration • Pneumonia • Urinary tract infection • Cardiac dysarrthmias • Deep vein thrombosis • Pulmonary Embolism
  • 37. COMPLICATION DUE TO IMMOBILITY • Pressure sores • DVT / PE • Painful shoulder • UTI / Constipation • Drpression & anxiety