Ischemic stroke IMG_20210522_055201_766

Definition

Is an unexpected loss of functioning resulting from the distruction in blood supply to a part of the brain.(M. Zomorodi, 2015)

Risk factors

High cholesterol levels

Elevated hematocrit

Diabetes mellitus and hypertension

Smoking and excessive alcohol consumption

Use of oral contraceptives

Age and gender

Genetics and race (M.Zomorodi, 2015)

Pathophysiology

Occlusion of the artery.

Decrease in blood flow.

Decrease in oxygen and nutrition supply to the brain.

There is an increase in glutamine and aspartate.

The high levels of Calcium, sodium and chlorine leads to the decrease in potassium.

Then there is increase in cell death (M. Zomorodi, 2015).

Clinical manifestations

Motor loss- paralysis of one side of the body (M. Zomorodi, 2015).

Sensory loss- temporary loss of vision or double vision.

Speech loss and slurred speech

Perceptual disturbances

Cognitive impairment

Diagnostic studies

12-lead electrocardiogram

Carotid ultrasound standard test

Cerebral angiography

Transthoracic

Xenon CT

Non- Contrast Computed Tomography scan (M. Zomorodi, 2015)

Treatment

Administration of warfarin sodium

50mg/d of aspirin

400 mg/d of dipyridamole

Thrombolytic therapy

Endarterectomy (M. Zomorodi, 2015)

Nursing intervention

Improve mobility and prevent compressive neuropathies

Encourage self care and patient should be well dressed according to their condition

To avoid dysphagia patients should be taught about foods they need to eat and that are easy to be swallowed.

Always ensure that the feeding inserted.

Patients should be inserted with indwelling catheter, in order to empty urinary bladder.

If patient is bedridden, there is a need for timing and positioning schedule (M. Zomorodi, 2015)

Which leads to the decrease in stored energy

Leading to the opening of calcium channels