STROKE
Sudden impairment of blood circulation to the brain Recurrences possible within weeks, months, or years Also known as cerebrovascular accident (CVA) or brain attack
PATHOPHYSIOLOGY
Oxygen supply to the brain is interrupted or diminished In thrombotic or embolic stroke, neurons die from lack of oxygen; in hemorrhagic stroke, impaired cerebral perfusion causes infarction
CAUSES
Cerebral embolism
Cardiac arrhythmias Post traumatic valvular disease
Cerebral Hemorrhage
Arteriovenous malforation Cerebral Aneurysm Chronic hypertension
CAUSES
Cerebral thrombosis
Most common cause of stroke results from obstruction of blood vessel in the extracerebral vessels Site may be intracerebral
RISK FACTORS:
History of Transient Ischemic Attack Heart Disease Smoking Familial History of CVA Obesity Alcohol use High Red Blood Count Diabetes Mellitus
RISK FACTORS:
High Serum Triglycerides and cholesterol level Use of hormonal contraceptives hypertension
TREATMENT
Secure patent airway Careful blood pressure management : tiration of fluids and vasoactive drugs to maintain normotension Medication: Analgesics, anticoagulants, anticonvulsants, antidepressants, antihypertensive, anti platelet, lipid lowering agents and stool softener
TREATMENT
Surgery: Craniotomy, endarterectomy, extracranial bypass, ventricular shunts Pureed dysphagia diet or tube feedings if indicated Physical, speech and occupational rehabilitation
NURSING INTERVENTION
Maintain a patent airway and oxygenation Insert an indwelling urinary catheter, if necessary Ensure adequate nutrition Follow the physical therapy program and assist the patient with exercise Establish and maintain patient communication
NURSING INTERVENTION
Protect the patient from injury and complications Provide careful positioning to prevent aspiration and contractures Monitor patients
neurologic, Gi and respiratory status Vital signs Fluid and electrolytes Nutritional intake Development of deep vein thrombosis Pulmonary Embolus