Nursing Care Plan - CEREBROVASCULAR ACCIDENT (CVA)

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by: Donnabell V. Incognito, RN

Cerebrovascular accident is the term that refers to any functional abnormality of the Central Nervous System that occurs when the normal blood supply to the brain is disrupted, as by a blood clot or a ruptured blood vessel, and vital brain tissue dies. Cerebrovascular accident is commonly called Strokes.

Cerebrovascular accident may be caused by any of three mechanisms.

• Cerebral Thrombosis – blockage in the thrombus (clot) that has built up on the wall of the brain artery.
• Cerebral Embolism – blockage by an embolus (usually a clot) swept into the artery in the brain.
• Hemorrhage - Rupture of a blood vessel and bleeding within or over the surface of the brain.

Thrombosis and embolism both lead to cessation of blood supply to part of the brain thus to infarction (tissue death). Rupture of a blood vessel in or near the brain may cause an intracerebral hemorrhage or subarachnoid hemorrhage.

The symptoms of a stroke usually develop over minutes or hours occasionally over several days. Depending on the site, cause and extent of damage, any or all of the symptoms at right may be present, in any degree of severity. The more serious cases lead to rapid loss of consciousness, coma, and death or to severe physical or mental handicap.

Hemiplegia – weakness or paralysis on one side of the body is one of the more common effects of a serious stroke.

The following are the symptoms of Cerebrovascular accident:

• Headache
• Dizziness and confusion
• Visual disturbance
• Slurred speech or loss of speech
• Difficulty of swallowing

Risk factors:

• Age
• High blood pressure – weakens the walls of arteries
• Atherosclerosis - narrowed artery channels
• Heart disease - cause blot clot in the heart that may break off and migrate to the brain.
• Diabetes mellitus – accelerated degeneration of small blood vessel
• Smoking – increase the risk ofhypertension
• Polycythemia - a raised level of red cells in the blood.
• Hyperlipidemia – high level of fatty substances in the blood

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