Cva

CVA class teaching ,b,sc nsg

1. PRAGYANSHREE NANDA PG 1 ST YR MED-SURG SPECIALITY KIIT UNIVERSITY

2. CEREBROVASCULAR ACCIDENT /STROKE

3. • INTRODUCTION Also called “brain attack”, cerebral infarction, cerebral hemorrhage, ischemic stroke or stroke A stroke, sometimes called a “brain attack,” occurs when blood flow to the brain is interrupted. When a stroke occurs, brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function.

4. •DEFINITION A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue.

5. RISK FACTORS: Being over age 55 Being an African-American Having diabetes Having a family history of stroke MEDICAL STROKE RISK Previous stroke Previous episode of transient ischemic attack (TIA) / ministroke High cholesterol High blood pressure Heart disease LIFESTYLE STROKE RISK Smoking Being overweight Drinking too much alcohol.

6. TYPES

7. )

8. ISCHEMIC STROKE :- Occurs when a clot or a mass clogs a blood vessel, cutting off the blood flow to brain cells. The underlying condition for this type of obstruction is the development of fatty deposits lining the vessel walls. This condition is called atherosclerosis. Almost 85% of strokes are ischemic

9. ATHEROSCLEROSIS “ hardening of the arteries ” “ athero ” – gruel or paste “ sclerosis ” – hardness It ’ s the process in which deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque. Occurs when a blood vessel bleeds into the tissue deep .

10. • HEMORRHAGIC STROKE Results from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. – About 15% of all strokes but responsible for 30% of stroke deaths INTRACEREBRAL HEMORRHAGE (ICH) SUBARACHNOID HEMORRHAGE (SAH)

11. INTRACEREBRAL HEMORRHAGE (ICH) Occurs when a blood vessel bleeds into the tissue deep within the brain. SUBARACHNOID HEMORRHAGE (SAH) Occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and the skull .

12. STAGES OF CVA Transient Ischemic Attack • sudden and short-lived attack • Is a "mini stroke" that occurs when a blood clot blocks an artery for a short time. Reversible ischemic neurologic deficit (RIND) similar to TIA, but symptoms can last up to a week Stroke in evolution (SIE) • Gradual worsening of symptoms of brain ischemia Completed stroke (CS) symptoms of stroke stable over a period and rehab can begin

13. Signs & Symptoms

14. DIAGNOSIS • Physical Examination series of X-rays neurological examination medical history •CT scan and MRI

15. ISCHEMIC STROKE

16. HEMORRHAGIC STROKE

17. MANAGMENT

18. Anticoagulants warfarin Antiplatelet medicines Aspirin ANTI-HYPERTENSIVE Angiotensin II receptor blockers (ARB Angiotensin -converting enzyme (ACE) inhibitors Beta-blockers Calcium channel blockers. Diuretics Antidepressants bupropion ( Wellbutrin ) fluoxetine (Prozac) Anticonvulsants Diazepam Lorazepam Clopidogrel

19. SURGICAL MANAGEMENT Cerebral revascularization Mechanical embolectomy

20. NURSING MANAGMENT

21. Ineffective Tissue Perfusion related to Interruption of   blood flow evidenced by Changes in vital signs . Impaired Physical Mobility related to cognitive impairment AS evidenced by decreased   muscle strength/control. Impaired Verbal Communication related to loss of facial/oral   muscle tone/control evidenced by Inability to modulate speech,

22. Disturbed Sensory Perception related to Altered sensory reception evidenced by altered thought processes /bizarre thinking Ineffective Coping related to Situational crises evidenced by Inappropriate use of defense mechanisms

23. SUMMARY

24. CONCLUSION

25. Mechanical embolectomy