CVA - SJM PowerPoint Presentation PDF

Cerebrovascular Disorders (aka Stroke or CVA) This Photo by Unknown Author is licensed under CC BY- Objectives Describe the risk factors and preventive measures for CVA disorders Compare types of CVA disorders, causes, clinical manifestations, and medical...

Cerebrovascular Disorders (aka Stroke or CVA) This Photo by Unknown Author is licensed under CC BY- Objectives Describe the risk factors and preventive measures for CVA disorders Compare types of CVA disorders, causes, clinical manifestations, and medical management Explain nursing management for a client in the acute stage of an ischemic stroke. Describe how a nurse will care for a client recovering from an ischemic stroke or a hemorrhagic stroke. Discuss essential elements of family education and preparation for home care. Sample Footer Text 2 What are the nonmodifia ble and modifiable risk factors? This Photo by Unknown Author is licensed under CC BY-NC-ND  STROKE Sudden loss of function resulting from a disruption of the blood supply to a part of the brain Two types 1. Ischemic 2. Hemorrhagic Major Types of Stroke Bleeding or leaking Copyright © 2017, Elsevier Inc. All Rights Reserved. PARTS OF THE RIGHT BRAIN BRAIN LEFT AFFECT BRAIN BRAIN ED BY A STEM STROKE Key Terms Agnosia Aphasia Expressive aphasia Receptive aphasia Apraxia Dysarthria Hemianopsia Hemiparesis Hemiplegia  Most common site of ISCHEMIC embolic stroke STROKE Disruption of the blood supply caused by an obstruction, usually a thrombus or embolism, that causes infarction of brain tissue Manifestations of Ischemic Stroke Symptoms Numbness or depend on the weakness of face, Confusion or Trouble speaking location and size arm, or leg, change in mental or understanding of the affected especially on one status speech area side Difficulty in walking, Sudden, severe Perceptual dizziness, or loss headache disturbances of balance or coordination  Transie Temporary neurologic deficit resulting from a temporary impairment of nt blood flow Ischemi “Warning of an c impending stroke” Attack Diagnostic workup is required to treat and (TIA) prevent irreversible deficits Diagnostic Findings CT CT Angiogram 12-lead electrocardiogram MRI Endovascul ar treatment Thrombolytic Therapy o t-PA o Mechanical intervention Endovascular Therapy Carotid Endarterecto my Medical Managemen t Anticoagulant therapy Antihypertensives Antiplatelet therapy Statins What should the nurse focus on with a client recovering from an ischemic stroke in the acute phase? This Photo by Unknown Author is licensed under CC BY What should the nurse focus on with a client recovering from an ischemic stroke in the post acute phase?  Nursing Interventions - improve mobility Improve mobility - prevent joint deformities Prevent joint deformities Enhance self-care Nutrition Bowel and bladder control Strategies to enhance communication Monitor and manage potential complications Hemorrha gic stroke Caused by bleeding into brain tissue, the ventricles, or subarachnoid space  Manifestations of Hemorrhagic Stroke Early and Similar to Severe sudden ischemic headache changes in stroke LOC Nausea/ Seizures Vomiting Diagnostic Findings CT CT Angiogram MRI Potential Complications Cerebral Hypoxia and Decreased Blood Flow Vasospasm Increased Intracranial Pressure Hypertension This Photo by Unknown Author is licensed under CC BY-NC- What should the nurse focus on with a client recovering from a hemorrhagic stroke?  Nursing Interventions - improve mobility Improve mobility - prevent joint deformities Enhance self-care Relieve anxiety Patient and family education Seizure precautions Aneurysm precautions Monitor and manage potential complications Aneurysm Precautions Provide a nonstimulating environment, prevent increases in ICP, prevent further bleeding Absolute bed rest with HOB 30 degrees Avoid all activity that may increase ICP or BP; Valsalva maneuver, acute flexion or rotation of neck or head Stool softener and mild laxatives Nonstimulating, nonstressful environment; dim lighting, no reading, no TV, no radio Visitors are restricted  Prevention of and signs and symptoms of complications Home Care Medication education and Education Safety measures Adaptive strategies and use of assistive devices for ADLs for the Client Nutrition: diet, swallowing techniques, tube feeding Recovering administration Elimination: bowel and bladder programs, catheter use from a Stroke Exercise and activities, recreation and diversion Socialization, support groups, and community resources This Photo by Unknown Author is licensed under CC BY-N This Photo by Unknown Author is licensed under CC BY-SA  NCLEX QUESTION The nurse is assessing a client with a suspected stroke. What assessment finding is most suggestive of a stroke? A. Facial droop B. Dysrhythmias C. Periorbital edema D. Projectile vomiting