The document discusses strokes, also known as brain attacks, including defining strokes as inadequate blood flow to the brain, risk factors, types of strokes, pathophysiology, clinical manifestations, diagnostic studies, prevention, acute care, and rehabilitation care. Strokes are a leading cause of death and disability in the United States, with the most common type being ischemic strokes caused by blockages interrupting blood flow to the brain. Nursing management focuses on monitoring vital signs and neurological status, managing respiratory issues, skin integrity, swallowing difficulties, and providing supportive care.
This document discusses the management of intensive care for patients with acute head injuries. It outlines factors that influence patient outcomes, such as the severity of the primary and secondary injuries. It emphasizes the importance of monitoring patients to avoid physiological insults that can exacerbate secondary brain injury, including intracranial hypertension, hypoxia, hypotension, and fever. A variety of monitoring modalities are described to optimize cerebral perfusion pressure and oxygenation in order to minimize ischemia. Both general and specific medical management strategies are covered, such as surgical intervention, ventilation, fluid management, and use of pharmacological agents to reduce intracranial pressure.
Management of head injury by Dr,Dawit Mekonnen @ jimma universityDr.dawit mekonnen
This document provides an overview of head injury management. It discusses evaluating head injuries in the emergency setting, classifying injuries as primary or secondary, monitoring intracranial pressure, and treating increased intracranial pressure and secondary injuries. Specific management strategies are outlined to prevent secondary brain injury and optimize outcomes for patients with head trauma.
Head trauma, also called traumatic brain injury (TBI), occurs in two phases: primary and secondary brain injury. Primary injury involves direct damage to brain tissue from impact. Secondary injury involves downstream effects like edema and ischemia that start minutes after primary injury. Managing TBI focuses on preventing secondary injuries like hypotension, hypoxia, fever and intracranial hypertension that can exacerbate primary damage. Treatment involves intensive monitoring, ventilation, controlling blood pressure/ICP, anticonvulsants and early rehabilitation. The goal is to minimize further brain injury and maximize recovery.
This document discusses the challenges in nursing care for patients experiencing a cerebrovascular accident (CVA) or stroke. It begins by defining a CVA as a sudden loss of brain function caused by disrupted blood flow to the brain. The document then covers the types, risk factors, clinical manifestations, investigations, and management of strokes. It emphasizes the nursing priorities of initial treatment to prevent further deterioration, ongoing risk assessment, and interventions to address impaired mobility, vital signs, nutrition, and more. The overall goal of nursing management is to control symptoms, prevent complications, and optimize recovery through a coordinated, multidisciplinary approach.
Head injuries are one of the most common causes of disability and death in adults. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone, or from internal bleeding and damage to the brain.
Internal Medicine - Cerebrovascular DiseasesNian Baring
The document discusses cerebrovascular diseases, focusing on ischemic and hemorrhagic stroke. It defines stroke, outlines the pathophysiology of ischemic stroke including necrotic and apoptotic pathways, and describes approaches to diagnosis and treatment. Treatment options for ischemic stroke include medical support to optimize cerebral perfusion, IV thrombolysis with rtPA within 3-4.5 hours, and endovascular techniques to restore blood flow and save ischemic penumbra.
- Head injuries are common presentations to the emergency department, representing up to 10% of visits. Common causes include road traffic accidents, falls, assaults, and sports injuries.
- CT head is the primary investigation to identify traumatic brain injuries and skull fractures. History should focus on mechanism of injury, time since injury, medications, and risk factors.
- Most head injuries are minor and can be safely discharged, but some serious underlying injuries can be missed if not properly evaluated. Patients require close monitoring for neurological changes that indicate deterioration.
This document provides guidelines for the assessment and management of head injuries. It outlines the steps for initial assessment including the ABCs (airway, breathing, circulation), indications for intubation and ventilation, and neurological assessment using the GCS. It also discusses indications for CT scanning, referral to hospital or neurosurgery. Key principles of management include maintaining cerebral perfusion pressure, avoiding hypoxia and reducing intracranial pressure through various means. Surgical intervention may be indicated for certain types or sizes of brain injuries or deterioration in condition.
This document discusses the management of intensive care for patients with acute head injuries. It outlines factors that influence patient outcomes, such as the severity of the primary and secondary injuries. It emphasizes the importance of monitoring patients to avoid physiological insults that can exacerbate secondary brain injury, including intracranial hypertension, hypoxia, hypotension, and fever. A variety of monitoring modalities are described to optimize cerebral perfusion pressure and oxygenation in order to minimize ischemia. Both general and specific medical management strategies are covered, such as surgical intervention, ventilation, fluid management, and use of pharmacological agents to reduce intracranial pressure.
Management of head injury by Dr,Dawit Mekonnen @ jimma universityDr.dawit mekonnen
This document provides an overview of head injury management. It discusses evaluating head injuries in the emergency setting, classifying injuries as primary or secondary, monitoring intracranial pressure, and treating increased intracranial pressure and secondary injuries. Specific management strategies are outlined to prevent secondary brain injury and optimize outcomes for patients with head trauma.
Head trauma, also called traumatic brain injury (TBI), occurs in two phases: primary and secondary brain injury. Primary injury involves direct damage to brain tissue from impact. Secondary injury involves downstream effects like edema and ischemia that start minutes after primary injury. Managing TBI focuses on preventing secondary injuries like hypotension, hypoxia, fever and intracranial hypertension that can exacerbate primary damage. Treatment involves intensive monitoring, ventilation, controlling blood pressure/ICP, anticonvulsants and early rehabilitation. The goal is to minimize further brain injury and maximize recovery.
This document discusses the challenges in nursing care for patients experiencing a cerebrovascular accident (CVA) or stroke. It begins by defining a CVA as a sudden loss of brain function caused by disrupted blood flow to the brain. The document then covers the types, risk factors, clinical manifestations, investigations, and management of strokes. It emphasizes the nursing priorities of initial treatment to prevent further deterioration, ongoing risk assessment, and interventions to address impaired mobility, vital signs, nutrition, and more. The overall goal of nursing management is to control symptoms, prevent complications, and optimize recovery through a coordinated, multidisciplinary approach.
Head injuries are one of the most common causes of disability and death in adults. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone, or from internal bleeding and damage to the brain.
Internal Medicine - Cerebrovascular DiseasesNian Baring
The document discusses cerebrovascular diseases, focusing on ischemic and hemorrhagic stroke. It defines stroke, outlines the pathophysiology of ischemic stroke including necrotic and apoptotic pathways, and describes approaches to diagnosis and treatment. Treatment options for ischemic stroke include medical support to optimize cerebral perfusion, IV thrombolysis with rtPA within 3-4.5 hours, and endovascular techniques to restore blood flow and save ischemic penumbra.
- Head injuries are common presentations to the emergency department, representing up to 10% of visits. Common causes include road traffic accidents, falls, assaults, and sports injuries.
- CT head is the primary investigation to identify traumatic brain injuries and skull fractures. History should focus on mechanism of injury, time since injury, medications, and risk factors.
- Most head injuries are minor and can be safely discharged, but some serious underlying injuries can be missed if not properly evaluated. Patients require close monitoring for neurological changes that indicate deterioration.
This document provides guidelines for the assessment and management of head injuries. It outlines the steps for initial assessment including the ABCs (airway, breathing, circulation), indications for intubation and ventilation, and neurological assessment using the GCS. It also discusses indications for CT scanning, referral to hospital or neurosurgery. Key principles of management include maintaining cerebral perfusion pressure, avoiding hypoxia and reducing intracranial pressure through various means. Surgical intervention may be indicated for certain types or sizes of brain injuries or deterioration in condition.
Head injuries are commonly caused by motor vehicle accidents (44%) and falls (21%). Common types of head injuries include scalp wounds, skull fractures, and brain injuries such as contusions, hematomas, and hemorrhages. Symptoms vary depending on the location and severity of the injury but may include changes in consciousness, headache, vomiting, and motor or sensory deficits. Diagnostic tests like CT scans are used to evaluate the injury. Treatment focuses on stabilizing the patient, treating increased intracranial pressure through medications like mannitol, and surgical intervention if necessary.
This document provides an overview of traumatic brain injury (TBI). It defines TBI and discusses its epidemiology. It then covers the pathophysiology of TBI, including primary and secondary brain injuries. It also classifies TBI based on clinical examination and imaging findings. The document outlines recommendations for monitoring TBI patients and discusses common complications. Finally, it summarizes guidelines for managing severe TBI, including treatments aimed at reducing intracranial pressure and optimizing cerebral perfusion.
1. Traumatic brain injury (TBI) is a leading cause of mortality and disability in industrialized countries. Intensive care is an integral part of managing acute TBI.
2. The early management of TBI involves a thorough clinical history and examination to determine the injury mechanism and assess the neurological state. Vital signs, oxygenation, ventilation, circulation and other functions are immediately assessed and stabilized.
3. Focal brain lesions like epidural hematomas, subdural hematomas, and intracerebral hemorrhages are common in TBI and may require surgical intervention. Other injuries include diffuse axonal injury, cerebral edema, and brain stem lesions.
This document provides guidance on caring for patients with head injuries. It discusses assessing neurological status, managing blood pressure/volume, oxygenation, temperature, seizures, nutrition, positioning, bladder/bowel care, minimizing stimulation, safety, rehabilitation, and educating family members. Key aspects include monitoring vital signs, avoiding hypotension, maintaining oxygen levels, managing ICP rise through osmotherapy, keeping the patient normothermic, starting early rehabilitation, and supporting family members through the recovery process.
This document provides information about neurological nursing related to increased intracranial pressure and head injuries. It discusses the anatomy and physiology of the brain, types of head injuries including primary and secondary injuries, complications such as hematomas, and management of increased ICP. Nursing assessments, diagnoses, and interventions are also reviewed, including monitoring for signs of increased ICP, maintaining airway and breathing, preventing injury, and using the Glasgow Coma Scale to assess level of consciousness.
This document summarizes information about yoga for cerebrovascular disease or stroke. It begins by defining stroke and its causes, then discusses the signs, symptoms, and modern medical treatments. It notes that yoga can help with stroke rehabilitation by improving flexibility, strength, and reducing stress. Specific yoga poses and practices are recommended for recovery from and prevention of stroke.
1. The document discusses classification and management of traumatic head injuries, including grading severity based on Glasgow Coma Scale and anatomical findings on CT scans.
2. Management involves stabilizing patients through the pre-hospital and hospital phases, monitoring intracranial pressure, and treating to prevent secondary brain injuries using medical and surgical methods like intubation, sedation, osmotherapy, and surgical evacuation of hematomas if needed.
3. The goal of management is to control factors that raise intracranial pressure like hypoxia, hypotension, and cerebral edema in order to maintain adequate cerebral perfusion pressure and optimize outcomes.
This document provides an overview of radiological imaging in the management of stroke. It discusses:
1) Various imaging modalities used including unenhanced CT, CT angiography, MRI, and their benefits. Diffusion weighted MRI can detect acute ischemia within 30 minutes.
2) Examples of imaging findings for different stroke types like ischemic and hemorrhagic strokes. Ischemic strokes appear as bright lesions on DWI MRI.
3) Surgical interventions for acute stroke management include decompressive hemicraniectomy to reduce intracranial pressure for large hemispheric infarcts, and external ventricular drainage for intraventricular hemorrhage and hydrocephalus.
CVA (cerebrovascular accident), also known as stroke, and TIA (transient ischemic attack) are disruptions in blood flow to the brain. A CVA is caused by ischemia or hemorrhage in the brain and results in cell death, while a TIA's disruption is temporary without cell death. Risk factors include atherosclerosis, hypertension, cardiac issues, and diabetes. Symptoms depend on the location and size of the affected area but may include paralysis, impaired speech/vision, and sensory changes. Treatment focuses on prevention by controlling risk factors and potentially using blood thinners. Nursing care revolves around monitoring for complications and maximizing recovery of functions.
This document provides information about head injuries, including:
- Head injuries are a major cause of death and disability, especially in young adults, often resulting from road traffic accidents and falls.
- The major types of head injuries are hematomas, hemorrhages, concussions, edema, skull fractures, and diffuse axonal injuries.
- Diagnostic evaluations for head injuries include X-rays, CT scans, MRI scans, and intracranial pressure monitoring.
- Emergency management of head injuries focuses on supportive care, decreasing cerebral edema, and surgical evacuation of hematomas if needed.
The document provides an overview of evaluating and managing a patient with head injury. It discusses initial assessment according to ATLS guidelines focusing on airway, breathing, and circulation. It also covers neurological assessment including Glasgow Coma Scale and pupil examination. Indications for CT scan and referral to a trauma center are outlined. Management goals include maintaining adequate oxygenation, ventilation, blood pressure, ICP and CPP. Further management may involve therapies such as hyperosmolar treatment, hypothermia, nutrition, antiseizure medications, and antibiotics.
This document discusses head injuries, including their epidemiology, pathophysiology, types, and management. Head injuries are a major public health problem worldwide and are mostly caused by road traffic accidents and assaults. The main types of head injuries discussed are cerebral contusions, diffuse axonal injury, cerebral edema, traumatic intracranial hematomas such as extradural, subdural, subarachnoid and intracerebral hemorrhages, and concussions. Initial management focuses on preventing secondary brain damage through measures such as neurological observation, immobilization, intubation if needed, and transport to a dedicated neurological facility for patients with more severe injuries.
This document provides an overview of cerebrovascular accidents (CVAs), also known as strokes. It defines CVAs, describes the blood supply to the brain, and classifies the major types of strokes as ischemic (caused by reduced blood flow) or hemorrhagic (caused by bleeding). It discusses the causes, risk factors, clinical presentation, progression, and management of different stroke subtypes, including transient ischemic attacks, infarction, and intracerebral hemorrhage.
Head injuries can range from mild to severe based on factors like loss of consciousness and Glasgow Coma Scale. The primary goals of management are to stabilize the patient by protecting the airway and maintaining adequate oxygenation, ventilation, and circulation to prevent secondary brain injury. Imaging with CT scan is important to identify fractures and intracranial bleeding like extradural and subdural hematomas that may require neurosurgery. Ongoing monitoring of things like neurological status and intracranial pressure is also important for managing head injuries.
Stroke is a leading cause of death and disability in the United States and worldwide. There are three main types of stroke: ischemic (caused by blockage), hemorrhagic (caused by bleeding), and transient ischemic attacks (TIAs or mini-strokes). Symptoms appear suddenly and without warning, and include numbness, confusion, trouble seeing or speaking. Prompt medical treatment is crucial. Diagnostic tests help determine the type and location of damage. Treatment depends on stroke type but may include clot-busting drugs or surgery to repair blood vessels. Rehabilitation is important for recovery. Risk can be reduced by maintaining a healthy lifestyle and managing medical conditions like high blood pressure.
The document discusses stroke, including its definition, causes, risk factors, symptoms, assessment, recovery stages, and complications. Key points include:
- Stroke is defined as sudden neurological dysfunction due to abnormal cerebral circulation lasting over 24 hours.
- Common causes include atherosclerosis, cerebral thrombus, embolism from the heart.
- Risk factors include hypertension, diabetes, heart disease, smoking, obesity.
- Symptoms can include weakness, numbness, vision issues, speech problems.
- Recovery is assessed based on severity, duration, and affected brain region. Complications can include contractures, seizures, DVT.
This document discusses the care of patients with severe head injuries. It covers the physiology of head injuries, types of injuries including skull fractures and brain injuries, assessment using the Glasgow Coma Scale, and monitoring of vital signs and intracranial pressure. Special issues in management are addressed, such as oxygenation, blood pressure control, seizure prophylaxis, and prevention of secondary injuries. A multidisciplinary approach is needed with nursing playing a key role in patient safety, rehabilitation, and family support.
The document discusses cerebrovascular accidents (strokes) including definitions, blood supply to the brain, conditions caused by occlusion of different arteries, classification of strokes, diagnostic studies, and management of strokes. It covers topics such as transient ischemic attacks, the circle of Willis, effects of reduced cerebral blood flow, intravenous thrombolysis with tPA, complications of strokes, and risk factors. Rehabilitation goals and emerging therapies are also mentioned.
This document provides definitions and classifications for different types of strokes and transient ischemic attacks. It defines a stroke as an acute neurologic injury caused by cerebral infarction or brain hemorrhage. Transient ischemic attacks are defined as transient episodes of neurologic dysfunction without acute infarction. Strokes are classified as ischemic, which make up 80% of cases, or hemorrhagic. Ischemic strokes can be thrombotic, embolic, or due to hypoperfusion. Hemorrhagic strokes are either intra-axial within the brain or extra-axial outside the brain. The document outlines risk factors, clinical presentations, and distinguishing characteristics that can help differentiate between stroke subtypes.
70% of RTA patients have head injury(HI).
One of the most important public health problems of today.
70% of deaths in RTA are due to HI.
At Risk population
Males 15-24
Infants
Young Children
Elderly
Cerebrovascular accident refers to a stroke, which occurs when blood flow to the brain is interrupted. The document discusses the causes, types, symptoms, risk factors, and diagnostic evaluation of strokes. It also summarizes hypertension, myocardial infarction, and coronary artery disease - all of which can increase the risk of strokes if not properly managed.
Brain attack stroke is a medical emergency that affects over 795,000 Americans each year. It is the third leading cause of death and the leading cause of adult disability in the US. Stroke is treatable if emergency medical services are contacted within 3 hours of symptom onset to quickly transport the patient to a primary stroke center for diagnosis and treatment. Recognizing the signs of stroke using the FAST acronym and calling 911 immediately can help save brain tissue and potentially limit disability from stroke.
Head injuries are commonly caused by motor vehicle accidents (44%) and falls (21%). Common types of head injuries include scalp wounds, skull fractures, and brain injuries such as contusions, hematomas, and hemorrhages. Symptoms vary depending on the location and severity of the injury but may include changes in consciousness, headache, vomiting, and motor or sensory deficits. Diagnostic tests like CT scans are used to evaluate the injury. Treatment focuses on stabilizing the patient, treating increased intracranial pressure through medications like mannitol, and surgical intervention if necessary.
This document provides an overview of traumatic brain injury (TBI). It defines TBI and discusses its epidemiology. It then covers the pathophysiology of TBI, including primary and secondary brain injuries. It also classifies TBI based on clinical examination and imaging findings. The document outlines recommendations for monitoring TBI patients and discusses common complications. Finally, it summarizes guidelines for managing severe TBI, including treatments aimed at reducing intracranial pressure and optimizing cerebral perfusion.
1. Traumatic brain injury (TBI) is a leading cause of mortality and disability in industrialized countries. Intensive care is an integral part of managing acute TBI.
2. The early management of TBI involves a thorough clinical history and examination to determine the injury mechanism and assess the neurological state. Vital signs, oxygenation, ventilation, circulation and other functions are immediately assessed and stabilized.
3. Focal brain lesions like epidural hematomas, subdural hematomas, and intracerebral hemorrhages are common in TBI and may require surgical intervention. Other injuries include diffuse axonal injury, cerebral edema, and brain stem lesions.
This document provides guidance on caring for patients with head injuries. It discusses assessing neurological status, managing blood pressure/volume, oxygenation, temperature, seizures, nutrition, positioning, bladder/bowel care, minimizing stimulation, safety, rehabilitation, and educating family members. Key aspects include monitoring vital signs, avoiding hypotension, maintaining oxygen levels, managing ICP rise through osmotherapy, keeping the patient normothermic, starting early rehabilitation, and supporting family members through the recovery process.
This document provides information about neurological nursing related to increased intracranial pressure and head injuries. It discusses the anatomy and physiology of the brain, types of head injuries including primary and secondary injuries, complications such as hematomas, and management of increased ICP. Nursing assessments, diagnoses, and interventions are also reviewed, including monitoring for signs of increased ICP, maintaining airway and breathing, preventing injury, and using the Glasgow Coma Scale to assess level of consciousness.
This document summarizes information about yoga for cerebrovascular disease or stroke. It begins by defining stroke and its causes, then discusses the signs, symptoms, and modern medical treatments. It notes that yoga can help with stroke rehabilitation by improving flexibility, strength, and reducing stress. Specific yoga poses and practices are recommended for recovery from and prevention of stroke.
1. The document discusses classification and management of traumatic head injuries, including grading severity based on Glasgow Coma Scale and anatomical findings on CT scans.
2. Management involves stabilizing patients through the pre-hospital and hospital phases, monitoring intracranial pressure, and treating to prevent secondary brain injuries using medical and surgical methods like intubation, sedation, osmotherapy, and surgical evacuation of hematomas if needed.
3. The goal of management is to control factors that raise intracranial pressure like hypoxia, hypotension, and cerebral edema in order to maintain adequate cerebral perfusion pressure and optimize outcomes.
This document provides an overview of radiological imaging in the management of stroke. It discusses:
1) Various imaging modalities used including unenhanced CT, CT angiography, MRI, and their benefits. Diffusion weighted MRI can detect acute ischemia within 30 minutes.
2) Examples of imaging findings for different stroke types like ischemic and hemorrhagic strokes. Ischemic strokes appear as bright lesions on DWI MRI.
3) Surgical interventions for acute stroke management include decompressive hemicraniectomy to reduce intracranial pressure for large hemispheric infarcts, and external ventricular drainage for intraventricular hemorrhage and hydrocephalus.
CVA (cerebrovascular accident), also known as stroke, and TIA (transient ischemic attack) are disruptions in blood flow to the brain. A CVA is caused by ischemia or hemorrhage in the brain and results in cell death, while a TIA's disruption is temporary without cell death. Risk factors include atherosclerosis, hypertension, cardiac issues, and diabetes. Symptoms depend on the location and size of the affected area but may include paralysis, impaired speech/vision, and sensory changes. Treatment focuses on prevention by controlling risk factors and potentially using blood thinners. Nursing care revolves around monitoring for complications and maximizing recovery of functions.
This document provides information about head injuries, including:
- Head injuries are a major cause of death and disability, especially in young adults, often resulting from road traffic accidents and falls.
- The major types of head injuries are hematomas, hemorrhages, concussions, edema, skull fractures, and diffuse axonal injuries.
- Diagnostic evaluations for head injuries include X-rays, CT scans, MRI scans, and intracranial pressure monitoring.
- Emergency management of head injuries focuses on supportive care, decreasing cerebral edema, and surgical evacuation of hematomas if needed.
The document provides an overview of evaluating and managing a patient with head injury. It discusses initial assessment according to ATLS guidelines focusing on airway, breathing, and circulation. It also covers neurological assessment including Glasgow Coma Scale and pupil examination. Indications for CT scan and referral to a trauma center are outlined. Management goals include maintaining adequate oxygenation, ventilation, blood pressure, ICP and CPP. Further management may involve therapies such as hyperosmolar treatment, hypothermia, nutrition, antiseizure medications, and antibiotics.
This document discusses head injuries, including their epidemiology, pathophysiology, types, and management. Head injuries are a major public health problem worldwide and are mostly caused by road traffic accidents and assaults. The main types of head injuries discussed are cerebral contusions, diffuse axonal injury, cerebral edema, traumatic intracranial hematomas such as extradural, subdural, subarachnoid and intracerebral hemorrhages, and concussions. Initial management focuses on preventing secondary brain damage through measures such as neurological observation, immobilization, intubation if needed, and transport to a dedicated neurological facility for patients with more severe injuries.
This document provides an overview of cerebrovascular accidents (CVAs), also known as strokes. It defines CVAs, describes the blood supply to the brain, and classifies the major types of strokes as ischemic (caused by reduced blood flow) or hemorrhagic (caused by bleeding). It discusses the causes, risk factors, clinical presentation, progression, and management of different stroke subtypes, including transient ischemic attacks, infarction, and intracerebral hemorrhage.
Head injuries can range from mild to severe based on factors like loss of consciousness and Glasgow Coma Scale. The primary goals of management are to stabilize the patient by protecting the airway and maintaining adequate oxygenation, ventilation, and circulation to prevent secondary brain injury. Imaging with CT scan is important to identify fractures and intracranial bleeding like extradural and subdural hematomas that may require neurosurgery. Ongoing monitoring of things like neurological status and intracranial pressure is also important for managing head injuries.
Stroke is a leading cause of death and disability in the United States and worldwide. There are three main types of stroke: ischemic (caused by blockage), hemorrhagic (caused by bleeding), and transient ischemic attacks (TIAs or mini-strokes). Symptoms appear suddenly and without warning, and include numbness, confusion, trouble seeing or speaking. Prompt medical treatment is crucial. Diagnostic tests help determine the type and location of damage. Treatment depends on stroke type but may include clot-busting drugs or surgery to repair blood vessels. Rehabilitation is important for recovery. Risk can be reduced by maintaining a healthy lifestyle and managing medical conditions like high blood pressure.
The document discusses stroke, including its definition, causes, risk factors, symptoms, assessment, recovery stages, and complications. Key points include:
- Stroke is defined as sudden neurological dysfunction due to abnormal cerebral circulation lasting over 24 hours.
- Common causes include atherosclerosis, cerebral thrombus, embolism from the heart.
- Risk factors include hypertension, diabetes, heart disease, smoking, obesity.
- Symptoms can include weakness, numbness, vision issues, speech problems.
- Recovery is assessed based on severity, duration, and affected brain region. Complications can include contractures, seizures, DVT.
This document discusses the care of patients with severe head injuries. It covers the physiology of head injuries, types of injuries including skull fractures and brain injuries, assessment using the Glasgow Coma Scale, and monitoring of vital signs and intracranial pressure. Special issues in management are addressed, such as oxygenation, blood pressure control, seizure prophylaxis, and prevention of secondary injuries. A multidisciplinary approach is needed with nursing playing a key role in patient safety, rehabilitation, and family support.
The document discusses cerebrovascular accidents (strokes) including definitions, blood supply to the brain, conditions caused by occlusion of different arteries, classification of strokes, diagnostic studies, and management of strokes. It covers topics such as transient ischemic attacks, the circle of Willis, effects of reduced cerebral blood flow, intravenous thrombolysis with tPA, complications of strokes, and risk factors. Rehabilitation goals and emerging therapies are also mentioned.
This document provides definitions and classifications for different types of strokes and transient ischemic attacks. It defines a stroke as an acute neurologic injury caused by cerebral infarction or brain hemorrhage. Transient ischemic attacks are defined as transient episodes of neurologic dysfunction without acute infarction. Strokes are classified as ischemic, which make up 80% of cases, or hemorrhagic. Ischemic strokes can be thrombotic, embolic, or due to hypoperfusion. Hemorrhagic strokes are either intra-axial within the brain or extra-axial outside the brain. The document outlines risk factors, clinical presentations, and distinguishing characteristics that can help differentiate between stroke subtypes.
70% of RTA patients have head injury(HI).
One of the most important public health problems of today.
70% of deaths in RTA are due to HI.
At Risk population
Males 15-24
Infants
Young Children
Elderly
Cerebrovascular accident refers to a stroke, which occurs when blood flow to the brain is interrupted. The document discusses the causes, types, symptoms, risk factors, and diagnostic evaluation of strokes. It also summarizes hypertension, myocardial infarction, and coronary artery disease - all of which can increase the risk of strokes if not properly managed.
Brain attack stroke is a medical emergency that affects over 795,000 Americans each year. It is the third leading cause of death and the leading cause of adult disability in the US. Stroke is treatable if emergency medical services are contacted within 3 hours of symptom onset to quickly transport the patient to a primary stroke center for diagnosis and treatment. Recognizing the signs of stroke using the FAST acronym and calling 911 immediately can help save brain tissue and potentially limit disability from stroke.
A stroke occurs when blood flow to the brain is interrupted, depriving brain tissue of oxygen and nutrients. The main causes are blood clots (ischemic stroke) or bleeding (hemorrhagic stroke). Symptoms depend on the affected brain region but may include weakness, numbness, vision issues, and speech problems. Risk factors include age, family history, diabetes, high blood pressure, smoking and obesity. Diagnosis involves physical exams, CT scans and MRI. Treatment focuses on rehabilitation to regain functions through therapies like occupational and physical therapy. Prevention emphasizes controlling risk factors through healthy lifestyle choices and medical management of conditions.
Heart murmurs are heart sounds produced when blood flows across one of the heart valves that is loud enough to be heard with a stethoscope.
There are two types of murmurs. A functional murmur or "physiologic murmur" is a heart murmur that is primarily due to physiologic conditions outside the heart. Other types of murmurs are due to structural defects in the heart itself. Functional murmurs are benign (an "innocent murmur").[1]
Murmurs may also be the result of various problems, such as narrowing or leaking of valves, or the presence of abnormal passages through which blood flows in or near the heart. Such murmurs, known as pathologic murmurs, should be evaluated by an expert.
The document discusses heart sounds and murmurs. It describes the normal first and second heart sounds and variations caused by different cardiac conditions. Abnormal heart sounds like S3, S4, clicks, and pericardial rubs are also outlined. Heart murmurs are classified based on timing, shape, location, intensity, pitch, quality, and radiation. Common causes of systolic, diastolic, and continuous murmurs are provided. Interventions that can change the characteristics of murmurs are summarized.
The document provides guidelines for diagnosing and managing different types and severities of acute brain attacks or strokes. It discusses classifying strokes as TIA, mild, moderate or severe based on symptoms. For TIA and mild strokes, the guidelines recommend emergent diagnostic tests like CT scan and treating conditions like high blood pressure. For moderate strokes, the priorities are supportive care, monitoring vitals, diagnostics like blood tests and CT scan. The guidelines provide recommendations for diagnosing the type of stroke and identifying underlying causes through further diagnostic testing.
This document provides an overview of different types of heart murmurs:
1. It describes systolic murmurs which occur during ventricular contraction and can be early, mid, or late systolic. Common causes are aortic stenosis, mitral regurgitation, and mitral valve prolapse.
2. It also describes diastolic murmurs which occur during ventricular relaxation and include early diastolic murmurs from aortic regurgitation and rumbling mid to late diastolic murmurs from mitral stenosis.
3. Continuous murmurs that begin in systole and continue into diastole are also discussed, along with how to characterize location and timing of different murmurs.
This document provides information on ischemic and hemorrhagic stroke. It discusses the types, risk factors, pathophysiology, symptoms, diagnosis, and treatment of each. For ischemic stroke, it outlines the five types according to cause and details tPA administration criteria. For hemorrhagic stroke, it describes the types including intracerebral hemorrhage from aneurysms or arteriovenous malformations. Nursing interventions for recovery are also summarized.
Tuberculous meningitis is inflammation of the membranes surrounding the brain and spinal cord caused by Mycobacterium tuberculosis. It typically develops secondary to a pulmonary tuberculosis infection. Symptoms progress through three stages - an initial prodromal stage with nonspecific symptoms, followed by signs of meningeal irritation and cranial nerve palsies, and finally a terminal stage with coma and death if untreated. Diagnosis involves lumbar puncture showing lymphocytic pleocytosis and decreased glucose. Treatment consists of a combination of antitubercular drugs for 12 months along with corticosteroids to reduce inflammation and complications. Prognosis depends on the stage of disease at treatment initiation, with mortality rates as high as 50%
This document discusses tuberculous meningitis, which is caused by Mycobacterium tuberculosis infecting the meninges and brain. India has a high burden of tuberculosis cases, with around 10% of TB patients developing central nervous system involvement like tuberculous meningitis. Risk factors include delays in diagnosis and treatment as well as immunocompromised states. Clinically, patients initially experience headaches, vomiting and fever, progressing to altered mental status. Diagnosis involves lumbar puncture showing lymphocytic predominant meningitis as well as imaging and culture of cerebrospinal fluid. Treatment involves a combination of anti-tuberculosis drugs administered for 9-12 months.
Stroke occurs when there is inadequate blood flow to the brain resulting in cell death. It is a leading cause of death and disability. There are two main types - ischemic caused by clots or blockages cutting off blood flow, and hemorrhagic caused by bleeding within or around the brain. Strokes cause deficits varying by location but often involve motor, communication, cognitive and emotional impairments. Risk factors include hypertension, smoking, obesity, age, and heredity.
Stroke occurs when there is inadequate blood flow to the brain resulting in cell death. It is a leading cause of death and disability. There are two main types - ischemic caused by clots or blockages cutting off blood flow, and hemorrhagic caused by bleeding within or around the brain. Strokes cause deficits varying by location but often involve motor, communication, cognitive and emotional impairments. Risk factors include hypertension, smoking, obesity, age, and heredity.
This document provides an overview of cerebrovascular accident (CVA), also known as stroke. It begins with definitions of CVA and discusses the anatomy of blood supply to the brain. It then covers the epidemiology, causes, risk factors, types, pathophysiology, clinical features, diagnosis, management, complications, prognosis, and rehabilitation of CVA. CVA is caused by interrupted blood flow to the brain, depriving it of oxygen and nutrients. The main causes are ischemia (blockage of an artery) and hemorrhage (bleeding). Risk factors include hypertension, diabetes, smoking, and high cholesterol. Treatment involves restoring blood flow, preventing further complications, and long-term rehabilitation. Prognosis depends on
This document discusses hypertensive diseases and their complications. It begins by outlining various hypertensive diseases that can affect the cerebrovascular system, eyes, heart and kidneys. It then defines hypertension and hypertensive emergencies/urgencies. The remainder of the document provides more details on specific hypertensive diseases and complications, including hypertensive encephalopathy, cerebrovascular accidents, retinopathy, left ventricular hypertrophy, coronary artery disease, cardiac arrhythmias, congestive heart failure, benign and malignant nephrosclerosis. It also discusses diagnostic criteria and management of various hypertensive conditions.
This document provides an overview of neurologic disorders, focusing on head trauma and spinal cord injury. It discusses the pathophysiology, clinical manifestations, classifications, and initial management of traumatic brain injury and spinal cord injury. Some key points include:
- Head trauma is a broad classification that includes injury to the scalp, skull, or brain and is a leading cause of death from trauma.
- Primary brain injury occurs at the time of impact while secondary injury involves damage over subsequent hours and days.
- Spinal cord injury results in loss of motor, sensory, and autonomic function below the level of injury. It can cause spinal shock, neurogenic shock, or autonomic dysreflexia.
This document discusses cerebrovascular diseases and stroke. It provides background on stroke symptoms and types, risk factors, cerebral circulation anatomy, physiology of the brain's blood flow regulation, causes of ischemic stroke, clinical presentations of acute stroke, differential diagnosis, and tests used in evaluation of acute ischemic stroke patients. Key information includes that stroke is the third leading cause of death in developed countries, with 80% of strokes being ischemic in origin. Major risk factors include hypertension, diabetes, smoking, hyperlipidemia and atrial fibrillation. Tests used for emergent evaluation include CT of the brain, EKG, blood tests and the NIH Stroke Scale.
This document provides an overview of strokes, including:
1) Strokes are caused by an interruption of blood flow to the brain and are a leading cause of death and disability in the US.
2) The two main types of strokes are ischemic, caused by blockage of arteries, and hemorrhagic, caused by bleeding in the brain.
3) Warning signs of a stroke include sudden weakness, confusion, trouble speaking, and vision changes. Acting FAST (Face, Arms, Speech, Time) and calling 911 immediately can help reduce stroke damage.
This document provides an overview of strokes, including:
1) Strokes are caused by an interruption of blood flow to the brain and are a leading cause of death and disability in the US.
2) The two main types of strokes are ischemic, caused by blockage of arteries, and hemorrhagic, caused by bleeding in the brain.
3) Warning signs of a stroke include sudden weakness, confusion, trouble speaking, or vision changes. Acting FAST (Face, Arms, Speech, Time) and calling 911 immediately can help reduce stroke damage.
1. The document discusses nervous system disorders including intracranial pressure, components of the brain, causes of increased ICP, signs and symptoms, investigations, and management of increased ICP including drug therapy and nursing care.
2. It also covers topics such as stroke, including types, signs and symptoms, diagnosis using FAST test, treatment including thrombolysis and antiplatelet/anticoagulant drugs, and nursing care to monitor patients and prevent complications.
3. Finally, it briefly discusses meningitis as an inflammation of the lining around the brain and spinal cord often caused by bacteria or viruses.
The document discusses cerebrovascular accidents (strokes), including types of strokes, risk factors, signs and symptoms, nursing management in the acute and hyperacute phases, and collaborative care approaches for prevention, diagnosis, and treatment. It provides an overview of strokes, their causes, impact, and the critical role of nurses in monitoring patients, administering treatments, and coordinating multidisciplinary care.
A cerebrovascular accident (CVA), also known as a stroke, occurs when blood flow to an area of the brain is interrupted, depriving brain tissue of oxygen and nutrients. This can be caused by a blood clot blocking an artery (thrombosis), bleeding within the brain (hemorrhage), or a blood clot traveling from another part of the body and lodging in the brain (embolism). Symptoms depend on the area of brain affected but may include weakness, numbness, vision issues, difficulty speaking, and more. Recovery depends on the severity and location of damage, with potential outcomes including permanent disability or recurrent strokes.
This document summarizes the management of patients with cerebrovascular disorders such as stroke. It discusses the two main types of strokes - ischemic and hemorrhagic. Ischemic strokes are caused by blockage of blood flow to the brain while hemorrhagic strokes involve bleeding into or around the brain. Risk factors, pathophysiology, clinical manifestations, diagnostic assessments, medical and nursing management are described for both types of strokes. Surgical procedures like carotid endarterectomy are mentioned as prevention and treatment options for ischemic strokes.
A stroke is a medical condition in which poor blood flow to the brain results in cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding.Both result in parts of the brain not functioning properly.
This document discusses stroke, also known as cerebrovascular accident. It defines stroke as the onset of neurological dysfunction lasting over 24 hours due to disrupted blood flow to the brain. Strokes are classified as either ischemic, caused by occlusion of cerebral blood vessels, or hemorrhagic, caused by leakage of blood into brain tissue. Signs and symptoms vary depending on the affected brain region but may include weakness, sensory changes, speech problems, and altered consciousness. Treatment involves stabilizing vital functions, reperfusion therapies if given early, managing blood pressure, and long term prevention strategies like anticoagulants or surgery. Nursing care focuses on prevention of injuries, management of deficits, communication support, and education to promote recovery.
This document provides information about stroke, including:
- Strokes are caused by a blockage or rupture of an artery in the brain, depriving brain tissue of oxygen.
- Symptoms vary depending on the area of brain affected but can include weakness, difficulty speaking or swallowing, and visual problems.
- Diagnosis involves medical history, physical exam, and brain imaging tests like CT scans or MRI.
- Treatment depends on the type of stroke but may include clot-busting drugs, surgery to repair blood vessels, and rehabilitation therapies. Prevention focuses on controlling risk factors like high blood pressure and smoking.
Stroke results from a disruption in blood flow to the brain. It is a leading cause of death and disability. Risk factors include hypertension, smoking, heart disease, diabetes, and older age. There are two main types - ischemic caused by blockage and hemorrhagic caused by bleeding. Treatment depends on the type but may include blood thinners, clot busters, or surgery. Physical therapy focuses on regaining mobility and function through exercises, gait training, and positioning. Prevention emphasizes controlling risk factors like blood pressure, cholesterol, diabetes, and lifestyle changes like quitting smoking.
The document discusses stroke, including its causes, risk factors, types, symptoms, diagnosis, and treatment. A stroke occurs when blood flow to the brain is interrupted, either by a blockage (ischemic stroke) or bleeding (hemorrhagic stroke). Risk factors include age, gender, family history, hypertension, heart disease, diabetes, and lifestyle factors like smoking. Diagnostic tests identify the location and size of damage, while treatment focuses on prevention, medications, surgery, rehabilitation, and managing symptoms.
diagnosis and management of ischemic cerebrovascular disease by Ismail SurchiIsmail Surchi
This document discusses ischemic cerebrovascular disease and stroke. It defines stroke as the interruption of blood flow to the brain. The most common type of stroke is ischemic stroke, which is caused by blocked arteries due to atherosclerosis and blood clots. Symptoms of stroke depend on the affected brain region and may include weakness, numbness, vision issues, and speech problems. Diagnosis involves CT/MRI imaging, ECG, and blood tests. Treatment focuses on rapidly restoring blood flow through clot-busting drugs or surgery. Long-term care aims to recover function and prevent future strokes through rehabilitation and risk factor management.
1. A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or ruptures, cutting off blood flow and causing brain cells to die.
2. There are two main types of stroke - ischemic caused by a clot and hemorrhagic caused by a ruptured blood vessel.
3. FAST is a mnemonic used to recognize the most common stroke symptoms - facial drooping, arm weakness, speech difficulties, and time to call emergency services.
The document discusses stroke, including its pathophysiology, types, risk factors, and management categories. Key points include:
- Stroke is caused by interrupted blood flow to the brain and can be ischemic (caused by clots or blockages) or hemorrhagic (caused by bleeding).
- Major risk factors include age, gender, race, family history, diabetes, heart disease, smoking, hypertension, and obesity.
- Strokes are classified based on location and cause, such as thrombotic, embolic, or hemorrhagic strokes.
- Complications include sensory and motor deficits, speech/swallowing issues, and cognitive/emotional changes.
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2. Objectives
Define “stroke”
Discuss incidence & risk factors
Review Cerebral flow and factors that
affect it
Discuss pathophysiology of CVA
Correlate clinical manifestations of
stroke with the pathophysiology.
3. History of Stroke
Hippocrates-2,400 yrs ago
Names for Stroke
Most commonly known today
Brain Attack
4. Definition
Ischemia is inadequate blood flow
Brain attack (Stroke) occurs when there
is ischemia to a part of the brain that
results in death of brain cells
5. Incidence
3rd Cause of death in US and Canada
Statistics
2/3 in people >65
= in men and women
Higher incidence and death rates
among African-Americans, Hispanics,
Native-American, Asian Americans
9. Blood supply by arteries
Blood is supplied to the brain by two
major pairs of arteries
Internal carotid arteries
Vertebral arteries
10. Blood supply by arteries
Carotid arteries branch to supply most
of the
Frontal, parietal, and temporal lobes
Basal ganglia
Part of the diencephalon
Thalamus
Hypothalamus
11. Blood supply by arteries
Vertebral arteries join to form the
basilar artery, which supply the
Middle and lower temporal lobes
Occipital lobes
Cerebellum
Brainstem
Part of the diencephalon
13. Etiology
Atherosclerosis – Disease of the
arteries; hardening and thickening of
the arterial wall because of soft
deposits of intraarterial fat and fibrin
that harden over time.
15. Transient Ischemic Attack
(TIA)
Transient ischemic attack (TIA) is a
temporary focal loss of neurologic
function caused by ischemia
Most TIAs resolve within 3 hours
TIAs are a warning sign of progressive
cerebrovascular disease
16. Types of Stroke
Strokes are classified based on the
underlying pathophysiologic findings
Ischemic
Hemorrhagic
18. Ischemic Stroke
Ischemic strokes result from inadequate
blood flow to the brain from partial or
complete occlusion of an artery
85% of all strokes are ischemic strokes
19. Ischemic Stroke
Thrombotic or Embolic
Most patients with ischemic
stroke do not have a decreased
level of consciousness in the
first 24 hours
May progress in the first 72
hours
20. Thrombotic stroke
Thrombosis occurs in relation to injury to a
blood vessel wall and formation of a blood
clot
Result of thrombosis or narrowing of the
blood vessel
Most common cause of stroke
21. Embolic stroke
Occur when an embolus lodges in and
occludes a cerebral artery
Results in infarction and edema of the area
supplied by the involved vessel
Second most common cause of stroke
22. Embolic stroke
Majority of emboli originate in the inside
layer of the heart, with plaque breaking off
from the endocardium and entering the
circulation
Patient with an embolic stroke commonly
has a rapid occurrence of severe clinical
symptoms
23. Hemorrhagic Stroke
Account for approximately 15% of all
strokes
Result from bleeding into the brain
tissue itself or into the subarachnoid
space or ventricles
24. Hemorrhagic Stroke
Intracerebral hemorrhage
Bleeding within the brain caused by a
rupture of a vessel
Hypertension is the most important cause
Hemorrhage commonly occurs during
periods of activity
25. Hemorrhagic Stroke
Intracerebral hemorrhage
Manifestations include neurologic deficits,
headache, nausea, vomiting, decreased
levels of consciousness, and hypertension
26. Hemorrhagic Stroke
Subarachnoid hemorrhage
Occurs when there is intracranial bleeding
into cerebrospinal fluid-filled space
between the arachnoid and pia mater
Commonly caused by rupture of a
cerebral aneurysm
27. Clinical Manifestations
Affects many body functions
Motor activity
Elimination
Intellectual function
Spatial-perceptual alterations
Personality
Affect
Sensation
Communication
28. Clinical Manifestations
Brain attack
Term increasingly being used to describe
stroke and communicate urgency of
recognizing stroke symptoms and treating
their onset as a medical emergency
29. Clinical Manifestations
Motor Function
Most obvious effect of stroke
Include impairment of
Mobility
Respiratory function
Swallowing and speech
Gag reflex
Self-care abilities
30. Clinical Manifestations
Motor Function
An initial period of flaccidity may last
from days to several weeks and is
related to nerve damage
Spasticity of the muscles follows the
flaccid stage and is related to
interruption of upper motor neuron
influence
31. Clinical Manifestations
Communication
Patient may experience aphasia when
a stroke damages the dominant
hemisphere of the brain
Aphasia is a total loss of
comprehension and use of language
32. Clinical Manifestations
Communication
Dysphasia refers to difficulty related to
the comprehension or use of language
and is due to partial disruption or loss
Dysphasia can be classified as
nonfluent or fluent
33. Clinical Manifestations
Communication
Dysarthria does not affect the
meaning of communication or the
comprehension of language
It does affect the mechanics of speech
34. Clinical Manifestations
Affect
Patients who suffer a stroke may have
difficulty controlling their emotions
Emotional responses may be
exaggerated or unpredictable
35. Clinical Manifestations
Intellectual Function
Both memory and judgment may be
impaired as a result of stroke
A left-brain stroke is more likely to
result in memory problems related to
language
39. Clinical Manifestations
Elimination
Most problems with urinary and bowel
elimination occur initially and are
temporary
When a stroke affects one hemisphere
of the brain, the prognosis for normal
bladder function is excellent
40. Diagnostic Studies
When symptoms of a stroke occur,
diagnostic studies are done to
Confirm that it is a stroke
Identify the likely cause of the stroke
CT is the primary diagnostic test used
after a stroke
41. Diagnostic Studies
Additional studies
Complete blood count
Platelets, prothrombin time, activated
partial thromboplastin time
Electrolytes, blood glucose
Renal and hepatic studies
Lipid profile
42. Collaborative Care
Prevention
Goals of stroke prevention include
Health management for the well individual
Education and management of modifiable
risk factors to prevent a stroke
43. Collaborative Care
Prevention
Antiplatelet drugs are usually the
chosen treatment to prevent further
stroke in patients who have had a TIA
Aspirin is the most frequently used
antiplatelet drug
44. Collaborative Care
Prevention
Surgical interventions for the patient
with TIAs from carotid disease include
Carotid endarterectomy
Transluminal angioplasty
Stenting
Extracranial-intracranial bypass
45. Collaborative Care
Acute Care
Assessment findings
Altered level of consciousness
Weakness, numbness, or paralysis
Speech or visual disturbances
Severe headache
↑ or ↓ heart rate
Respiratory distress
Unequal pupils
46. Collaborative Care
Acute Care
Interventions – Initial
Ensure patient airway
Remove dentures
Perform pulse oximetry
Maintain adequate oxygenation
IV access with normal saline
Maintain BP according to guidelines
47. Collaborative Care
Acute Care
Interventions – Initial
Remove clothing
Obtain CT scan immediately
Perform baseline laboratory tests
Position head midline
Elevate head of bed 30 degrees if no
symptoms of shock or injury
48. Collaborative Care
Acute Care
Interventions – Ongoing
Monitor vital signs and neurologic status
Level of consciousness
Motor and sensory function
Pupil size and reactivity
O2 saturation
Cardiac rhythm
49. Collaborative Care
Acute Care
Recombinant tissue plasminogen
activator (tPA) is used to
Reestablish blood flow through a blocked
artery to prevent cell death in patients
with acute onset of ischemic stroke
symptoms
50. Collaborative Care
Acute Care
Thrombolytic therapy given within 3
hours of the onset of symptoms
↓ disability
But at the expense of ↑ in deaths within
the first 7 to 10 days and ↑ in intracranial
hemorrhage
51. Collaborative Care
Acute Care
Surgical interventions for stroke
include immediate evacuation of
Aneurysm-induced hematomas
Cerebellar hematomas (>3 cm)
52. Collaborative Care
Rehabilitation Care
After the stroke has stabilized for
12-24 hours, collaborative care shifts
from preserving life to lessening
disability and attaining optimal
functioning
Patient may be transferred to a
rehabilitation unit
53. Nursing Management
Nursing Implementation
Respiratory System
Management of the respiratory system is a
nursing priority
Risk for aspiration pneumonia
Risks for airway obstruction
May require endotracheal intubation and
mechanical ventilation
54. Nursing Management
Nursing Implementation
Neurologic System
Monitor closely to detect changes
suggesting
Extension of the stroke
↑ ICP
Vasospasm
Recovery from stroke symptoms
55. Nursing Management
Nursing Implementation
Cardiovascular System
Monitoring vital signs frequently
Monitoring cardiac rhythms
Calculating intake and output, noting
imbalances
Regulating IV infusions
56. Nursing Management
Nursing Implementation
Cardiovascular System
Adjusting fluid intake to the individual
needs of the patient
Monitoring lung sounds for crackles and
rhonchi (pulmonary congestion)
Monitoring heart sounds for murmurs or
for S3 or S4 heart sounds
57. Nursing Management
Nursing Implementation
Musculoskeletal System
Trochanter roll at hip to prevent external
rotation
Hand cones to prevent hand contractures
Arm supports with slings and lap boards
to prevent shoulder displacement
58. Nursing Management
Nursing Implementation
Integumentary System
Skin of the patient is susceptible to
breakdown related to loss of sensation, ↓
circulation, and immobility
Compounded by patient age, poor
nutrition, dehydration, edema, and
incontinence
59. Nursing Management
Nursing Implementation
Integumentary System
Pressure relief by position changes,
special mattresses, or wheelchair
cushions
Good skin hygiene
Emollients applied to dry skin
60. Nursing Management
Nursing Implementation
Integumentary System
Early mobility
Position patient on the weak or paralyzed
side for only 30 minutes
61. Nursing Management
Nursing Implementation
Gastrointestinal System
After careful assessment of swallowing,
chewing, gag reflex, and pocketing, oral
feedings can be initiated
Feedings must be followed by scrupulous
oral hygiene
62. Nursing Management
Nursing Implementation
Communication
Nurse’s role in meeting psychologic needs
of the patient is primarily supportive
Patient is assessed both for the ability to
speak and the ability to understand
Speak slowly and calmly, using simple
words or sentences
63. Nursing Management
Nursing Implementation
Sensory-Perceptual Alterations
Blindness in the same half of each visual
field is a common problem after stroke
Other visual problems may include diplopia
(double vision), loss of the corneal reflex,
and ptosis (drooping eyelid)
64. Nursing Management
Nursing Implementation
Ambulatory and Home Care
The rehabilitation nurse assesses the
patient and family with
Rehabilitation potential of the patient
Physical status of all body systems
Presence of complications caused by the stroke
or other chronic conditions
Cognitive status of the patient
65. Nursing Management
Nursing Implementation
Ambulatory and Home Care
The patient is usually discharged from the
acute care setting to home, an
intermediate or long-term care facility, or a
rehabilitation facility
66. Nursing Management
Nursing Implementation
Ambulatory and Home Care
Nurses have an excellent opportunity to
prepare the patient and family for
discharge through
Education
Demonstration
Practice
Evaluation of self-care skills