Cerebrovascular Accident (CVA)
-also known as: stroke or brain attack
-localized insufficient blood supply
-" contralateral deficit"
Risk Factors
a. hypertension (HPN)
b. diabetes mellitus (DM)
c. atherosclerosis- narrowing of blood vessels
d. high cholesterol- low density lipoprotein
e. sedentary liestyle
f. smoking
g. alcoholism
h. advancing age
i. family history
Causes
a. aneurysm- dilation of blood vessels
b. uncontrolled HPN
c. AV (atrioventricular) malformation
d. prolonged anticoagulant used
Two Types
a. Ischemic or Non-hemorrhagic-80%
1. thrombotic stroke, static clot
e.g; atherosclerosis
2. embolic stroke
e.g; air, fats, bacterial, tumor
3. ischemic stroke
- decrease blood supply
b. Hemorhagic: slowest recovery
e.g; epidural hematoma
subdural hematoma
subarachnoid hematoma
intracerebral hematoma: most fatal, necrosis ocurs 3-10 minutes after hemorrhage
Manifestation
1. Warning Signs
-loss of speech
-transient hemiparesis
-hemisensory loss
a. numbness/weakness in face, arms, legs (unilateral)
b.seizures
c.vomiting
d. dysphagia
e. dysarthria- imperfect articulation
f. headache
g. fever
h. hemiparesis
i. hemiplegia
j. homonymous hemianopia- loss of vision of the 1/2 of the visual field
k. ataxia
l. apraxia
m. aphasia
Aphasia
Two types
a. Wernickes
-superior temporal gyrus
-understanding, comprehension of spoken language
-receptive, sensory, fluent
- infarction of temporal lobe
b. Broca
-inferior frontal lobe
-language processing, spech production, comprehension
- expressive, motor, non-fluent
-infarction of the frontal lobe
Management
Pharmacologic
a. Antihypertensive
b. Antipyretics
c. Corticosteroids
d. Diuretics
e. Anticonvulsant
f. Anticoagulant
-heparin
-warfarin
g. Thrombolytics
-streptokinase
-urokinase
-tissue plasminogen activators
h. Antiplatelet
Nursing Management
a. restore and regain normal blood flow
b. NGT feeding because of dysphagia
c. side rails up
d. symptomatic care
e. physical therapy
f. speech therapy
-localized insufficient blood supply
-" contralateral deficit"
Risk Factors
a. hypertension (HPN)
b. diabetes mellitus (DM)
c. atherosclerosis- narrowing of blood vessels
d. high cholesterol- low density lipoprotein
e. sedentary liestyle
f. smoking
g. alcoholism
h. advancing age
i. family history
Causes
a. aneurysm- dilation of blood vessels
b. uncontrolled HPN
c. AV (atrioventricular) malformation
d. prolonged anticoagulant used
Two Types
a. Ischemic or Non-hemorrhagic-80%
1. thrombotic stroke, static clot
e.g; atherosclerosis
2. embolic stroke
e.g; air, fats, bacterial, tumor
3. ischemic stroke
- decrease blood supply
b. Hemorhagic: slowest recovery
e.g; epidural hematoma
subdural hematoma
subarachnoid hematoma
intracerebral hematoma: most fatal, necrosis ocurs 3-10 minutes after hemorrhage
Manifestation
1. Warning Signs
-loss of speech
-transient hemiparesis
-hemisensory loss
a. numbness/weakness in face, arms, legs (unilateral)
b.seizures
c.vomiting
d. dysphagia
e. dysarthria- imperfect articulation
f. headache
g. fever
h. hemiparesis
i. hemiplegia
j. homonymous hemianopia- loss of vision of the 1/2 of the visual field
k. ataxia
l. apraxia
m. aphasia
Aphasia
Two types
a. Wernickes
-superior temporal gyrus
-understanding, comprehension of spoken language
-receptive, sensory, fluent
- infarction of temporal lobe
b. Broca
-inferior frontal lobe
-language processing, spech production, comprehension
- expressive, motor, non-fluent
-infarction of the frontal lobe
Management
Pharmacologic
a. Antihypertensive
b. Antipyretics
c. Corticosteroids
d. Diuretics
e. Anticonvulsant
f. Anticoagulant
-heparin
-warfarin
g. Thrombolytics
-streptokinase
-urokinase
-tissue plasminogen activators
h. Antiplatelet
Nursing Management
a. restore and regain normal blood flow
b. NGT feeding because of dysphagia
c. side rails up
d. symptomatic care
e. physical therapy
f. speech therapy
Categories:
Medical Surgical Nursing
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