Stroke (CVA) System Disorder PDF

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ACTIVE LEARNING TEMPLATE:

System Disorder

Espinosa ST UDENT NAME Catherine _____________________________________ Acute Cerebrovascular Accident DISORDER/DISEASE PROCESS __________________________________________________________

Alterations in Health (Diagnosis)

Pathophysiology Related to Client Problem A cerebrovascular accident occurs when there is (1) ischemia (inadequate blood flow) to a part of the brain or (2) hemorrhage (bleeding) into the brain that results in death of brain cells.

-Impaired communication -Risk for aspiration -Impaired mobility

57 REVIEW MODULE CHAPTER ___________

Health Promotion and Disease Prevention -Regular BP screening and adhering to antihypertensives if prescribed -Smoking cessation -Eating a diet rich with fruits and vegetables and low in saturated fat

ASSESSMENT

SAFETY CONSIDERATIONS

Risk Factors

Expected Findings -Cerebral edema -Headache -Motor deficits -Aphasia

-HTN -Diabetes -Smoking -Age -Genetics

Laboratory Tests

Diagnostic Procedures

-Troponin 1 -Creatine Kinase-MB -Coagulation studies: PT, PTT -Lipid profile

-Screen patient for contraindications for tPA therapy -Assess respiratory status and start necessary actions i.e. O2, suctioning -Assess neurological status, including ICP if needed. -Monitor CV status including hemodynamic monitoring if needed. -Calculate I&Os noting imbalances

-Physical Therapy -Occupational Therapy -Drug Therapy

Medications -tPA (if signed off by provider) -Antiplatelets

-Antihypertensiv es -Beta Blockers -ACE inhibitors

ACTIVE LEARNING TEMPLATES

-Impaired swallowng and speech

Complications Client Education -Teaching the patient to reduce salt and sodium intake -Teaching to the patient to exercise 40 min, 3-4 days a week -Teaching the patient to follow the prescribed treatment plan

-Increased Intracranial Pressure -Aspiration -Pneumonia

-Anticoagulants Therapeutic Procedures

-Impaired mobilty

-Spatial perceptual problems

-CT Scan -MRI -ECG

PATIENT-CENTERED CARE

Nursing Care

-Impaired gag reflex

Interprofessional Care -Primary Care Provider -Cardiologist -Physical Therapist -Occupational Therapist -Speech Therapist

-UTI -Seizures -Limb contractures

THERAPEUTIC PROCEDURE

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