CVA HEALTH EDUCATION SESSION PRC.pptx

A CASE PRESENTATION ON CVA STROKE

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1. A HEALTH EDUCATION ON CEREBROVASCULAR ACCIDENT (STROKE) By: Airon Vince Calica Stephanie Mickey Advincula BSN- V SAINT PADRE PIO OF PIETRECLINA 2019

2. Opening Prayer…

3. OBJECTIVES: At the end of the 30-minute health education session, the student nurses will be able to: To inform the employees about cerebrovascular accident (stroke) its epidemiology, types, risk factors, prevention, and management. To promote awareness on the lifestyle modifications to prevent the occurrence of cerebrovascular accident (stroke). To evaluate employees’ understanding about cerebrovascular accident (stroke).

4. INTRODUCTION Cerebrovascular accident /brain attack is a sudden loss of function resulting from disruption of the blood supply to a part of the brain. It also defined as a death of an area of brain tissue (cerebral infarction) resulting from an inadequate supply of blood and oxygen to the brain due to blockage of an artery.

5. Two types of hemorrhagic stroke   INTRACEREBRAL HEMORRHAGE   The most common hemorrhagic stroke happens when a blood vessel inside the brain bursts and leaks blood into surrounding brain tissue (intracerebral hemorrhage). SUBARACHNOID HEMORRHAGE   This type of stroke involves bleeding in the area between the brain and the tissue covering the brain, known as the subarachnoid space. This type of stroke is most often caused by a burst aneurysm.

6. EPIDEMIOLOGY Stroke is the Philippines' second leading cause of death. It has a prevalence of 0·9%; ischemic stroke comprises 70% while hemorrhagic stroke comprises 30%. Age-adjusted hypertension prevalence is 20·6%, diabetes 6·0%, dyslipidemia 72·0%, smoking 31%, and obesity 4·9%. Source: Navarro J., Baroque A., Lokin J., Venketasubramanian , N., (May 20, 2014) The real stroke burden in the Philippines. https://doi.org/10.1111/ijs.12287

7. Stroke in the Philippines (May 2014) Deaths Percentage Rate World Rank 63,261 12.14 119.21 54 According to the latest WHO data published in May 2014, stroke deaths in Philippines reached 63,261 or 12.14% of total deaths. The age adjusted Death Rate is 119.21 per 100,000 of population ranks Philippines #54 in the world. Source: Stroke in Philippines. (May 2014). Retrieved March 29, 2018, from http://www.worldlifeexpectancy.com/philippines-stroke

8. In the world Stroke and Cerebrovascular Disease when considered separately from other CVDs, stroke ranks No. 5 among all causes of death, behind diseases of the heart, cancer, chronic lower respiratory disease, and unintentional injuries/accidents. Globally, in 2013 there were 6.5 million stroke deaths, making stroke the second-leading cause of death behind ischemic heart disease. Source: Benjamin E., Blaha M., Chiuve S., et al., (March 7, 2017) Heart Disease and Stroke Statistics- 2017 Update. A Report from the American Heart Association. doi: 10.1161/CIR.0000000000000485

9. In the world Approximately 795 000 strokes occur in the United States each year. On average, every 40 seconds, someone in the United States has a stroke, and on average, every 4 minutes, someone dies of a stroke. Approximately 60% of stroke deaths occurred outside of an acute care hospital. A review of recent clinical trials identified the benefit of intense BP reduction, which reduced risks of stroke outcomes. Source: Benjamin E., Blaha M., Chiuve S., et al., (March 7, 2017) Heart Disease and Stroke Statistics- 2017 Update. A Report from the American Heart Association. doi: 10.1161/CIR.0000000000000485

10. RISK FACTORS PRECIPITATING FACTORS High blood pressure Smoking Diabetes High cholesterol Physical inactivity and obesity . Source: American Stroke Association (November 17, 2016). Retrieved March 29, 2018, from http://www.strokeassociation.org/STROKEORG/AboutStroke/Lets-Talk-About-Stroke-Patient-Information-Sheets_UCM_310731_Article.jsp#.WrxlPohubIU

11. RISK FACTORS PRECIPITATING FACTORS 6. Carotid or other artery disease 7. Transient ischemic attacks (TIAs) 8. Atrial fibrillation (AFib) or other heart disease 9. Certain blood disorders 10. Excessive alcohol intake . 11. Illegal drug use . 12. Sleep apnea . Source: American Stroke Association (November 17, 2016). Retrieved March 29, 2018, from http://www.strokeassociation.org/STROKEORG/AboutStroke/Lets-Talk-About-Stroke-Patient-Information-Sheets_UCM_310731_Article.jsp#.WrxlPohubIU

12. How hypertension impacts on your heart and blood vessels: Hypertension stresses your body’s blood vessels, causing them to clog or weaken.  Hypertension can lead to atherosclerosis and narrowing of the blood vessels making them more likely to block from blood clots or bits of fatty material breaking off from the lining of the blood vessel wall. Damage to the arteries can also create weak places that rupture easily or thin spots that balloon out the artery wall resulting in an aneurysm.

13. RISK FACTORS PREDISPOSING FACTORS   1. Age 2. Family history 3. Race 4. Gender 5. Prior stroke or heart attack Source: American Stroke Association (November 17, 2016). Retrieved March 29, 2018, from http://www.strokeassociation.org/STROKEORG/AboutStroke/Lets-Talk-About-Stroke-Patient-Information-Sheets_UCM_310731_Article.jsp#.WrxlPohubIU

14. Comparison of Left and Right Hemispheric Strokes Left Hemispheric Stoke Right Hemispheric Stoke - Paralysis/weakness on right side of the body -Right visual field deficit - Aphasia (expressive, receptive, or global) - Altered intellectual ability - Slow, cautious behavior - Paralysis/weakness on left side of body - Left visual field deficit - Spatial-perceptual deficits - Increased distractibility - Impulsive behavior and poor judgement - Lack of awareness of deficits

15. Assessment and Diagnostics   History and Complete Physical and Neurologic examination Computed Tomography Scan (Initial Diagnostic test) 12-lead Electrocardiogram (ECG) CT angiography/CT perfusion Magnetic resonance Imaging (MRI) Magnetic resonance angiography of brain and neck vessels

16. Prevention Smoking Cessation Maintaining a Healthy Weight Following a Healthy Diet Modest Alcohol Consumption Regular Exercise Dietary Approaches to Stop Hypertension diet (DASH)

17. Medical Management Anticoagulants such as aspirin Platelet inhibiting medications: Aspirin, Extended-release dipyridamole plus aspirin (Aggrenox), and Clopidogrel (Plavix) Statins Thrombolytic Therapy

18. ANY QUESTIONS OR CLARIFICATIONS?

19. REFERENCES: BOOKS: Brunner, L. S., Suddarth , D. S., & Smeltzer, S. C. 0. (2008). Brunner & Suddarth's textbook of medical-surgical nursing (12th ed.). Philadelphia Lippincott Williams & Wilkins. Doenges, Marilyn E. et al. Nurse's Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales, 12th Edition. F.A. Favis Company Seeley, Stephens. Essentials of Anatomy and Physiology, 8th Edition. McGraw-Hill Porth, C. M. Essentials of Pathophysiology, 3rd Edition. Lippincott Williams & Wilkins Schull, P. D. Nursing Spectrum Drug Handbook McGraw-Hill Kozier, et al. Kozier & Erb's Fundamentals of Nursing, Eight Edition.

20. REFERENCES: ELECTRONIC RESOURCES: [1] Cerebrovascular Accident (Stroke) Nursing Care and Management: A Study Guide. (2017, September 26). Retrieved March 29, 2018, from https://nurseslabs.com/cerebrovascular-accident-stroke/ [2] Navarro J., Baroque A., Lokin J., Venketasubramanian , N., (May 20, 2014) The real stroke burden in the Philippines. https://doi.org/10.1111/ijs.12287 [3] Stroke in Philippines. (May 2014). Retrieved March 29, 2018, from http://www.worldlifeexpectancy.com/philippines-stroke [4] Benjamin E., Blaha M., Chiuve S., et al., (March 7, 2017) Heart Disease and Stroke Statistics- 2017 Update. A Report from the American Heart Association. doi: 10.1161/CIR.0000000000000485 [5] American Stroke Association (November 17, 2016). Retrieved March 29, 2018, from http://www.strokeassociation.org/STROKEORG/AboutStroke/Lets-Talk-About-Stroke-Patient-Information-Sheets_UCM_310731_Article.jsp#.WrxlPohubIU [6] “Stroke: Risk Factors.” (2018) WJMC - West Jefferson Medical Center, www.wjmc.org/strokecare/WJMC-Neuroscience-Stroke-Risk-Factors.aspx. [7] Anatomy of the Brain. (n.d.). Retrieved March 31, 2018, from https://www.mayfieldclinic.com/PE-AnatBrain.htm [8] Neurogistics . (n.d.). Retrieved March 31, 2018, from https://www.neurogistics.com/the-science/what-are-neurotransmitters  

21. Closing Prayer…