CEREBROVASCULAR ACCIDENT

1. CLASS ROOM PRESENTATION
-: PREPARED BY :-
MAJEVDIVALA OVESH F,
NURSING TUTOR,
GENERAL NURSING SCHOOL,
AMRELI.

2. CEREBROVASCULAR ACCIDENT

3. CENTRAL OBJECTIVE :
After completion of class presentation on cerebro-vascular
accident students will be able understand definition, causes,
pathophysiology, clinical manifestation, management and
complication of cerebrovascular accident.
SPECIFIC OBJECTIVES : After completion of class presentation on
cerebrovascular accident students will be able to:
1.Define meaning of cerebrovascular accident.
2.Explain the causes of stroke (cerebrovascular accident).
3.Explain the pathophysiology of cerebrovascular accident.
4.Identify the clinical manifestation of CVA.
5.Describe the management of patient with cerebrovascular
accident.
6.Identify the complication of cerebrovascular accident.
7.Summarize the important points of lesson learned.
8.Enhance critical thinking abilities by doing assignment given.

4. CEREBROVASCULAR ACCIDENT
DEFINITION:-
“ A stroke is an interruption of the blood supply to any part of
the brain resulting in a sudden loss of brain function. ’’
A stroke is sometimes called a “ brain attack "
•It occurs when blood flow to a part of the brain is suddenly stopped
and oxygen cannot get to that part.
•This lack of oxygen may damage or kill the brain cells.
•Death of a part of the brain may lead to loss of certain body
functions controlled by that affected part.

5. CAUSES OF CEREBROVASCULAR ACCIDENT
•Stroke may result from either interrupted
delivery of blood and oxygen to the brain
(ischemic stroke) or abnormal bleeding in the
brain (hemorrhagic stroke).
1. Transient Ischemic Attack (TIA):
2. Cerebral Thrombosis:
3. Cerebral Embolism:
4. Cerebral Hemorrhage:

6. 1. Transient Ischemic Attack (TIA):
•TIA or 'mini-stroke' is a short-term stroke that lasts for less
than 24 hours.
•The oxygen supply to the brain is quickly restored and
symptoms disappear.
•TIAs occur before almost 30% of ischemic strokes.
2. Cerebral Thrombosis:
•Cerebral thrombosis is when a blood clot (thrombus) forms
in an artery that supplies blood to the brain.
•The clot prevents blood flowing to the brain and cells are
starved of oxygen.

7. 3. Cerebral Embolism:
•Cerebral embolism is a blood clot that forms elsewhere in
the body before traveling through the blood vessels and
lodging in the brain.
•In the brain, it starves cells of oxygen.
4. Cerebral Hemorrhage:
•Cerebral hemorrhage is when a blood vessel bursts inside
the brain and bleeds (hemorrhages).
•This causing temporary or permanent loss of movement,
thought, memory, speech or sensation.
1.Epidural hemorrhage ( outside duramater )
2.Subdural hemorrhage ( between duramater & arachnoid
membrane )
3.Subarachnoid hemorrhage ( In the subarachnoid space )
4.Intracerebral hemorrhage ( into the brain substances )

8. PATHOPHYSIOLOGY :
HYPERTENTION
INCREASE INTRACRANIAL PRESSURE
HIGH B.P. IN CEREBRAL VESSELES
CEREBRAL VESSELES ARE BREACK DOWN
CEREBRAL HAMMORRHAGE
CEREBRAL HAEMATOMA
DUE TO THROMBUS & EMBOLI , ISCHEMIA TO PERTICULAR PART
AS PER AFFECTED AREA BRAIN FUNCTIONS DISTERBED

9. HEMIPARESIS, HEMIPLEGIA OCCURS
LOSS O COMMUNICATION FUNCTIONS, LOSS OF MOTOR FUNCTIONS
PERCEPTUAL DISTURBANCE, BLADDER DISFUNCTIONS,
…. ALL SINGS AND SYMPTOMS DEVELOPS
IF NOT TREATED PATIENT BECOME UNCONSCIOUS, AND COMA
DEATH

10. CLINICAL MANIFESTATIONS
•Hemiplegia ( paralysis of one side of the body )
•Hemiparesis ( weakness of one side of the body )
•Sensory Loss : impaired touch, pain, cold & hot.
•Motor Loss : Loss of voluntary control over motor movements.
•Communication Loss : Dysfunction of language &
communication.
•Aphasia : Defective speech or loss of speech.
•Alexia ( Dyslexia ) : Difficulty in reading.
•Ataxia : Difficulty in walking, Unsteady gait.
•Apraxia : Inability to perform a previously learned action.
•Agnosia : Failure to recognize familiar objects.
•Diplopia : Double vision.
•Dysphagia : Difficulty in swallowing.
•Difficulty in interprting : visual, tectile & auditory stimuli.

11. MANAGEMENT :-
1. MEDICAL MANAGEMENT :-
•Medical treatment of the patient with a stroke may include
Diuretics to reduce cerebral edema, which reaches maxi­
mum levels 3 to 5 days after cerebral infarction.
• Anticoagu-lants may be prescribed to prevent further
development or propagation of the thrombosis or
embolization from elsewhere in the cardiovascular system.
• Antiplatelet medi­cations may be prescribed because
platelets play a major role in thrombus formation and
embolization.

12. 2. SURGICAL MANAGEMENT
Plaque, a potential source of emboli in
stroke, is surgically removed from the carotid
artery.

13. NURSING MANAGEMENT :-
NURSING DIAGNOSIS
1. Ineffective cerebral tissue perfusion related to interruption
of blood flow secondary to CVA.
2. Impaired physical mobility related to neuromuscular
impairment secondary to CVA.
3. Risk for injury related to neurologic deficits.
4. Impaired verbal communication related to loss of facial or
oral muscle tone control.
5. Altered nutrition: Less than body requirement related to
impaired swallowing and chewing.
6. Self­Care Deficit: bathing/hygiene, grooming, feeding,
toileting related to stroke sequele.
7. Ineffective Coping related to situational crises,
vulnerability, cognitive perceptual changes.
8. Disturbed sensory perception: Tactile related to altered
sensory reception and transmission.

14. NURSING INTERVENTION :-
1. Give Lateral or semi prone position to prevent
tongue fall down.
2. Intubation and mechanical ventilation.
3. First clear the airway, breathing , and circulation
then start oxygen therapy 100 % 15 litre /minute.
4. Auscultation of chest for air entry every 8 hourly.
5. Suction: Remove mucus ,saliva , fluid and vomited
material from mouth.
6. Maintain fluid and nutritional balance.
Intravenous fluid & Blood transfusion if require .
7. Elevate the head of the bed to a 30 degree angle.

15. 8. NBM if patient is not able to eat or drink.
9. RYles tube feeding 200 ml every 2 hourly.
10. Oral hygiene (Mouth care).Maintain healthy oral
mucus membrane.
11. Maintain corneal integrity.
12. Preventing urinary retention by catheterization.
13. Promoting bowel function.
14. Change the position frequently (Two hourly).
15. maintain safety by providing side rails.
16. Promoting sensory stimulation by instructing
patient daily once about time,place and person.
17. Supporting the family.

16. COMPLICATIONS
1.Cerebral hypoxia is minimized by providing
ade­quate oxygenation of blood to the brain.
2.Cerebral blood flow is dependent upon the
blood pressure, cardiac output, and integrity of
cerebral blood vessels.
3. Cerebral embolism The embolus will
decrease blood flow into the brain and further
compromise cerebral blood flow..

17. -: SUMMARY :-
In the topic of “Cerebrovascular accident” we learned
the..
Definition
Causes
Pathophysiology
Clinical manifestation
Management
Complication

18. ANY QUERY??????????

19. ASSIGNMENT………
Write down any 5 cause and symptoms of CVA
& will be submitted to me on 20/02/18 at 4.00
pm..
You may refer Lippincot manual of nursing
practice or Textbook of Medical Surgical
nursing ­ brunner and suddarth.

20. THANK YOU
HOPE YOU ENJOY LEARNING TOGETHER.