HEY THIS IS STROKE FROM COMMUNITY

2. “STROKE”
CASE PRESENTATION FOR
COMMUNITY HEALTH NURSING
GROUP 1

3. Presented by:
ALAMILLO, DEMARK
BANGI-AN, RHEA
CAJILIG, NICE
CASTROMAYOR, JEAN
DACLES, JOANNA MARIE
GONZALES, MARK JOSEPH
GUZMAN, BLESSY
HOSEÑA, KATHEA
MALABOSA, MICHELLE
PALMA, JIM CLARENCE
PALO, ROSS CHITO
PERASOL, KRYZL MARIE
VERTUDAZO, DASHIEL ROXETTE

4. According to the World Health Organization (WHO), stroke is responsible for
approximately 11% of all deaths globally, making it the second leading cause of death
after coronary heart disease.
According to a study published in The Lancet (2021), the global age-standardized
incidence rate of stroke in 2020 was 74.9% per 100,000 person-years. The highest
incidence rates were observed in East Asia and Southeast Asia, while the lowest rates
were observed in Western Europe and North America.
Introduction
Demark Alamillo
REPORTER

5. BAB II
BAB III
BAB IV
BAB V
According to a study published in the International Journal of Stroke (2020),
the age-adjusted prevalence of stroke in the Philippines was 0.8% in 2020. There
were approximately 843,000 stroke survivors in the country in 2020.
According to the study published in the International Journal of Stroke in
2020, the prevalence of stroke was highest in the Manila (1.2%), followed by the
Ilocos Region (1.1%) and Central Visayas (1.0%).
Introduction
Demark Alamillo
REPORTER

6. Introduction
Demark Alamillo
REPORTER
In local statistics, there has been newly identified hypertensive adults
within 20 years of age and older gathered: 1,366 females and 985 males,
for a total of 2,351 cases in 2022. The prevalence rate of hypertension in
the year 2022 was 0.10% out of 21, 569 total population within the
vicinity.

7. OBJECTIVES
A. General Objectives:
Within three days of our rotational duty, our fundamental goal for
this study is to identify health problems or potential threats that could
arise to our patients and to properly give immediate nursing
intervention prior to the Barangay Health Center.

8. OBJECTIVES
B. Specific Objectives
Upon the completion of this study, the student nurses will be
able to:
a. Knowledge
 Define the complete diagnosis of the patient’s condition;
 Comprehend the effect of poor sanitation/hygiene/lifestyle to
their health and well-being;
 Determine family’s coping index in assessing the functioning and
potential areas of the family strength and resources;

9. OBJECTIVES
 Apply knowledge and skills on how to give health education to the
community in relation to their identified problem;
 Gather information about the barangay profile;
 Gather the biographical data of the patient;
 Gather information about the family’s past and present illnesses,
medical history, family history, and personal/social history;
 Review the anatomical and physiological landmarks involved with
the patient’s condition;

10. OBJECTIVES
 Identify the etiology and symptomatology of the problem;
 Trace down the pathophysiology of the disease;
 Relate the medication taken by the patient to their illness; and
 Formulate a family nursing care plan;
B: Skills
 Demonstrate proper measures of cleaning the environment;
 Perform a complete physical assessment (in a cephalocaudal format), and determine the
complaints of the patient;
 Provide the best quality of care along with the principles of nurse-to-patient relationship;

11. OBJECTIVES
 Conduct health teachings to the family to promote health and
prevent diseases that can be acquired on daily lifestyle.
 Render effective independent nursing interventions to minimize or
reduce possible health risks.
 Generate recommendation that focuses on the care for the family
and patient with Stroke, and how it can be attain and maintain
optimum quality of life; and
 Present summary, evaluation to the family with implications to the
study

12. BARANGAY PROFILE
Historical Population
The population of Barangay Visayan Village in
Tagum City has increased from 14, 746 in the year
1990 to 45,342 in the current year. This represents a
substantial population change of 56.6% over the
period. The barangay experiences an annual
population change of 1.1%.

13. Table 1: Historical Population of Barangay Visayan
Village, Tagum City from 1990 – 2023
Date Population Growth Rate
1990 May 1 14,726 -
1995 Sep 1 23,939 9.53%
2000 May 1 28,932 4.15%
2007 Aug 1 30,756 0.85%
2010 May 1 35,323 5.17%
2015 Aug 1 40,297 2.54%
2020 May 1 42,648 1.20%
2023 March 28 45,324 1.10%

14. Figure 1: Historical Population of Visayan Village, Tagum
City from 2000 – 2023

15. REPORTER

16. REPORTER

17. REPORTER
• The Barangay Visayan Village is the largest barangay out of
23 barangays that Tagum City has. It has a total land area of
153,943.75 sq. m. and a population of 45,342.
• They are estimated to have 9,435 households with an
average household size of 4.24.

18. BAB I BAB II
REPORTER
AGE GROUP POPULATION AGE GROUP PERCENTAGE
Under 1 779 1.93%
1 to 4 3,137 7.78%
5 to 9 3,823 9.49%
15 to 19 4,168 10.34%
20 to 24 4,235 10.51%
25 to 29 3,701 9.18%
30 to 34 3,111 7.72%
35 to 39 2,900 7.20%
40 to 44 2,396 5.95%
45 to 49 2,123 5.27%
50 to 54 1,800 4.47%
55 to 59 1,493 3.70%
60 to 64 1,233 3.06%
65 to 69 757 1.88%
70 to 74 448 1.11%
75 to 79 271 0.67%
80 and over 251 0.62%
Total 45, 324 100.00%

19. BAB I BAB II
• The barangay currently faces various health issues, with the most common diseases being animal bites,
coughs and colds, hypertension, and type 2 diabetes mellitus.
• The barangay health center receives 10 to 15 patients daily seeking medical attention
• Animal bites having the highest incidence rate of 5 to 8 patients per day,
• Coughs and colds having an estimated rate of 1 to 2 patients per day.
• There has been 2,351 newly identified hypertensive cases were reported among adults aged 20 years and
above, with 1,366 cases in females and 985 cases in males.
• A total of 221 newly identified cases of type 2 diabetes mellitus were reported, with 104 cases in males and 117
cases in females.

20. BAB I BAB II
BAB III
BAB IV
BAB V
Table 3: The top four disease confronting Barangay Visayan
Village.
Case Total Number of Cases
Annually
Animal Bites 9,467
Coughs and Colds 2,400
Hypertension 2,351
Diabetes Mellitus 221

21. Table 4: Programs and Services Offered in the Barangay
Health Center
NUTRITION PROGRAM
Operation Timbang
Vitamin A Supplementation
Deworming
Feeding
CONTROL OF ACUTE RESPIRATORY INFECTION PROGRAM
CONTROL OF DIARRHEA DISEASE PROGRAM
CARDIOVASCULAR DISEASE CONTROL PROGRAM
BP Taking and Monitoring
RABIES CONTROL PROGRAM
CANCER CONTROL PROGRAM
Breast Examination
Pap Smear
TUBERCULOSIS PROGRAM
Sputum Examination

22. Barangay Organizational Chart
Barangay Organizational Chart
Alfredo B. De Veyra Jr.
Barangay Chairman
Barangay Council
Kelly G. Coquilla Kheen V. Batingal Catherine S. Elioy-
Paguio
Richard O. Orongan Jesus V. Parcon Melvin D. Lemos Carmelita S. Malacaste
Rogelio A. Sanchez, Jr.
Barangay Secretary
Lenyln M. Pagay
Barangay Treasurer
Liezel Mae Cajes
SK- Chairman

23. MEMBER OF THE HOUSEHOLD RELATIONSHIP TO THE HEAD OF
THE FAMILY
Mr. J Father
Mrs. J Mother
FAMILY DATA
I. FAMILY STRUCTURE, CHARACTERISTICS and DYNAMICS
A. Member of the Household and Relationship to the head of the
Family

24. MEMBER
OF THE
HOUSEHO
LD
BIRTHDAY AGE SEX CIVIL
STATUS
POSITION
IN THE
FAMILY
Mr. J February
11, 1961
62 Male Married Father
Mrs. J July 23,
1958
64 Female Married Mother
MEMBER OF THE HOUSEHOLD PLACE OF RESIDENCE
Mr. J Purok White Dove, Visayan Village,
Tagum City, Davao del Norte
Mrs. J Purok White Dove, Visayan Village,
Tagum City, Davao del Norte
B. Demographic Data
C. Place of residence of each member

25. D. Type of Family Structures
I. Empty Nest (according to membership)
The J family is an empty nest type of family because their children have grown up and
left the home to pursue their own lives, leaving only the two of them.
II. Patriarchal (according to authority)
The J family is a patriarchal family. The husband is the one who makes decisions for the
family and at the same time the head of the family.
E. Dominant family members in terms of decision-making.
The husband is the one who decides what’s best for the family.
F. General Family Relationship/dynamics
Mr. J is the type of person that is kind and joyful and while Mrs. J is lovable. In terms
of their family relationship, Mr. and Mrs. J have a great bond with each other

26. ACTIVITIES OF DAILY LIVING
A. Sleeping patterns and daily activities.
Mrs. J always goes to bed at 5:00 p.m. and wakes up at 8 a.m. Every day, she just
sits inside the house doing nothing due to her stroke. Mr. J has a problem in sleeping. He
goes to sleep at 7 p.m., but when he wakes up at midnight, he can't get back to sleep.
B. Eating Patterns
Mr. and Mrs. J only drink milk during breakfast, but sometimes they also eat rice with
no side dish. During lunch, they eat rice together with fried fish or eggs. For dinner, they eat
rice with vegetables and fruits. Their meals are prepared by the husband, but sometimes their
grandchildren bring them food.
C. Leisure time
During free time, Mr. J rides his bicycle while Mrs. J just stays in the house.

27. II. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS
A. Income and Expenses
MEMBER OF
THE
HOUSEHOLD
POSITION IN THE
FAMILY
OCCUPATION INCOME PLACE OF
WORK
Mr. J Father Garbage Collector P2,000/m (not
stable)
Purok White
Dove, Visayan
Village, Tagum
City, Davao del
Norte
Mrs. J Mother Housewife None None
MONTHLY EXPENDITURE AMOUNT
Foods 800
Drinking Water 400

28. B. Educational Attainment, Religious Affiliation, and
Cultural Factors of the Family
NAME OF
THE FAMILY
MEMBERS
POSITION IN
THE FAMILY
EDUCATIONAL
ATTAINMENT
SCHOOL ETHNIC
BACKGROUND
RELIGION
Mr. J Father Elementary
Undergraduate
Bincungan Elem.
School
Ilocano Roman
Catholic
Mrs. J Mother Elementary
Undergraduate
Asuncion Elem.
School
Cebuano Roman
Catholic

29. C. Relationship of the Family to Larger
Communities – Nature and extent of participation
of the family in community activities.
The J family does not participate in any types of
community activities due to their age and Mrs. J’s
condition. They also verbalized that they are not
interested in these types of community activities.

30. III. HOME ENVIRONMENT
They reside in a small wooden house where the living room, kitchen, and
bedroom are combined into one space, offering very little privacy. Moreover, Mr.
and Mrs. J share the floor space to sleep since they don't have a bed, which can
be uncomfortable and may affect their quality of sleep.
The laundry area outside the house and garbage cans attract vectors of
disease, such as flies, mosquitoes, and roaches, which can lead to the spread of
various illnesses. Additionally, the presence of scattered sharp metal objects
outside the house poses a risk of injury to the family members.
Without a refrigerator, the J family is limited in storing their food in closed-door
cabinets, which may not be enough to keep their food fresh and safe for
consumption. They rely on distilled water bought from water refilling stations for
drinking as the water from their deep well is not suitable for consumption.

31. Their bathroom and toilet are located at their grandchildren's house,
which is not very convenient, and they don't have their own sanitation
facilities. Moreover, their garbage cans are not properly segregated, and
their canal drainage system has poor sanitary conditions.
The J family's neighborhood is congested, with no space for trees and
plants to grow, and scattered scraps on the ground make it challenging to
hang out or play. Despite this, they are fortunate to have access to the
Tagum Mission Hospital and Barangay Visayan Village Health Center for
medical care.

32. IV. HEALTH STATUS OF EACH FAMILY MEMBERS
A. Medical Nursing History
MEMBERS OF THE
HOUSEHOLD
MEDICAL AND NURSING
HISTORY
Mr. J Ulcer Disease
Mrs. J Stroke
B. Nutritional Assessment
NAME AGE WEIGHT HEIGHT BMI
Mr. J 62 114 pounds 5’3 20.2
(Normal)
Mrs. J 64 118 pounds 4’5 29.5
(Overweight)
NAME DIETARY HISTORY EATING HABITS AND
PRACTICES
Mr. J 3x a day Rice, Milk, Egg,
Fish(sometimes), and
Vegetables
Mrs. J 3x a day Rice, Milk, Egg,
Fish(sometimes), and
Vegetables

33. V. Value, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
MEMBER OF THE HOUSEHOLD IMMUNIZATION STATUS OF THE FAMILY
MEMBERS
HEALTHY LIFESTYLE PRACTICES
Mr. J No Data Biking on free time and Walking
Mrs. J No Data -
Adequacy of:
MEMBER OF THE
HOUSEHOLD
REST/SLEEP EXERCISES/
ACTIVITIES
USE OF PROTECTIVE
MEASURES
RELAXATION AND OTHER
STRESS MANAGEMENT
ACTIVITIES
Mr. J 5 – 6 hours 1 hour Uses a cap outside the
house
Riding on his bicycle
Mrs. J 8 – 10 hours N/A N/A Rest and eat

34. FAMILY GENOGRAM
Son Son Daughter Daughter
Husband
Patient
Mother
Grandparents (Maternal) Grandparents (Paternal)
Unknown cause of death
Father
Male
Female
Male (Deceased)
Female (Deceased)
Patient

35. PhilPEN Risk Assessment and Screening Form
DATE: __03-04-23_________________
NAME: Ms. J
Gender: Female
FAMILY HISTORY (Have 1st degree relative with)
Hypertension
Asthma
Stroke (RIGHT LOWER LEG)
Cancer Heart Attack
Kidney Disease Diabetes
LIFESTYLE RISK FACTORS
Smoking (Tobacco/Cigarette)
Current Smoker
Stopped less than 1 year Stopped > a year
Passive Smoker Never smoked
Harmful Use of Alcohol
Never consumed
Yes, drinks alcohol
Had 5 drinks in 1 occasion in the past month
Unhealthy Eating
Eats processed/fast food (eg. Instant noodles,
hamburgers, fries, fried chicken skin etc.)
and ihaw-ihaw (eg. Isaw, adidas, etc.) weekly
Eats less than 3 servings of vegetables daily
Eats less than 2-3 servings of fruit per day
Lack of Physical Activity
Does less than 2.5 hours a week of moderate
intensity physical activity
(Because of her stroke she can't move her body that
much. She urinate on a urinal with the help of her
husband as evidence)
ANTHROPOMETRIC MEASUREMENTS
Waist Circumference: ___78 centimeters
Height: ___4'5inch 1.34 meter
Weight: ____118 pounds 53 kg
Body Mass Index (BMI) (follow the formula below using
your measurements above)
Weight = 53kg X 1.34 (2) =
Height x Height
DIAGNOSED WITH HYPERTENSION? YES NO
Taking Medications? YES NO
Specify Medicines: AMLODIPINE (5mg OD)
Blood pressure measurement:
Arm 1st
Take 2nd
Take Average
Right 130/80 130/80 130/80
Left 130/80 130/80 130/80
DIAGNOSED WITH DIABETES? YES NO Taking
medications? YES NO
Specify Medicine: _______________________________ IF
NOTE DIAGNOSED. Do you have the ff. symptoms?
Polyphagia (gutomon kanunay)
Polydipsia (uhawon kanunay)
Polyuria (sige ug ihi-ihi)
BLOOD SUGAR:
FBS ______mmol/L or RBS ______mmol/L
OTHER BIOCHEMICAL TESTS:
• Total Cholesterol: _______________mmol/L
Here are the interpretation of results and
recommendation of your screening / monitoring:
LIFESTYLE RISK FACTORS
o Smoking - Quit smoking/encourage other to quit
smoking. Go to the nearest smoking cessation clinic.
o Harmful Use of Alcohol - drink alcohol in
moderation
o Unhealthy Eating - start eating healthy- consult
your nutritionist or ask your health care team
o () Lack of Physical Activity - Increase your
physical activity
WAIST CIRCUMFERENCE
() FEMALE: 80cm or below or MALE: 90cm or below -
NORMAL continue screening once a year
FEMALE: more than 80cm or MALE: more than 90cm
- AT RISK strive to reduce your waist circumference
BODY MASS INDEX (BMI)
Below 18.5 - UNDERWEIGHT - eat healthy
18.5 - 22.9 - NORMAL - maintain your weight
23 and above - OVERWEIGHT TO OBESE - AT RISK
- strive to lose your weight by practicing a healthy
lifestyle
BLOOD PRESSURE
If NOT DIAGNOSED with Hypertension OR NOT
TAKING MEDICATIONS:
Below 120/80 – NORMAL
continue screening once a year and healthy lifestyle
120-139/80-89 – PRE-HYPERTENSION intensifies
monitoring and lifestyle interventions
140/90 and above – HYPERTENSION consult
your Physician
If ALREADY DIAGNOSED AND TAKING MEDICATIONS
for Hypertension:
Below 130/80 – CONTROLLED
continue monitoring of blood pressure monthly
130/80 and above – UNCONTROLLED
consult your Physician as soon as possible
BLOOD SUGAR
If NOT DIAGNOSED with Diabetes:
FBS: <5.6 mmol/L NORMAL – continue screening once
a year and healthy lifestyle
FBS: 5.6 - 6.8 mmol/L PRE-DIABETES – continue
screening once a year and intensify healthy lifestyle
FBS: ≥ 7 mmol/L DIABETES – if asymptomatic repeat
FBS and consult your Physician ASAP
RBS: INCONCLUSIVE for screening of clients without
symptoms– for 75g OGTT or FBS
RBS: < 11.1 mmol/L with symptoms – SUSPECT –
for FBS or 75g OGTT
RBS: ≥ 11.1 mmol/L with symptoms – DIABETES –
consult your Physician as soon as possible
If DIAGNOSED with Diabetes:
FBS = <5.6 mmol/L or RBS = < 7.8 mmol/L
CONTROLLED continue medications, monitoring, and
healthy lifestyle
FBS = ≥ 5.6 mmol/L or RBS = ≥ 7.8 mmol/L
UNCONTROLLED consult your Physician ASAP
TOTAL CHOLESTEROL
Below 5.2 mmol/L DESIRABLE – continue screening
once a year and healthy lifestyle
5.2 - 6.2 mmol/L BORDERLINE HIGH – intensify
monitoring and lifestyle interventions
Above 6.2 mmol/L HIGH – consult your Physician
29.5
Overweight

36. DATE: 03-04-23
NAME: MR. J Gender: MALE
FAMILY HISTORY (Have 1st
degree relative with)
(Verbalized having ulcer)
Hypertension
Asthma Stroke
Cancer Heart Attack
Kidney Disease Diabetes
LIFESTYLE RISK FACTORS
Smoking (Tobacco/Cigarette)
Current Smoker
Stopped less than 1 year Stopped > a year
Passive Smoker Never smoked
Harmful Use of Alcohol
Never consumed
Yes, drinks alcohol
Had 5 drinks in 1 occasion in the past month
(Consumed on his adolescence years)
Unhealthy Eating
Eats processed/fast food (eg. Instant noodles,
hamburgers, fries, fried chicken skin etc.)
and ihaw-ihaw (eg. Isaw, adidas, etc.) weekly
Eats less than 3 servings of vegetables daily
Eats less than 2-3 servings of fruit per day
Lack of Physical Activity
Does less than 2.5 hours a week of moderate
intensity physical activity
(During free time, Mr. J rides his bicycle while Mrs. J
just stays in the house)
ANTHROPOMETRIC MEASUREMENTS
Waist Circumference: 68 centimeters
Height: 5'3 inch 1.60 meter
Weight: 114 pounds 51kg
Body Mass Index (BMI) (follow the formula below using
your measurements above)
Weight = 51kg / 1.60 (2) =
Height x Height
DIAGNOSED WITH HYPERTENSION? YES NO
Taking Medications? YES NO
Specify Medicines: ______________________________
Blood pressure measurement:
Arm 1st Take 2nd Take Average
Right 120/80 120/80 Normal
Left 120/80 120/80 Normal
DIAGNOSED WITH DIABETES? YES NO Taking
medications? YES NO
Specify Medicine: _______________________________ IF
NOTE DIAGNOSED. Do you have the ff. symptoms?
Polyphagia (gutomon kanunay)
Polydipsia (uhawon kanunay)
Polyuria (sige ug ihi-ihi)
BLOOD SUGAR:
FBS ______mmol/L or RBS ______mmol/L
OTHER BIOCHEMICAL TESTS:
• Total Cholesterol: _______________mmol/L
Here are the interpretation of results and
recommendation of your screening / monitoring:
LIFESTYLE RISK FACTORS
o Smoking - Quit smoking/encourage other to quit
smoking. Go to the nearest smoking cessation clinic.
o Harmful Use of Alcohol - drink alcohol in
moderation
o Unhealthy Eating - start eating healthy- consult
your nutritionist or ask your health care team
o Lack of Physical Activity - Increase your
physical activity
WAIST CIRCUMFERENCE
FEMALE: 80cm or below or MALE: 90cm or below -
NORMAL continue screening once a year
FEMALE: more than 80cm or MALE: more than 90cm
- AT RISK strive to reduce your waist circumference
BODY MASS INDEX (BMI)
Below 18.5 - UNDERWEIGHT - eat healthy
18.5 - 22.9 - NORMAL - maintain your weight
23 and above - OVERWEIGHT TO OBESE - AT RISK
- strive to lose your weight by practicing a healthy
lifestyle
BLOOD PRESSURE
If NOT DIAGNOSED with Hypertension OR NOT
TAKING MEDICATIONS:
Below 120/80 – NORMAL
continue screening once a year and healthy lifestyle
120-139/80-89 – PRE-HYPERTENSION intensifies
monitoring and lifestyle interventions
140/90 and above – HYPERTENSION consult
your Physician
If ALREADY DIAGNOSED AND TAKING MEDICATIONS
for Hypertension:
Below 130/80 – CONTROLLED
continue monitoring of blood pressure monthly
130/80 and above – UNCONTROLLED
consult your Physician as soon as possible
BLOOD SUGAR
If NOT DIAGNOSED with Diabetes:
FBS: <5.6 mmol/L NORMAL – continue screening once
a year and healthy lifestyle
FBS: 5.6 - 6.8 mmol/L PRE-DIABETES – continue
screening once a year and intensify healthy lifestyle
FBS: ≥ 7 mmol/L DIABETES – if asymptomatic repeat
FBS and consult your Physician ASAP
RBS: INCONCLUSIVE for screening of clients without
symptoms– for 75g OGTT or FBS
RBS: < 11.1 mmol/L with symptoms – SUSPECT –
for FBS or 75g OGTT
RBS: ≥ 11.1 mmol/L with symptoms – DIABETES –
consult your Physician as soon as possible
If DIAGNOSED with Diabetes:
FBS = <5.6 mmol/L or RBS = < 7.8 mmol/L
CONTROLLED continue medications, monitoring, and
healthy lifestyle
FBS = ≥ 5.6 mmol/L or RBS = ≥ 7.8 mmol/L
UNCONTROLLED consult your Physician ASAP
TOTAL CHOLESTEROL
Below 5.2 mmol/L DESIRABLE – continue screening
once a year and healthy lifestyle
5.2 - 6.2 mmol/L BORDERLINE HIGH – intensify
monitoring and lifestyle interventions
Above 6.2 mmol/L HIGH – consult your Physician
20.2
Normal

37. PHYSICAL
ASSESSMENT

38. ANATOMY AND PHYSIOLOGY

40. Predisposing Factors
Etiology Actual Findings Rationale
Overweight The patient is overweight
with a BMI result of 29.5.
Too many fatty and oily foods increase the chance or risk of having
atherosclerosis or plaque formation in the arteries of the body,
including the brain. Plaque formation thins the passage of blood, which
results in a decrease of oxygenated blood in the brain and then
eventually results in ischemia.
Physical Inactivity The patient is not
physically active.
Limited physical inactivity has a chance of not melting the fats or
cholesterol, which means having plaque formation, which results in
blood obstruction.
Hypertension The patient is
hypertensive with a result
of 130/80.
High blood pressure can damage the walls of blood vessels, making
them more susceptible to the build-up of plaque, which can lead to
stroke.
Use of
Contraceptives
The patient uses
contraceptives before.
Women who take birth control pills or hormone replacement therapy
may have an increased risk of stroke due to changes in estrogen
levels. Studies have found that women who use these types of
contraceptives have a slightly increased risk of stroke compared to
women who do not use hormonal contraceptives.
Diet The patient only drinks
milk during breakfast and
sometimes eat rice.
During lunch, they eat rice
with fried fish or egg and
during dinner they eat rice
and vegetables.
Eating a diet high in saturated fats, trans fat, and cholesterol has been
linked to stroke and related conditions, such as heart disease. Also,
getting too much salt (sodium) in the diet can raise blood pressure
levels.
ETIOLOGY AND SYMPTOMATOLOGY
Etiology

41. Smoking The patient verbalizes that she is not a
smoker but expose to 2nd hand smoke
from her husband.
Smoking cigarettes or using other tobacco
products can double or even quadruple your risk
of stroke, depending on how much you smoke and
for how long. Smoking can damage your blood
vessels, increase your blood pressure, and make
your blood more likely to clot, all of which can
contribute to stroke.
Heavy Alcohol Consumption The patient does not drink alcohol
substances.
Too much alcohol intake can damage the liver. A
damaged liver also damages clotting factor, which
is the cause of blood clot formation and blocks the
artery in the brain.
Diabetic The patient is not diabetic. High levels of glucose (sugar) in the blood can
damage blood vessels over time, increasing the
risk of atherosclerosis, a condition in which the
arteries become narrowed and hardened. This can
lead to the formation of blood clots, which can
block blood flow to the brain and cause a stroke.
Atrial Fibrillation (irregular
heart rhythm)
PR: 86bpm When the heart beats irregularly, blood can pool in
the heart and form clots. If a clot forms and travels
to the brain, it can block blood flow and cause a
stroke.
Gender The patient is female. Strokes are more common in men between the
ages of 20 and 50 because testosterone levels are
higher. High levels of testosterone cause low
levels of good cholesterol, while bad cholesterol is
not affected, which is why there is a high chance
of plaque formation or atherosclerosis.

42. Precipitating Factors
Age The patient is 64 years old.
Strokes are most common
in people over 60 whose
arteries in the brain are
fragile because of the
aging process. Fragile or
not elastic arteries become
narrowed, which is not
enough for the flow of
oxygenated blood, which is
why the risk of having a
stroke is high.
Previous stroke or transient
ischemic attack
The patient experience
previous stroke a year ago.
Higher risk for having a
second stroke after you
has already had a stroke.
Family History of stroke or
heart disease
The patient does not have
a family history of stroke or
heart disease.
The chance of stroke is
greater in people with a
family history of stroke.

43. Symptomatology
The following symptoms stated in this study are manifested by the patient during our visitation.
List of Symptoms Actual Findings Effect on the Patient/Implication
Inability to walk Present
The patient is unable to walk because of her
stroke. She can only lie down and sit and is in
need of assistance.
It affects the activity and daily living pattern.
Pain in right knee Present
When the patient moves her right leg, she makes
a grimace. She also verbalized being numb at the
right patellofemoral joint.
This could lead to a reduction in physical activity, which can negatively impact
their recovery and overall health.
Dehydrated Present
The patient is dehydrated, as evidenced by poor
capillary refill, dry mouth and lips, and sunken
eyes.
Dehydration leads to a reduction in blood volume, which can worsen stroke
symptoms such as confusion, weakness, and fatigue.
Trouble Speaking Present
The patient has trouble speaking or has slurred
speech. She cannot fully open her mouth and
cannot fully control her tongue.
Trouble speaking to a stroke patient causes frustration and isolation as they
struggle to express themselves and connect with others. It could also affect their
performance on everyday tasks, such as communicating their needs, following
instructions, and engaging in social activities.
Confusion Present
The patient is disoriented to time and date.
Confusion and disorientation can make it challenging for stroke patients to
communicate their needs effectively, leading to frustration and
misunderstandings. It will also increase the burden on caregivers, who may need
to provide more assistance with daily activities and monitor the patient's
condition.
Trouble Seeing Present
She has trouble with vision problems, she was
able to recognize object from afar but cannot
clearly see numbers, letters nearly.
This affects their ability to navigate their environment safely, leading to an
increased risk of falls and injuries.

44. RECOMMENDATION
For the patient, follow the doctor’s prescription for medication, treatment, and advice. Your healthcare provider may suggest
drugs, surgery, rehabilitation, or a mix of these therapies, depending on the type and severity of your stroke.
• Attend rehabilitation therapy since it helps stroke patients in regaining lost function, enhancing their strength and mobility, and
discovering new ways to carry out routine chores.
• Adopting a healthy lifestyle can help and improve overall health.
• Get emotional support since stroke recovery can be a challenging and emotional process, and it is important to have emotional
support from friends, family, or a mental health professional.
For healthcare providers, early intervention is vital to maximize the patient's chances of recovery in stroke treatment
because time is of the essence. Particularly in the initial hours following a stroke, healthcare providers should be ready to act
promptly and effectively. To offer complete care for stroke patients, healthcare professionals should collaborate. Throughout the
rehabilitation process, stroke sufferers and their families require knowledge and assistance.
• To help avoid future strokes, healthcare professionals should advise patients about the risk factors for stroke, the warning
symptoms, and lifestyle changes.
• Additionally, they have to offer details on the recuperation process, such as possibilities for rehabilitation and neighborhood
services.
• To monitor their development and patients who have suffered a stroke need to get follow-up care and constant observation.
• To make sure that patients are receiving the right treatment and support, healthcare providers should plan routine appointments
and check-ups.

45. )
PICTURE OF THE FAMILY’S HOUSE

46. THANK YOU!