"NURSING CARE IN CLIENTS

WITH CEREBROVASCULAR
ACCIDENT (CVA)"
Compiled By Group 5
Irma Febriani
Tika Maulidia
Andy Anugrah
Reni Raenipah
......
.....

DEFINITIONS
A stroke (apoplexy) is the sudden onset of
weakness, numbness, paralysis, slurred speech,
aphasia, problems with vision and other
manifestations of a sudden interruption of blood
flow to a particular area of the brain.
Stroke occurs when the supply of blood to the
brain is either interrupted or reduced. When this
happens, the brain does not get enough oxygen
or nutrients which cause brain cells to die.

CLASSIFICATION
Ischemic
stroke

Ischemic stroke is similar to a heart attack, except it

occurs in the blood vessels of the brain. Ischemic
stroke can also occur when too much plaque (fatty
deposits and cholesterol) clogs the brain's blood
vessels.

Hemorrhagic strokes occur when a blood vessel in

the brain breaks or ruptures. The most common
Hemorrhagic causes of hemorrhagic stroke are
high blood pressure and brain aneurysms.
stroke

CAUSES OF STROKE
The primary pathophysiology of
stroke is an underlying heart or
blood vessel disease.
The primary pathologies include
hypertension, atherosclerosis
leading to coronary artery
disease, dyslipidemia, heart
disease, and hyperlipidemia.

Causes of Stroke

RISK FACTORS FOR STROKE

These risk factors for stroke cannot be changed by
medical treatment or lifestyle changes
Age. Although stroke risk increases with age, stroke can
occur at any age.
Gender. Men have a higher risk for stroke, but more
women die from stroke.
Race. People from certain ethnic groups have a higher
risk of stroke.
Family history of stroke. Stroke seems to run in some
families. Several factors may contribute to familial stroke.

Some of the most important risk factors for stroke

that CAN be treated are:

High Blood Pressure

Smoking
Heart Disease
High Blood Cholesterol
Warning Signs or History of a Stroke
Diabetes

CLINICAL MANIFESTATIONS
General signs and symptoms include
numbness or weakness of face, arm, or leg
(especially on one side of body); confusion or
change in mental status; trouble speaking or
understanding speech; visual disturbances; loss
of balance, dizziness, difculty walking; or
sudden severe headache.

Continue..
Motor Loss (Hemiplegia,
hemiparesis, flaccid paralysis and
loss of or decrease in the deep
tendon reexes)
Communication Loss
(Dysarthria, Dysphasia, Apraxia)
Perceptual Disturbances and
Sensory Loss (Visual-perceptual
dysfunctions Disturbances in
visual spatial relations Sensory
losses)
Impaired Cognitive and
Psychological Effects (Frontal
lobe damage, depression or other
psychological problems)

Right Brain Left Brain Damage

DIAGNOSTIC STUDIES
CT scan (with/without enhancement)
PET scan
MRI
Cerebral angiography
Lumbar puncture (LP)
Transcranial Doppler ultrasonography
EEG
X-rays (skull)
Laboratory studies to rule out systemic
causes
ECG, chest x-ray, and
echocardiography

CT scan taken some

time after a large
stroke. The black
area is where the
stroke was and now
the brain tissue has
died and left a large
hole.
Photo via:
emedicinehealth.com

 Face drooping: if the person

tries to smile does one side of
the face droop?
Arm weakness: if the person
tries to raise both their arms
does one arm drift downward?
Speech difficulty: if the person
tries to repeat a simple phrase
is their speech slurred or
strange?
Time to call 911: if any of
these signs are observed,
contact the emergency
services

PREVENTION
Help patients alter
risk factors for
stroke
Administer
anticoagulant agents
as prescribed
Prepare and support
patient through
carotid
endarterectomy

6 ways to reduce your stroke risk.

Photo via:HuffingtonPost.com

MEDICAL
MANAGEMENT
Recombinant tissue
plasminogen activator (tPA)
Anticoagulation therapy
Management of increased
intracranial pressure (ICP)
Possible hemicraniectomy
Intubation with an
endotracheal tube
Continuous hemodynamic
monitoring

MANAGEMENT OF
COMPLICATIONS
Decreased cerebral
blood ow
Monitor for UTIs,
cardiac
dysrhythmias, and
complications of
immobility

Hemorrhagic-Subarachnoid
Cerebral Aneurysm Surgical Tx

Carotid Endarterectomy

Nursing Care Plans in Clients

of Stroke
Lanjutkeun ku andy yah ^_^