Professional Documents
Culture Documents
Case Pres.
Case Pres.
Case Pres.
Introduction
Mortality/Morbidity
Race
Sex
Age
Risk Factors
• Hypertension
• Diabetes
• Alcoholic drinks
• Caffeine
This research can assist student nurse, nurses and other health care member
in revealing and educating individuals and family members about
Intracranial hemorrhage treatment and intracranial recovery. This would
permit the development of appropriate strategies to target high risk group.
This study would aid us to understand how patient will live through and
expand to the experience of intracranial hemorrhage. This will help us in
providing proper approach and improve standard in providing proper
approach and improve standard of nursing care that wound maintain and
promote wellness of the patient with hypertensive bleeding(ICH).
Demographic Data:
Gender: female
Nationality: Filipino
Admission Data:
B. Nursing History
Noticing that the symptoms did not subside, her sister and daughter
decided to rush Mrs. Matute at Southern Isabela General Hospital(SIGH)
located at Santiago City. She was received via wheelchair at emergency
room(ER) and admitted for confinement at 4:15 AM of June 24, 2009. The
patient was attended by Dra. Cabanilla. The doctor ordered her to be on
NPO and Intravenous(IV) Therapy given. She had received Initial
Medications: Hydralazene 500 mg, Dexamethasone and citicolene.
Oxygen inhslstion is ordered every `1-2 hours.
According to her sister, Mrs. Matute doesn’t haze any allergy to food
and drugs. She never experienced any serious medical condition during
her childhood except for common sickness like colds, fever and cough. No
known immunization received. Previous hospitalization was 6 years ago
for prolong menstrual bleeding. She had dilatation and curettage and
release from hospital after a day.
The patient is self medicating with nifedipine for control of high
blood pressure. She did not seek/consult medical advice from physician.
2. Elimination
3. Activity-Exercise Pattern
4. Sleep-Rest Pattern
She is a very much concern with the future of her family, she is very
supportive to her 3 children since the death of her husband. She is a
strong willed woman performing both the roles and responsibilities as a
mother and father to her children prior to confinement, she is in charge to
all decisions regarding family matters. Hence, upon her hospitalization it
is her sister and daughter that taking care of her and her other children.
She will be brought home to her sister residence upon discharge for
recovery.
7. Sexual-Reproductive Pattern
She is living with a partner for two(2) years and has active sexual
life, uses oral contraceptive as birth control measure. She menstruate
regularly.
9. Value-Belief Pattern
BLOOD PRESSURE
What Is It?
The most common site for these hemorrhage are the deep grey matter
of the brain, including areas called BASAL GANGLIA and the THALAMUS. They
occur deep in the brain. In this type of hemorrhage, common symptoms
include hemiparesis or hemiplagia(weakness or paralysis of the opposite side
of the body) because the fibers of the motor system(called the internal
capsule) run right alongside this location in the brain. Hemorrhage in the
dominant hemisphere(usually the left side in most patients) can result in
aphesia(abnormalities in the comprehension or production of normal
language). If the hematoma is large enough it can increase the pressure on
the brain in general and lead to a deterioration in the level of consciousness
including coma and death if severe enough.
Symptoms vary depending on the location of the bleed and the amount
of brain tissue affected. The symptoms usually develop suddenly, without
warning, often during activity. They may occasionally develop in a stepwise
patter, or they may worse over time.
Symptoms include:
Unconscious, comatose
• Difficulty swallowing
• Headache
• Loss of coordination
• Loss of balance
• Movement change
Hand tremor
• Seizure
• Sensation changes
Abnormal sensations
Decreased sensations
Facial paralysis
Numbness or tingling
• Vision changes
Double vision
Eyelid drooping
• Difficulty breathing
• Loss of consciousness
If a patient with high blood pressure presents with the sudden onset of
new neurological symptoms, the diagnosis of intracerebral hemorrhage is
generally made on an imaging study such as a CT scan or MRI scan which
demonstrate a hemorrhage within the brain in one of the usual locations.
Because some of the symptoms may be similar to ischemic stroke(weakness
of half the body, difficulty with speech and language, etc.) this must be ruled
out. Generally the CT scan is adequate to demonstrate the hemorrhage.
• Bleeding time
• Platelet count
• Painkillers
You may need blood, blood products in fluids given through a vain(IV)
to make up for loss of blood and fluids.
Prognosis:
How will a patient does depends on the size of the hematomas and the
amount of swelling. These may be a complete recovery, or some permanent
loss of brain function. Death is possible and may occur quickly despite
prompt medical treatment. Recovery depends in the area where the bleeding
occur. Medications, surgery, or other treatment may have severe side
effects.
Prevention:
Restriction of blood
flow
Rapture of the
arterioles
Subarachnoid
haemorrhage/bleeding
Cerebral
-nausea
Oliguria and and projectile vomiting
Organ • related
damage to inc.
Weakened Pressure
muscles
dysuria -decrease oxygen
INEFFECTIVE CEREBRAL TISSUE
PERFUSION
Decrease in oxygen
Objectives:
• Changes in motor
response
• Extremity weakness
IMPAIRED PHYSICAL MOBILITY
Destruction of neuromuscular
junctions
Interruption in transportation of
electrical impulses to
neuromuscular receptors
Bradykinesia
Plasma leakage from persistently elevated blood pressures also can result in
hyaline degeneration of the cerebral blood vessels. Serum protein
accumulates in the basement membranes of the arterioles and results in
collagen formation. Arterial sclerosis and fibrinoid necrosis may occur, as
well as focal aneurysmal dilatation
Medication
Emphasize to the client and caregiver the need and importance for
medication/treatment by providing them information that would enhance
their knowledge and understanding of the said regimen.
Exercise
Treatment
Prescribed medicine was given for continuous oral medication. Teaching plan
for medication and care of NGT is implemented. The caregiver is instructed
on how to properly feed in NGT.
Hygiene
Instruct caregiver on how to properly groom Mrs. Matute for her to maintain
proper grooming.
OPD follow up
Diet