NURSING CARE PLAN FOR CLIENT

WITH CHRONIC
CEREBROVASCULAR ACCIDENT
(CVA)

DEFINITION
Cerebrovascular Accident(CVA) or stroke occurs due to brain cell death
caused by impaired blood flow to the brain.In many cases resulted in
permanent disability to the sufferer (American Heart Association(AHA)),
2009).

PHATOPHYSIOLOGY
Cerebral function depends on the distribution of oxygen and glucose to the
brain.However, oxygen and glucose will not be stored in the brain.Thus, the brain
needs a steady supply of oxygen and glucose continuously.If the supply of oxygen
and glucose is suspended, then the cells in the brain will die.

VARIANT OF CVA
Stroke is classified into two: ischemic stroke and hemorrhagic stroke.
1. ischemic stroke
1a. Thrombotic Strokes
1b. Embolic Stroke
2. Hemorrhagic Stroke
2a. Subarachnoid Hemorrhage
2b. Intracerebral Hemorrhage

RISK FACTORS (MODIFIED)

1.

High blood pressure

This is the most important risk factor for stroke because its the No. 1
cause of stroke. Knowing the blood pressure and having it checked at least
once every two years is needed. Normal blood pressure is below 120/80. If it
is consistently 140/90 or above, it is too high. Discuss with your doctor about
how to manage it.
2. Smoke
Smoking can damage blood vessels and raise blood pressure. Smoking
also may reduce the amount of oxygen that reaches your bodys tissues.
Exposure to secondhand smoke also can damage the blood vessels

3. Diabetes Melitus
People withdiabetesare at increased risk for strokes caused by blood
clots. Glucose can lead to increased fatty deposits or clots on the insides of
the blood vessel walls. These clots can narrow or block the blood vessels in
the brain or neck, cutting off the blood supply, stopping oxygen from getting
to the brain and causing a stroke.
4. Atrial Fibrillation
Atrial fibrillation (AFib) or other heart disease. In AFib the hearts upper
chambers quiver (like a bowl of gelatin) rather than beat in the rhythmic
way. This causes the blood to pool and clot, increasing the risk of stroke.
5. Physical Inactivity and Obesity
Being inactive, obese, or both, can increase your risk of cardiovascular
disease. And cardiovascular disease can lead in to stroke.

CONT (CAN NOT BE

MODIFIED)
1.

Age

Stroke affects people of all ages. But, the older you are, the greater your risk of
stroke.
2. Gender
In most age groups, more men than women have stroke, but more women die from
stroke.
3. Heredity and Race
People whose family have a history of stroke, have a higher risk of stroke.
4. Prior stroke
Someone who has had a stroke is at higher risk of having another one.

HOW TO KNOW THE SIGNS

OF STROKE QUICKLY :

DIAGNOSTIC TEST
1. CT SCAN
2. Electrocardiograph (ECG)
3. Complete Blood Count(CBC)
4. Carotid Doppler

NURSING CARE PLAN

CLIENT WITH CHRONIC
STROKE

ASSESSMENT
In chronic stroke, nurses have to assess and monitor vital signs client:
Blood pressure
Respiratory rate
Pulse
Temperature

DIAGNOSIS
Impaired physical mobility (00085)
Risk for falls (00155)
Impaired Verbal Communication (00051)

INTERVENTION

THANKYOU