Foundation University

COLLEGE OF NURSING
Dumaguete City

WARD CLASS
Cerebrovascular Disease
Submitted to:
Mr. Anthony Barrera, RN

Submitted by:
Futalan, Ruby Jane A.

Date:
September 06, 2023
Objective:
By the end of the presentation, participants will possess a comprehensive understanding of cerebrovascular disease, encompassing its primary
types, risk factors, pathophysiology, diagnostic procedures, nursing assessments, and appropriate interventions and management strategies.

Time Specific Learning Topics Method of Reference Method of

Frame Outcome Teaching Evaluation
3 mins - I. Introduction to Cerebrovascular Disease PowerPoint Brunner & Q&A: What are two
Cerebrovascular disease is a medical Presentation suddarth’s main types of
condition that affect the blood vessels and textbook of cerebrovascular
blood supply to the brain. If blood flow to the medical-surgical disease?
brain is interrupted, it can lead to a stroke. In nursing, 15th
the U.S., stroke stands out as the primary edition.
concern, ranking fifth in causes of death and
leading in long-term disabilities. There are
two main types of cerebrovascular disease:
ischemic stroke and hemorrhagic stroke.
5 mins Understand the A. Ischemic Stroke (Thrombotic and Embolic, PowerPoint Brunner & Q&A: What are the
types of Transient Ischemic Attack, and Cerebral Presentation suddarth’s primary differences
cerebrovascular venous sinus thrombosis) textbook of between ischemic and
diseases Ischemic strokes occur when a blood vessel medical-surgical hemorrhagic strokes?
supplying blood to the brain is obstructed. nursing, 15th
They can be classified into: edition.

Thrombotic Stroke: This type of stroke is

caused by a blood clot that forms inside an
artery that supplies blood to the brain. The
 clot may be caused by fatty deposits (plaque)
that build up in arteries and cause reduced
blood flow (atherosclerosis) or other artery
conditions.

Embolic Stroke: This type of stroke occurs

when a blood clot or other debris forms away
from your brain — commonly in your heart
— and is swept through your bloodstream to
lodge in narrower brain arteries.

Others:
Transient Ischemic Attack (TIA): Often called
a "mini-stroke," a TIA is a brief episode of
symptoms similar to those of a stroke.
However, TIAs don't cause permanent
damage and are often a warning sign of a
future stroke.

Cerebral Venous Sinus Thrombosis (CVST):

This is a rare form of stroke where a blood
clot forms in the brain's venous sinuses. It
prevents blood from draining out of the
brain, leading to bleeding and stroke.

B. Hemorrhagic Stroke (Intracerebral

hemorrhage, Subarachnoid hemorrhage)
Hemorrhagic strokes are caused by bleeding
within the brain. They can be classified into:
 Intracerebral Hemorrhage: This is when a
blood vessel in the brain bursts and spills into
the surrounding brain tissue, damaging cells.
Brain cells beyond the leak are deprived of
blood and are also damaged.

Subarachnoid Hemorrhage: This is bleeding

in the space between the brain and the
surrounding membrane (subarachnoid space).
It can be caused by a burst aneurysm.

5 mins Identify and Risk Factor for Stroke: PowerPoint Mayo Clinic. Q&A: Name one
understand the risk 1. Lifestyle Risk Factors: Presentation (2020). Stroke: modifiable and one
factors associated Overweight or Obesity: Carrying excess Risk factors. non-modifiable risk
with strokes. weight increases the likelihood of stroke. Retrieved from: factor for stroke.
Physical Inactivity: Sedentary lifestyles https://www.may
contribute to stroke risk. oclinic.org/disea
Alcohol Consumption: Heavy or binge ses-conditions/str
drinking can elevate the risk. oke/symptoms-
Illegal Drug Use: Drugs like cocaine and causes/syc-
methamphetamine are associated with a 20350113
higher risk of stroke.

2. Medical Risk Factors: .

High Blood Pressure: Hypertension is a
leading risk factor for stroke.
Tobacco Use: Both active smoking and
exposure to secondhand smoke increase
stroke risk.
High Cholesterol: Elevated cholesterol can
lead to artery blockages.
Diabetes: Diabetic individuals have a
heightened risk of stroke.
Obstructive Sleep Apnea: This sleep disorder
is linked to a higher stroke risk.
Cardiovascular Diseases: Conditions like
heart failure, heart defects, infections, or
irregular heart rhythms (e.g., atrial
fibrillation) contribute to stroke risk.
History: A personal or family history of
stroke, heart attack, or transient ischemic
attack increases the likelihood.
COVID-19 Infection: Recent studies have
shown a correlation between COVID-19 and
increased stroke risk.

3. Other Factors:
Age: Individuals aged 55 or older face a
higher risk.
Race or Ethnicity: African Americans and
Hispanics are at a greater risk compared to
other groups.
Sex: Men face a higher risk, but women tend
to be older when they experience strokes and
have a higher mortality rate.
Hormones: The use of birth control pills or
hormone therapies containing estrogen can
elevate the risk.
5 mins Understand the II. Pathophysiology Diagrams National Institute Q&A: How does
underlying and of Neurological atherosclerosis
pathophysiological  The pathophysiological mechanisms underlying flowcharts, Disorders and contribute to the
mechanisms of strokes are complex and vary depending on the PowerPoint Stroke. (2019). pathophysiology of
both ischemic and type of stroke. For ischemic strokes, the primary Presentation Stroke thrombotic ischemic
hemorrhagic mechanism involves the obstruction of blood Information strokes?
strokes. vessels, which results in the deprivation of Page. Retrieved
essential oxygen and nutrients to the brain cells. from:
This blockage can be due to various reasons, https://www.nind
such as a clot or plaque buildup. As the blood s.nih.gov/health-
flow is compromised, brain cells, which are information/disor
highly sensitive to oxygen deprivation, begin to ders/stroke1.035
die within minutes. This rapid cell death can 850
lead to lasting neurological impairments or even
fatality if not promptly addressed.

 On the other hand, hemorrhagic strokes are

characterized by the rupture or leakage of blood
vessels. This rupture leads to bleeding either
within the brain (intracerebral) or around the
brain, typically in the subarachnoid space. The
accumulation of blood from the ruptured vessel
exerts pressure on the surrounding brain tissue,
causing damage to the brain cells. Additionally,
the area affected by the hemorrhage is deprived
of its regular blood supply, further exacerbating
the injury. Hemorrhagic strokes, while less
 common than ischemic strokes, are often more
severe and have a higher mortality rate.

5 mins Conduct a III. Nursing Assessment PowerPoint Brunner & Q&A: What is the
comprehensive Presentation suddarth’s primary focus during
nursing  Begin with a detailed history to determine the textbook of the initial nursing
assessment for last time the patient was observed in their usual medical-surgical assessment of a
patients with state of health. nursing, 15th patient suspected of
suspected  Conduct a focused physical and neurologic edition. having a stroke?
cerebrovascular examination.
disease.  Key assessment areas include:
 Airway Patency: Ensure there's no
obstruction, especially if there's a
compromised gag or cough reflex or altered
respiratory patterns.
 Cardiovascular Status: Evaluate blood
pressure, cardiac rhythm, rate, and check for
the presence of a carotid bruit.
 Be aware of patients presenting temporary
neurologic symptoms, indicative of a transient
ischemic attack (TIA):
 TIAs are characterized by a sudden loss of
 motor, sensory, or visual function.
 Typically resolves within 24 hours.
 Despite its transient nature, brain imaging
often doesn't show any signs of ischemia.
 Understand the significance of TIAs:
 They can act as precursors to strokes.
 3% to 15% of all strokes are preceded by a
TIA, usually occurring within the first three
months post-TIA.
 Neglecting or inadequately addressing a
TIA can lead to a severe stroke with
permanent deficits.
5 mins Understand the IV. Diagnostic Procedure PowerPoint Brunner & Q&A: Which
diagnostic Presentation suddarth’s diagnostic test is
procedures used to The primary diagnostic test for stroke is a textbook of typically the first to be
confirm noncontrast computed tomography (CT) medical-surgical conducted when a
cerebrovascular scan, which should be conducted within 20 nursing, 15th stroke is suspected?
diseases and minutes of a patient's arrival at the edition.
interpret their emergency department. This swift action is
results. crucial to ascertain whether the stroke is
ischemic or hemorrhagic, as the treatment
approach varies based on the type. Some
advanced cities have introduced mobile
stroke units, essentially ambulances equipped
with CT scanners, enabling quicker diagnosis
and immediate commencement of medical
management. For ischemic strokes, the next
step involves pinpointing the origin of the
thrombi or emboli and assessing the need for
 mechanical intervention, such as clot
removal. Various studies can be employed
for this purpose, including CT angiography,
CT perfusion, magnetic resonance imaging
(MRI), and magnetic resonance angiography
of the brain and neck vessels. Transcranial
Doppler flow studies, transthoracic or
transesophageal echocardiography, a 12-lead
electrocardiogram (ECG), and carotid
ultrasound are other standard diagnostic tests
utilized in this context.
1 min Formulate V. Sample Diagnosis
appropriate Risk for ineffective tissue perfusion
nursing diagnoses associated with bleeding or vasospasm
for patients with
cerebrovascular
diseases.
6 mins Implement VI. Interventions: Mayo Clinic - Q&A: What is the
appropriate  Dependent Interventions with Rationale: Stroke Diagnosis difference between
nursing & Treatment. dependent and
interventions for  Administer thrombolytic therapy as Retrieved from: independent nursing
patients with ordered: Thrombolytic agents can dissolve https:// interventions?
cerebrovascular clots in ischemic stroke, restoring blood www.mayoclinic
diseases based on flow to the affected area. .org/diseases-
the diagnosis and  Monitor vital signs closely: Vital signs can conditions/
patient's needs. indicate the patient's hemodynamic status stroke/diagnosis-
and the effectiveness of interventions. treatment/drc-
20350119#dialog
 Independent Interventions with Rationale: Id15489505
  Position patient to prevent aspiration:
Stroke patients may have difficulty National Institute
swallowing, increasing the risk of of Neurological
aspiration. Disorders and
 Provide a safe environment: Stroke patients Stroke - Post-
may have altered mobility and cognition, Stroke
increasing the risk of falls and injuries. Rehabilitation.
Retrieved from:
 Collaborative Interventions with Rationale: https://www.nind
s.nih.gov/health-
 Consult with a physical therapist: Early information/disor
mobilization and rehabilitation can improve ders/stroke
outcomes for stroke patients.
 Collaborate with a speech therapist: Stroke
can affect speech and swallowing, requiring
specialized interventions.