Macrovascular complication; Stroke
Pathophysiology
Signs and symptoms
Cerebral blood flow determined resistance within cerebral blood vessels.
Cerebral blood flow is maintained at constant level despite variations in perfusion pressure.
Smooth muscle contract when CCP increases and relax when CPP drops.
Nitric oxide also plays a role in autoregulation.
Occurs within a mean arterial pressure 60-150mmHg
Outside this range, CBF increases or decreases with CPP.
Ischemia at low and oedema at high CPP.
Cardiac embolism-MCA PCA
Atherosclerosis carotid artery.
Arterial dissection neurosyphilis.
Thrombophilia vasculitis
Sickle cell anaemia- children.
Trouble with understanding and speaking.You may experience confusion. You may slur your words or having difficulty understanding speech.
Paralysis or numbness of the face, leg or arm. You may develop sudden numbness, weakness or paralysis in your face. Try to raise both your arms over your head at the same time.
Trouble with seeing in one or both eyes. You may suddenly have blurred vision in one or both eyes.
Headache. A sudden, severe, headache which may be accompanied by vomiting, dizziness or altered consciousness, may indicate stroke.
Trouble with walking. You may stumble sudden dizziness, loss of balance or loss of coordination.
Risk factors
Lifestlye risk factors
Being overweight or obese
Physical inactivity
Heavy or binge drinking
Use of illicit drugs such as cocaine and methamphetamines.
Medical risk factors
Blood pressure readings higher than 120/80 mmHg
Cigarette smoking or exposure to secondhand smoke
High cholesterol
Diabetes
Causes
Ischemic stroke
Haemorrhagic stroke
Transient ischemic stroke
Diagnostic procedures
Physical examination
Blood tests
Computerised tomography scan
Magnetic resonance imaging
Carotid ultrasound
Nursing care plan
Relieve sensory deprivation and anxiety
Implement reality orientation
Provide patient support and family teaching
Promote self-care and rehabilitation
Help the patient to attain bowel and bladder control
Promote bowel and bladder retraing
Regular turning and positionong
Keep skin dry and massage non-reddened areas
Correctly position patient to prevent contractures
Place pillow under axilla