Date post: | 06-May-2015 |
Category: |
Health & Medicine |
Upload: | xtrm-nurse |
View: | 3,274 times |
Download: | 5 times |
CEREBROVASCULAR DISORDERS
A Nursing Approach in the Management of
BY: DAVE JAY S. MANRIQUEZ BSN,RN.
CEREBROVASCULAR DISORDERS
An umbrella term that refers to any functional abnormality of the central nervous system that occurs when the normal blood supply to the brain is
disrupted.
STROKEa sudden neurological event which results in
the new onset of neurological symptoms.
TYPES of
STROKE
ISCHEMIC STROKE
“BRAIN ATTACK”
MOTOR LOSS-disturbance of voluntary motor control on the side of the body opposite the location of the stroke lesion
•Hemiplegia•Hemiparesis
COMMUNICATION LOSS
•Dysarthria•Apraxia•Agnosia•Dysphasia or Aphasia
PERCEPTUAL DISTURBANCES
•Homonymous Hemianopsia•Disturbance in Visual-Spatial Relations
- Unilateral Neglect•Loss of Peripheral Vision•Night Blindness•Diplopia•Horner’s Syndrome
SENSORY LOSS
•Slight Impairment of Touch•Loss of Proprioception•Difficulty in interpreting visual, tactile, and auditory stimuli
COGNITIVE IMPAIRMENT & PSYCHOLOGICAL EFFECTS
ASSESSMENT & DIAGNOSTICS
•Patient History•Complete Physical and Neurologic Examination•Initial Assessment: Airway Patency, Cardiovascular Status, Gross Neurologic Losses•Stroke Time Course Classification
STROKE TIME COURSE CLASSIFICATION
Stage 1: Transient Ischemic Attack
Stage 2: Reversible Ischemic Neurologic Deficits
Stage 3: Stroke in Evolution
Stage 4: Completed Stroke
DIAGNOSTIC TESTS
•CT Scan•12-Lead ECG •Carotid ultrasound•Cerebral Angiography•Transcranial Doppler Flow Studies•Transthoracic or Transesophageal Echocardiography•MRI of the brain and/or neck •Xenon CT •Single Photon Emission CT
MEDICAL MANAGEMENT
1. Treatment of TIA from atrial fibrillation or suspected embolic or thrombotic causes
2. Thrombolytic Therapy for Ischemic Stroke3. Therapy for Patients with Ischemic Stroke
NOT Receiving Thrombolytic Therapy4. Managing Potential Complications
SURGICAL MANAGEMENT
CAROTID ENDARTERECTOMY- Main surgical procedure for the management of TIAs and small stroke- Indicated for patients with symptoms of TIA or mild stroke found to be due to carotid stenosis - Complications: stroke, cranial nerve injuries, infection, hematoma at the incision site, carotid artery disruption
NURSING MANAGEMENT
•Improving Mobility and Preventing Joint Deformities•Managing Sensory-Perceptual Difficulties•Attaining Bowel and Bladder Control•Improving Thought Processes•Improving Communication•Maintaining Skin Integrity•Improving Family Coping•Helping the Patient Cope with Sexual Dysfunction
HEMMORHAGIC STROKE
CEREBRAL ANEURYSMSUBARACHNOID HEMORRHAGE