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Prepared by:
Bautista, Jovy Rose RN (soon2be)
Gorgonio, Jeraldine RN (soon2be)
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DESCRIPTION:
-CAN BE DIVIDED INTO TWO MAJOR CATEGORIES:
ISCHEMIC
HEMORRHAGIC
- BOTH CONDITION SHOULD HAVE SERIOUS MEDICAL
EMERGENCY WHICH NECESSITATES IMMEDIATE
INTERVENTION TO PREVENT PERMANENT DISABILITY
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THROMBUS
EMBOLUS
HEMORRHAGE
RUPTURED ANEURYSM
ARTERIOVENOUS MALFORMATION
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MODIFIABLE RISK FACTORS:
1.) Smoking
2.) Alcohol
3.) Substance Abuse
4.) Sedentary Lifestyle
5.) Diabetes Mellitus
6.) Hypertension
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NONMODIFIABLE RISK FACTORS:
1.) Race
2.) Gender
3.) Older Adult
4.) Family History
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A.) ISCHEMIC
1.)Transient Ischemic Attacks
2.) Reversible Ischemic Neurologic
Deficit
B.) HEMORRHAGIC
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A.) ISCHEMIC
- Result from occlusion of a
cerebral artery by a thrombus or
embolus
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1.) TRANSIENT ISCHEMIC ATTACKS
- temporary loss of neurological functionoften lasting less than 15 minutes and no more than
24hours.
2.) REVERSIBLE ISCHEMICNEUROLOGIC DEFICIT
- is a temporary loss of neurological function
lasting more than 24hrs but less than 1 week
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B.) HEMORRHAGIC
-Interruption in thevessel wall integrity
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a. Altered level of consciousness
b. Denial of disorder
c. Failure to make appropriate
decisions
d. Inappropriate judgment
e. Poor memory
f. Emotional stability
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g. Proprioceptive or spatial difficulty
decreased awareness of the body in space
h. Hemiplegia- one sided paralysis
i. Hemiparesis
weakness in one side of the
body
j. Dysarthria- difficulty in speech articulation
k. Alexia- difficulty reading
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l. Agraphia difficulty writing
m. Agnosia
loss of recognition ability
n. Hemianopsia- blindness in one side of visual
fieldo. Amaurosis fugax temporary blindness in one
eye
p. Dysphagia
difficulty swallowing
q. Ptosis drooping eyelids
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r. Aphasia Impaired Communication
1.) Expressive aphasia inability to
express oneself (frontal lobe)
2.) Receptive aphasia
inability to
understand what someone
else is saying (temporal lobe)
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a. Complete history and
physical assessment
b. CBC
c. Thrombin and
prothrombin timesd. CSF Analysis
e. CT scan
f. MRI Scan
g. Angiography
h. ECG
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a. Primary prevention
- instruct client and
family on reducingmodifiable risk factors
b. Acute stroke mgnt
- maintain ABC
- assess LOC
- perform cranial nerve
assessment
- administer prescribed
antihypertensive
- monitor fluid and
electrolytes
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- elevate head of bed
30
- monitor for ICP- administer prescribed
analgesics
- administer prescribed
diuretics (mannitol orfurosemide)
- insert FC
- administer prescribed
anticoagulants (heparinor warfarin)
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c. Intermediate stroke
mgnt
-Maintain patent airway- maintain upright position
for 30min after eating
-Initiate bladder training
-Increase fiber and fluids
- implement aphasia
interventions
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d. Rehabilitative nsg.
Interventions
-encourage pt. to participate inoccupational therapy
- encourage pt. to participate
in speech therapy
- instruct the client aboutmedications
- encourage importance of
scheduled follow-up with
health care provider- instruct client about
importance of frequent BP
checks
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Theend
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