Stroke due to Hypertension

By:
 TEACHING
LEARNING OUTCOMES CONTENT LEARNING REFERENCES
ACTIVITIES
1. Recall the topic of High blood pressure or hypertension increases the risk of Lecture www.medicalnewstoday.com/articles/150109.php
Hypertension heart disease and stroke. Hypertension risk factors include obesity,
Discussion
and Stroke drinking too much alcohol, smoking, and family history.

Stroke is the sudden death of brain cells due to lack of oxygen,

caused by blockage of blood flow or rupture of an artery to the
brain. Sudden loss of speech, weakness, or paralysis of one side of
the body can be symptoms. A suspected stroke may be confirmed
by scanning the brain with special X-ray tests, such as CAT scans.
The death rate and level of disability resulting from strokes can be
dramatically reduced by immediate and appropriate medical care.
Prevention involves minimizing risk factors, such as controlling high
blood pressure and diabetes. Abbreviated CVA. Also known as
cerebrovascular accident.

2. Recite related Blood Pressure- the pressure of the blood in the circulatory system,
terms often measured for diagnosis since it is closely related to the force
and rate of the heartbeat and the diameter and elasticity of the
arterial walls.

3. Know the GENERAL DATA OF THE PATIENT

general data of Patient: M.L.C.
 the patient Age: 67 years old
Birthday:
Gender: Female
Civil Status: Married
Address: Kasambagan, Cebu city
Occupation: House wife
Religion: Roman Catholic

4. Recognize the HISTORY OF PRESENT ILLNESS

A case of M.L.C 67 years old, female, married, a Roman
present and past
Catholic, residing at Kasambagan , Cebu city. 6 years ago, patient
history of the was cooking when she felt dizzy and fainted. She can not move
right side of her body so she was rushed to City Government of
client
Cebu but she signed a waiver that she do not want to be admitted.

PAST HEALTH HISTORY

Patient is hypertensive, diabetic, non-smoker, no drug and
food allergies. Patient grandson was diagnosed with Henoch-
Schonlein purpura
5. Explain the EYES
Patient’s iris is black. Eyebrows are evenly distributed,
physical
symmetrically aligned, equal movement of eyebrows when raise.
assessment of Eyelid skin is intact. It closes symmetrically, blinks symmetrically.
Can move eyes freely without pain. Experiencing vision loss.
the patient
HEAD AND FACE
Patient’s head is round and symmetrical. There are no
nodules or masses when palpated. Patients face appeared smooth
and has uniform consistency.

EARS
Patient’s color of the ear is fair brown and it is symmetrical.
The alignment of pinna is symmetrical. The pinnas are elastic and
recoil when folded. No discharges were noted.

MOUTH AND THROAT

The lips is bluish, dry and cracked. The gum is pinkish. The
tongue is in the midline and is pinkish in color and smooth. She has
upper and lower dentures.

NOSE
The color of the client’s nose is fair brown. The mucosa is
pink. Nostrils are not patent and nasal flaring is present.

RESPIRATORY
Patient’s respiratory rate is 24 cycles per minute. The chest
was symmetrical on both sides

HEART
The rhythm is regular with 80 beats per minute. No
murmurs noted.

ARMS, HANDS and FINGERS

Upon testing CN XI, patient cannot shrug her right shoulder
properly and can turn head against resistance. No lesions,
tenderness, swellings were noted upon palpating shoulder. Upon
 testing ROM patient cannot freely move her right wrist and
fingers.

6. Summarize the Marieb, Elaine (2013), Human Anatomy &

organ or system Physiology. Jurong, Singapore 629733.
involved in
Hypertension
And Stroke Sylvia S. Mader, Inquiry into Life, 8th edition. Copy
right © 1997 The McGrew-Hill Companies, Inc.

The heart is a large muscular organ which constantly pushes

oxygen-rich blood to the brain and extremities and transports
oxygen-poor blood from the brain and extremities to the lungs to
gain oxygen. Blood comes into the right atrium from the body,
moves into the right ventricle and is pushed into the pulmonary
arteries in the lungs. After picking up oxygen, the blood travels
back to the heart through the pulmonary veins into the left atrium,
to the left ventricle and out to the body's tissues through the aorta.
7. Trace the Conceptual Framework of the pathophysiology of Hypertension and Smeltzer, S.C.(2010) Brunner &Suddarth's
conceptual Textbook of Medical-Surgical Nursing. Wolters
Stroke (See Appendix A.)
framework of Kluwer Health. Lipincott Company
the
pathophysiology
Hypertension
and Stroke
8. Explain the Stroke is a leading cause of death and severe, long-term www.heart.org/en/health-topics/high-blood-
pathophysiology disability. Most people who’ve had a first stroke also had high pressure/health-threats-from-high-blood-
of Hypertension blood pressure (HBP or hypertension). pressure/how-high-blood-pressure-can-lead-to-
and Stroke stroke
ischemic stroke High blood pressure damages arteries throughout
the body, creating conditions where they can burst or clog more
easily. Weakened arteries in the brain, resulting from high blood
pressure, put you at a much higher risk for stroke — which is why
managing high blood pressure is critical to reduce your chance of
having a stroke

9. Comprehend the Smeltzer, S.C.(2010) Brunner &Suddarth's

symptomatology LIST OF SIGNS AND SYMPTOMS Textbook of Medical-Surgical Nursing. Wolters
(signs and HYpertension can include: Kluwer Health. Lipincott Company
symptoms) ● Severe headache.
Hypertension
● Fatigue or confusion.
and Stroke
● Vision problems.

● Chest pain.

● Difficulty breathing.

● Irregular heartbeat.
 ● Blood in the urine.

● Pounding in your chest, neck, or ears.

10. Identify the Source: J.H. Deglin, et.al., Davis’s Drug Guide for
medication for Nurses Twelfth Edition. F.A.DavisCompany,
List of
patient with Philadelphia
Medication Indications
Hypertension
and IVF
and Stroke
Carvedilol To control hypertension
(Nursing Drug Guide, 2007)
ACE inhibitors Angiotensin-converting enzyme (ACE)
inhibitors reduce blood pressure by relaxing
your blood vessels.
(nursing Drug Guide,2007)
Angiotensin-2 ARBs work in a similar way to ACE inhibitors.
receptor They're often recommended if ACE inhibitors
blockers (ARBs) cause troublesome side effects.
(https://www.webmd.com)
Calcium channel Calcium channel blockers reduce blood
blockers pressure by widening your blood vessels
(Nursing Guide,2007)
Diuretics Sometimes known as water pills, diuretics
work by flushing excess water and salt from
the body through urine. They're often used if
calcium channel blockers cause troublesome
side effects.
(Nursing Gide, 2007)
Beta-blockers Beta-blockers can reduce blood pressure by
making your heart beat more slowly and with
less force.Handbook,2010)
Anticoagulants Anticoagulants are drugs that help keep your
 blood from clotting easily by interfering with
the blood clotting process. These are used for
preventing ischemic strokes and TIAs.
(Nursing Guide,2007)
Antiplatelet Antiplatelets such as clopidogrel (Plavix) and
drugs aspirin can be used to help prevent blood
clots. They work by making it more difficult for
the platelets in your blood to stick together,
which is the first step in the formation of
blood clots. They are sometimes prescribed to
people who have had ischemic strokes or
heart attacks. Your doctor will probably have
you take them on a regular basis for an
extended period for prevention of heart attack
and stroke.
(Nursing Guide,2007)
Tissue Tissue plasminogen activator (TPA) is the only
plasminogen stroke drug that actually breaks up a blood
activator clot. It is used as a common emergency
treatment during a stroke. For this treatment,
TPA is injected into a vein or artery so it can
get to the blood clot quickly. TPA isn’t used for
everyone. People at high risk of bleeding into
their brain aren’t given TPA.
(Nursing Guide,2007)

11. Discover the Smeltzer, S.C.(2010) Brunner &Suddarth's

diet Textbook of Medical-Surgical Nursing. Wolters
Recommended
recommended to Rationale Kluwer Health. Lipincott Company
Diet
patient with
Avoid Salt A high-sodium diet increases blood pressure
 Hypertension (Sodium) in many people. In fact, the less sodium you
and stroke eat, the better blood pressure control you
might have.
(https://ncbi.nlm.nih.gov)
Potassium, may help control blood pressure.
magnesium, and (https://ncbi.lm.nih.gov)
fiber,
Fruits and are high in potassium, magnesium, and
vegetables fiber, and they’re low in sodium.
(https://ncbi.lm.nih.gov)
12. State the If you have a stroke and survive the first month, your www.ncbi.nlm.nih.gov/pmc/articles/PMC3537773/
prognosis of the likelihood of dying in the first year after the stroke is about 10%,1
disease condition and your risk of having a second stroke in the next 10 years is
43%. Treatment of elevated blood pressure reduces the risk of
recurrent stroke by 30%.