Nursing Care Plan for Cerebral Vascular Accident / Stroke

Cerebral Vascular Accident (CVA) or Stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue.

Many things can go wrong and cause the disruption of the blood supply to the brain.  However, the most common culprits are a ruptured artery, or a blood clot that blocks the flow of blood.  It is commonly called CVA which is a major cause of death. It also causes serious problems in the way that the body functions.

There are two types of CVA. They are:

• Hemorrhagic CVA – This occurs when the there is a ruptured artery that leaks blood to the brain.
• Ischemic CVA – This happens when there is a blood clot in the arteries that blocks the transfer of oxygenated blood to the brain tissue.

You may ask what the risk factors are. This depends on the age of the affected individual and the part of the brain whose blood supply has been interfered with. In the most severe cases of stroke, death has been known to occur within a short period of time. However, in most cases, the deterioration of one’s health is gradual with many tell-tale signs.

There is more to Cerebral Vascular Accident than meets the eye. For example, did you know that there are three main causes of CVA that are known to doctors? They are:

• Cerebral hemorrhage
• Cerebral embolism
• Cerebral thrombosis

Risk factors for narrowed blood vessels in the brain are the same as those that cause narrowing blood vessels in the heart and heart attack (myocardial infarction). These risk factors include:

•     high blood pressure (hypertension),
•     high cholesterol,
•     diabetes, and
•     smoking.

The most common symptom of a stroke is sudden weakness or numbness of the face, arm or leg, most often on one side of the body. Other symptoms include: confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache with no known cause; fainting or unconsciousness.

Management of Stroke
To treat acute conditions need to be considered critical factors as follows:
1. Trying to stabilize vital signs with:

• Maintaining a patent airway suctioning of mucus that is done frequently, oxygenation, if you need to do tracheostomy, help breathing.
• Controlling blood pressure is based on the patient's condition, including efforts to improve hypotension and hypertension.

3. Trying to find and correct cardiac arrhythmias.
4. Treating bladder, as far as possible do not wear a catheter.
5. Placing the patient in the proper position, it should be done as soon as possible the patient should be shifted position every 2 hours and performed passive motion exercises.

Nursing Care Plan for Cerebral Vascular Accident / Stroke

Nursing Priority for Cerebral Vascular  Accident (CVA) or Stroke

1. Increasing cerebral perfusion and oxygenation adequate.
2. Preventing and minimizing complications and permanent disability.
3. Helping patients to fulfill their daily needs.
4. Provide support to the process of coping mechanisms and integrating the changes in self-concept.
5. Provide information about disease process, prognosis, treatment and rehabilitation needs.

The Goal for Cerebral Vascular Accident nursing (CVA) or Stroke
1. Increased cerebral function and decrease neurological deficits.
2. Prevent / minimize complications.
3. Daily needs are met either by himself or others.
4. Positive coping mechanisms and to plan for the state after illness
5. Understand the process of disease and prognosis.

CVA - Stroke Definition and Nursing Diagnosis

A cerebral vascular accident is another name for a stroke. It is damage to the brain caused by a disruption of the blood supply to a part of the brain. This disruption of blood supply can be caused by a blood clot, or by a ruptured artery.

The symptoms of a cerebral vascular accident depend on which part of the brain is affected. Common symptoms may include paralysis of a part of the body, loss of all or part of the vision, or loss of the ability to speak or to understand speech.

A stroke is a medical emergency and can cause permanent neurological damage, complications, and death. Risk factors for stroke include old age, high blood pressure, previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, tobacco smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. It is the second leading cause of death worldwide.

Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive the area of brain affected, the more functions that are likely to be lost. Some forms of stroke can cause additional symptoms. For example, in intracranial hemorrhage, the affected area may compress other structures. Most forms of stroke are not associated with headache, apart from subarachnoid hemorrhage and cerebral venous thrombosis and occasionally intracerebral hemorrhage.

Stroke is diagnosed through several techniques: a neurological examination (such as the Nihss), CT scans (most often without contrast enhancements) or MRI scans, Doppler ultrasound, and arteriography. The diagnosis of stroke itself is clinical, with assistance from the imaging techniques. Imaging techniques also assist in determining the subtypes and cause of stroke. There is yet no commonly used blood test for the stroke diagnosis itself, though blood tests may be of help in finding out the likely cause of stroke.

Nursing Diagnosis for CVA - Stroke:

1. Ineffective Cerebral Tissue Perfusion

2. Impaired Physical Mobility.

3. Imbalanced Nutrition, Less Than Body Requirements.

4. Impaired Skin Integrity.

5. Impaired Verbal Communication

6. Disturbed Sensory Perception

7. Self-Care Deficit

8. Knowledge Deficit