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Cerebrovascular Disease ,[object Object],[object Object]
ISCHEMIC STROKE  ,[object Object],[object Object]
Five Types according to causes: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stroke Continuum: Time Course Classification  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors 10. Drug abuse 9. Excessive alcohol consumption 8. Smoking 7. Use of Oral Contraceptive  6. Diabetes Mellitus 5. Elevated hematocrit 4. Genetics 4. Obesity 3. Race 3. High cholesterol levels 2. Sex 2. Cardiovascular diseases 1. Age 1. Hypertension Uncontrollable Risk Factors   Controllable Risk Factors
 
 
Pathophysiology Occlusion of artery Dec blood flow Dec oxygenation and nutrition of brain  Dec energy stores
Pathophysiology Open Ca channels Inc Ca, Na and Cl  Dec K Inc cell death Inc glutamine  and aspartate
Assessment  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cooperation of Left and Right Hemispheric Stroke Lack of awareness of deficits Impulsive behavior and poor judgment Slow, cautions behavior Increase distractibility Altered intellectual ability Spatial-perceptual deficits Aphasia (expressive, receptive, or global) Left visual field loss Right visual field deficit Paralysis or weakness on left side of the body Paralysis or weakness on right side of the body Right Hemispheric Stroke   Left Hemispheric Stroke
Diagnostic Examination  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria for t-PA Administration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dosage and administration of t-PA administration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Side effects ,[object Object],[object Object]
Therapy for patients with ischemic stroke not receiving t-PA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endarterectomy  ,[object Object],[object Object],[object Object]
Post operative Nursing management for Endarterectomy  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Managing potential complication ,[object Object],[object Object]
Potential Complication  ,[object Object],[object Object],[object Object]
NURSING PROCESS: The Patient Recovering from an Ischemic Stroke
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Planning and Goals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nursing Interventions
[object Object],[object Object],Nursing Interventions
Evaluation: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evaluation:
HEMORRHAGIC STROKE ,[object Object]
Types of Hemorrhagic Stroke ,[object Object],[object Object],[object Object],[object Object],[object Object]
Intracerebral Hemorrhage  ,[object Object],[object Object],[object Object],[object Object]
Intracranial (Cerebral) Aneurysms ,[object Object]
Most commonly affected by an aneurysm: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arteriovenous Malformations  ,[object Object],[object Object]
Subarachnoid Hemorrhage  ,[object Object]
Pathophysiology
Pathophysiology Hypertension Inc pressure to the vessels  Rupture of the blood vessels  Bleeding
Pathophysiology Compression of the adjacent to the brain tissue Neuronal dysfunction
Clinical Manifestation: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Findings: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hunt-Hess Classification of systems  Modified classification adds the following  No acute meningeal/brain reaction, but with fixed neurological deficit Ia Unrupture aneurysm 0 Deep coma, decerebrate rigidity, moribund appearance Add one grade for serious systemic disease or severe vasospasm on angiography V Stupor, moderate to severe hemiparesis, early decerebrate rigidity IV Mild focal deficit, lethargy, or confusion III Cranial nerve palsy, abducens, moderate-to-severe headache, nuchal rigidity II Asymptomatic, or mild headache and slight nuchal rigidity  I
Medical Management: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Management: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Post-operative complication ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING PROCESS: The patient with a Hemorrhagic Stroke
Assessment  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object]
Planning and Goals ,[object Object],[object Object],[object Object],[object Object]
Nursing Intervention:  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Intervention: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Potential Complication: ,[object Object],[object Object],[object Object],[object Object]
Managing Potential Complications: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluation: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evaluation:

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Cerebrovascular Disease

  • 1.
  • 2.
  • 3.
  • 4.
  • 5. Risk Factors 10. Drug abuse 9. Excessive alcohol consumption 8. Smoking 7. Use of Oral Contraceptive 6. Diabetes Mellitus 5. Elevated hematocrit 4. Genetics 4. Obesity 3. Race 3. High cholesterol levels 2. Sex 2. Cardiovascular diseases 1. Age 1. Hypertension Uncontrollable Risk Factors Controllable Risk Factors
  • 6.  
  • 7.  
  • 8. Pathophysiology Occlusion of artery Dec blood flow Dec oxygenation and nutrition of brain Dec energy stores
  • 9. Pathophysiology Open Ca channels Inc Ca, Na and Cl Dec K Inc cell death Inc glutamine and aspartate
  • 10.
  • 11. Cooperation of Left and Right Hemispheric Stroke Lack of awareness of deficits Impulsive behavior and poor judgment Slow, cautions behavior Increase distractibility Altered intellectual ability Spatial-perceptual deficits Aphasia (expressive, receptive, or global) Left visual field loss Right visual field deficit Paralysis or weakness on left side of the body Paralysis or weakness on right side of the body Right Hemispheric Stroke Left Hemispheric Stroke
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22. NURSING PROCESS: The Patient Recovering from an Ischemic Stroke
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 51. Pathophysiology Hypertension Inc pressure to the vessels Rupture of the blood vessels Bleeding
  • 52. Pathophysiology Compression of the adjacent to the brain tissue Neuronal dysfunction
  • 53.
  • 54.
  • 55. Hunt-Hess Classification of systems Modified classification adds the following No acute meningeal/brain reaction, but with fixed neurological deficit Ia Unrupture aneurysm 0 Deep coma, decerebrate rigidity, moribund appearance Add one grade for serious systemic disease or severe vasospasm on angiography V Stupor, moderate to severe hemiparesis, early decerebrate rigidity IV Mild focal deficit, lethargy, or confusion III Cranial nerve palsy, abducens, moderate-to-severe headache, nuchal rigidity II Asymptomatic, or mild headache and slight nuchal rigidity I
  • 56.
  • 57.
  • 58.
  • 59. NURSING PROCESS: The patient with a Hemorrhagic Stroke
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.