NURSING CARE WITH CLIENTS CVA / STROKE myocardial
I. INTRODUCTION.
CVA or cerebro Vascular Accident known by ordinary people with Stroke.Istilah term is more popular in this appeal occurred on CVA.abnormality organ is exactly brain.Lebih Blood Vessel Disorders brain.Berupa degradation brain.Stroke blood vessels causing high mortality .
Genesis most experienced by the men lai than women (difference 19% higher) and generally aged over 55 years.
II.SIGN and CLASSIFICATION.
Rupture of cerebral blood vessels caused largely by the poor quality of the blood vessels of brain.until with high blood pressure blood vessel fragility.
Stroke risk factor is 2:
1.Factor risk that can be treated / prevented:
Smokers.
Heart disease (heart fibrillation)
High blood pressure.
Increasing the number of red blood cells (Policitemia).
Transient Ischemic Attack (tias)
2. Risk factor that can not be in the fox:
Age above 65.
Increased carotid pressure (artheriosklerosis indicate that increases the risk of stroke).
DM.
Heredity (family have a stroke).
Ever had a stroke.
Race (higher in black skin)
Sex (more men than women 30%).
In pathological an MI can be divided into:
1.Trombosis blood vessels (cerebral thrombosis).
2.Emboli a.l from the heart (cerebral embolism.)
As a result 3.Arteritis Lues / temporal arteritis.
SIGNS AND SYMPTOMS.
An increase in ICT 1.when the common signs and symptoms:
Changes in the level of consciousness: decrease in orientation and response to stimuli.
Changes of mobility ekstrimitas: weakness to paralysis.
Changes in pupil size: bilateral or unilateral dilatasi.Unilateral signs of cerebral hemorrhage.
Changes in vital signs: low pulse, widened pulse pressure, irregular breathing, increased body temperature.
Headache complaints.
Projectile vomiting (without any stimulation).
2.paralysis and weaknesses.
3.deficit vision.
4.Deficit cognitive and language (communication).
5.disartria.
6.infark cranial nerve.
7.Inkontinensia alvi and uri.
V. The medical management.
A. Investigations.
1.LABORATORIUM.
Calculate the full blood.
Clinical chemistry.
Protombin period.
Urinalysis.
2.DIAGNOSTIC
SCAN HEAD
Cerebral angiography.
EEG.
Lumbal puntion.
MRI.
X-ray skull
B. Treatment.
1.Konservatif.
a. fluids and electrolytes with the installation of a drip.
ICT b.prepare increase.
Antihypertensives.
Deuritika.
Peripheral vasodilator.
Anticoagulants.
Diazepam when seizures.
Anti-ulcer eg cimetidine.
Corticosteroids: in this case there is no benefit because the client will be prone to infection, and stress ulcer hiperglikemi / bleeding of the stomach.
Mannitol: reduce brain edema.
2.Operatif.
If efforts to reduce the ICT did not succeed it is necessary to consider the evacuation of intracranial hematoma due to persistent hypertension would endanger the life of the client.
Sub-acute phase 3.Pada / recovery (> 10 days) to:
Speech therapy.
Physical Therapy.
Anti-embolism stockings.
VI. COMPLICATIONS AND PREVENTION OF STROKE.
Aspirations.
Paralitic illeus.
Atrial fibrillation.
Diabetus insipidus.
Improved ICT.
Hidrochepalus.
PREVENTION:
Control of blood pressure regularly.
Stop smoking
Reduce consumption of cholesterol and cholesterol control routine.
Maintaining a normal sugar levels.
Preventing drinking alcohol.
Regular physical exercise.
Prevent obesity.
Preventing heart disease can reduce the risk of stroke.