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Stroke

is also called a cerebrovascular accident (CVA).  There could be an obstruction of arterial blood flow (ischemic stroke) such as a blood clot, and it can also be a ruptured blood vessel (hemorrhagic stroke).

  • Assessment
  • Mental Impairment
  • Disorientation, confusion

There are two types of strokes being ischemic and hemorrhagic.

Ischemic

  • There is some kind of disruption of blood flow in the brain causing a decrease in oxygenation to the brain. Usually caused by an embolus or thrombosis
  • A Carotid Endarterectomy may be done. ( A plaque is removed from the carotid artery)

Hemorrhagic

  • Usually caused by a ruptured aneurysm or and AVM (Arteriovenous Malformation), which can be due to hypertension.

 



Diagnostic Tests:

  • CT scan and MRI would usually reveal either bleeding (hemorrhagic) or an occlusion or a narrowing (thrombolytic).

Treatments:

  • Anticoagulants: Heparin, Warfarin (Coumadin), Ticlopidine
  • Anticonvulsants: Phenytoin (Dilantin)
  • Thrombolytic Therapy: Tissue Plasminogen Activator is given.
  • Glucocorticoids: Dexamethasone

Interventions:

  • Elevate the head of the bed 30 degrees.
  • Monitor neurological status

Hemianopsia– client has a blindness in half the visual field.

Homonymous Hemianopsia– is blindness in the same visual field of both eyes.

  • If patient has Hemianopsia, encourage the client to turn head in a full range from either left to right or the opposite, in order to see the complete range of vision.

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