Nursing Management of the Adult Patient with Neurologic Alterations: CVA

1
Nursing Management of the Adult Patient with
Neurologic Alterations CVA

• NURS 228 Fall 2008
• Tracy Heberlig, MSN, RN, CNE

2
CVA Stroke, Brain Attack

• Ischemic
• Hemorrhagic

3
(No Transcript)
4
Risk Factors

• Nonmodifiable
• Modifiable
• HTN
• Heart Disease
• DM
• Others

5
Save the Penumbra
http//www.strokecenter.org/education/ais_pathogen
esis/22_ischemic_penumbra.htm
6
Ischemic

• 80
• Classification
• Transient
• Ischemic
• Embolic

7
TIA

• Mini Stroke
• Temporary Loss
• Warning Sign

8
Hemorrhagic

• Most fatal
• Intracerebral, Subarachnoid (SAH)

9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
Diagnostic Evaluation

• HP
• Neuro Exam
• CT scan, Cerebral angiogram
• MRI/MRA, PET, SPECT

13
Interdisciplinary Care - Mgmt

• NIH Stroke Scale (assessment tool)
• Prevention
• Acute Stroke
• Anticoagulants
• Fibrinolytics
• Antithrombotics
• Surgery
• Rehabilitation

14
(No Transcript)
15
(No Transcript)
16
Warning! Time of the Essence!

• Sudden Numbness or Weakness
• Face, arm or leg
• Especially on one side of the body
• Sudden Confusion
• Difficulty speaking
• Difficulty comprehending speech
• Sudden Difficulty Seeing
• One or both eyes

17
Warning! Time of the Essence!

• Sudden Difficulty
• Walking
• Dizziness
• Loss of balance/coordination
• Sudden Severe HA
• No known cause

18
(No Transcript)
19
Nsg Diagnoses

• Ineffective tissue perfusion cerebral
• Impaired physical mobility
• Self-care deficits
• Impaired verbal communication
• Impaired swallowing
• Self-care deficits

20
Nsg Diagnoses

• Disturbed sensory-perceptual deficits
• Impaired urinary elimination
• Risk for constipation
• Risk for impaired skin integrity, swallowing
• Interrupted family processes

21
Nsg Diagnoses

• PC
• ? cerebral blood flow
• IICP
• Pneumonia
• Vasospasm
• Seizures

22
(No Transcript)
23
(No Transcript)
24
Brain Attack - Rehabilitation

• Recovery and Rehabilitation
• Continuing Care
• Emotional problems
• Support groups
• Caregiver strain

25
Brain Attack - Outcomes