St.

Paul University Dumaguete

College of Nursing

Rayna Lynn R. De Castro,

RN
Clinical Instructor
cerebrovascular accident (CVA) or “brain
attack.”
Stroke
Risk factors include:

•Age (greater than 50 years old)

•Taking birth control pills and being over
30 year old
•Overweight
•Smoking
•Hypertension
•High blood cholesterol levels
•Diabetes
•Heart disease
•Substance abuse, particularly of crack
cocaine
•Family history of strokes or transient
ischemic attacks
TYPES OF STROKE
TIA: transient ischemic attack
“mini stroke.”
WHAT TO LOOK FOR

• Weakness, numbness, or paralysis

of the
face, an arm, or a leg on one side
of the
body
• Blurred or decreased vision,
especially in
one eye
• Problems speaking (drooling or
slurred
speech) or understanding
• Dizziness or loss of balance

• Sudden, severe and unexplained

headache

• Deviation of the eyes from PERRLA

(Pupils Equally Round Reactive to Light)
Los Angeles Stroke Screen
• Is a proven method for quickly
identifying stroke victims

• Involves 3 simple test for one-side

paralysis
1. Arm strength (both
arms)

Person closes eyes and

holds both arms out
with palms down.
Slowly count to 5. If
one arm does not
move and other drifts
down, suspect a
stroke.
2. Facial smile
Person smiles or
show teeth. If one
side of face does not
move as well as the
other side, suspect a
stroke.
3. Hand grip (both hands)
Person grips two of your
fingers at the same time. If
grip strength is not equal,
suspect a stroke.
Exam: look for obvious asymmetry
  Normal Right Left

Facial smile / __ Droop __ Droop

grimace:

Grip: __ Weak __ Weak

Grip Grip
__ No Grip __ No Grip

Arm weakness: __ Drifts __ Drifts

Down Down
__ Falls __ Falls
Rapidly Rapidly
WHAT TO DO

•First aid for a stroke victim is limited

to supportive care:

1.Call EMS. Minimize brain damage by

getting the victim to a hospital.

2.If the victim is unresponsive, check

ABCs:
3. If the victim is conscious, lay the
victim down with the head and
shoulders slightly elevated.

• Place a victim who is unresponsive

but breathing in the recovery
position to keep the airway open
and to permit secretions and vomit
to drain from the mouth.
DIABETES

• is a condition in which
insulin, a hormone
produced by the
pancreas that helps the
body use the energy in
food, is either lacking or
ineffective.
TYPES:

1.Type I : juvenile-onset or
insulin-dependent diabetes

2.Type II : Adult-onset or
non-insulin dependent

3.Gestational diabetes
HYPOGLYCEMIA

-Very low blood sugar.

- Insulin Reaction/Insulin Shock
LOW BLOOD SUGAR
• Sudden onset
•Staggering, poor
coordination
•Anger, bad temper
•Confusion, disorientation
•Sudden hunger
•Excessive sweating
•Trembling
•Eventual consciousness
•Pale color
WHAT TO DO
1. Give sugar using the “rule
of 15s” for insulin reaction if all
three conditions are present:
•The victim is known diabetic
and
•The victim’s mental status is
altered and
•The victim is awake enough
to swallow
 “Rule of 15s” for Insulin
Reaction
(hypoglycemia)
• Give 15 grams of
carbohydrate (sugar)
•Wait 15 minutes.
•If no improvement, give 15
more grams of carbohydrate.
•If no improvement, seek
medical attention.
•Fast-acting sugars of 10 -15
grams:
•1 tube of glucose gel
•2 – 5 glucose tablets
•2 large lumps or teaspoons of sugar
•½ can of regular soda
•4 oz. of orange juice
•2 tablespoons of raisins
•5 – 7 seven lifesavers
•6 jellybeans
•10 gumdrops
•6-8 oz. of skim or 1% milk
•2 teaspoons of honey or corn syrup
An injectable medication
called glucagon,
available by a physician’s
prescription, raises blood
sugar quickly.
HIGH BLOOD SUGAR
•Hyperglycemia – also known as
diabetic coma -- is the
opposite of hypoglycemia.

•Occurs when the body has too

much sugar in the blood.
•This condition may be caused by
insufficient insulin, overeating,
inactivity, illness, stress or a
combination of these factors.
s/s of diabetic coma and
hyperglycemia as diabetic
emergencies requiring first aid:
•Gradual onset
•Drowsiness
•Extreme thirst
•Very frequent urination
•Flushed skin
•Vomiting
•Fruity breath odor
•Heavy breathing
•Eventual unconsciousness
Insulin Shock

- Too much insulin

in the body.
WHAT TO DO
1. If you are uncertain whether
the victim has high or low blood
sugar level, give the person
sugar-containing foods or drinks.

2.If improvement is not seen in

15 minutes, take the victim to
the hospital.