KUL 8 Stroke Nursing Management
KUL 8 Stroke Nursing Management
KUL 8 Stroke Nursing Management
(Cerebrovascular Accident)
Nursing
Care
Management
Dr Juliana Christina, S.Kep.Ners, MNg, PhD
OUTLINE
Definition, classification, risk factors
Statistics & epidemiology
Causes & Pathophysiology
Clinical manifestations & Complications
Preventions
Assessment & Diagnostic Findings
Medical & Surgical Management
Nursing Management (Assessment, Diagnosis, Care
planning and goals, Interventions & Evaluation
Discharge and Home care guidelines
What is STROKE?
A neurological disorder characterized
by blockage of blood vessels. Clots
form in the brain and interrupt blood
flow, clogging arteries and causing
blood vessels to break, leading to
bleeding.
Rupture of the arteries leading to the
brain during stroke results in the
sudden death of brain cells owing to a
lack of oxygen.
Stroke can also lead to depression and
dementia
CAUSES
Large artery thrombosis. Large artery thromboses are
caused by atherosclerotic plaques in the large blood vessels
of the brain.
Small penetrating artery thrombosis. Small penetrating
artery thrombosis affects one or more vessels and is the
most common type of ischemic stroke.
Cardiogenic emboli. Cardiogenic emboli are associated
with cardiac dysrhythmias, usually atrial fibrillation.
Pathophysiology
Classification
Ischemic stroke. Haemorrhagic stroke.
This is the loss of Haemorrhagic strokes
function in the brain as a are caused by bleeding
result of a disrupted into the brain tissue, the
blood supply. ventricles, or the
subarachnoid space.
Risk Factors
Non- modifiable : Modifiable:
Advanced Age (>55 Hypertension
years) Atrial Fibrillation
Gender (Male) Hyperlipidaemia
Race (African American) Obesity
Smoking
Diabetes
Statistics & epidemiology
•Tissue ischemia
If cerebral blood flow is inadequate, the amount of oxygen
supplied to the brain is decreased, and tissue ischemia will
result.
•Cardiac dysrhythmias
The heart compensates for the decreased cerebral blood flow,
and with too much pumping, dysrhythmias may occur.
Assessment and Diagnostic Findings
Lumbar puncture
PET scan
Pressure is usually normal and CSF is clear in
Demonstrates structural
cerebral thrombosis, embolism, and TIA.
Pressure elevation and grossly bloody fluid abnormalities, oedema,
suggest subarachnoid and intracerebral hematomas, ischemia,
. and
haemorrhage. CSF total protein level may be infarctions.
elevated in cases of thrombosis because of
inflammatory process. LP should be performed
if septic embolism from bacterial endocarditis
is suspected.
SKULL-X RAY
May show a shift of pineal gland to the opposite side from an
expanding mass; calcifications of the internal carotid may be visible
in cerebral thrombosis; partial calcification of walls of
an aneurysm may be noted in subarachnoid haemorrhage.
Assessment and Diagnostic Findings
endocarditis).
Refer to Physiotherapy
Start an active rehabilitation program when
consciousness returns
Perform ROM Exercises
Encourage to Mobilize short and frequent (sitting, standing &
walking)
Turning q2 Hours
Imbalanced Nutrition
Defisit nutrisi berhubungan dengan ketidakmampuan menelan
makanan