A stroke occurs when blood flow to the brain is interrupted, depriving brain cells of oxygen and nutrients. There are two main types of strokes: ischemic, caused by a blockage in an artery, and hemorrhagic, caused by a ruptured blood vessel. The brain is divided into left and right hemispheres that control opposite sides of the body and have distinct functions like language processing and spatial awareness. Nursing interventions for stroke patients focus on monitoring vital signs, neurostatus, preventing injury, and managing medications or treatments like tPA to reduce disability from the stroke.

1. Cerebrovascular
Accident(CVA) stroke
Muhammed Muhsin K K
Senior Staff Nurse (Neuro I C U)
AMRI HOSPITALS BHUBANESHWAR

2. WHAT IS STROKE ?
 It is a condition that develops when blood rich in oxygen can NOT reach brain
cells (due to either a blockage or bleeding).This causes the brain cells to
die
 Types of Strokes

3. Happens Due to:
Embolism : a clot has left a part of
the body (example of heart: heart
valve problem or atrial fibrillation)
and travelled to the brain ,which
stops blood flow.
Thrombosis: Clot within the artery
wall within the neck or brain….
seen patients with hyper lipidemia
or atherosclerosis

4. Happens Due to:
Bleeding in the brain due to a
break in blood vessel.
Leads to no blood to perfuse the
brain cells and excessive swelling
from the leakage of blood in the
brain.
Cause : a brain aneurysm bursts
,uncontrolled hypertension, old
age (vessels are NOT as resilient

5. BRAIN”S Functions & Anatomy
Blood supply to the brain
Carotid and vertebral arteries

6. Functions Of The Different Lobes Of The
Brain

7. creativity logical

8. Right Side
• Attention span
• Showing emotions
• Ability to solve everyday problems
by making decisions /plan
• Reasoning (understanding jokes
...reading in between the lines)
• Making judgment calls
• Memory recall
• Music/art awareness
• Controls the left side of the body

9. Left Side
• Speaking
• Writing
• Reading
• Math skills
• Analyzing info
• planning

10. Right Brain Injury
Findings:
 Left side weakness: Hemiplegia
 Impairment of creativity
 Confused on date , time, place
 Cannot recognize faces or the
person’s name
 Loss of depth perception
 Trouble saying on topic when
talking
Left Brain Injury
Findings:
 Right side Hemiplegia
 Aphasia (trouble formulating
words
 Aware of their
limits…..experience
depression, anger ,frustration
 Trouble understanding written
text
 Issue in writing (agraphia)
 Issue with seeing right side

11. Risk factors

12. Recognize the signs of a stroke

14. Stroke Algorithm(AHA 2015)

15. If yes
tPA (tissue plasminogen Activator)
For ischemic stroke within 3hours from onset of sign and
symptoms
If negative
Labs value normal limit
BP controlled
Recently received
Administer heparin or other anti coagulants

16. Nursing interventions for tPA
 Check for bleeding
 Neurochecks around the clock
 Blood pressure medications if needed for hypertension
 Vital signs
 Labs values
 Glucose monitoring
 Preventing injury
 Avoid unnecessary venepunctures

17. Nursing interventions for stroke
 Monitor Vital Signs And Neurostatus:
 Blood Pressure (Notify RMO If Hypertensive)
 Airway (Difficulty Swallowing HOB 30
 Turn Every 2hours With Proper Alignement
 watch For Increased ICP
 Headache , nausea , vomiting Hypertension ,bradycardia ,
bradypnea,
 Low GCS And Pupils Reactions