Please enable JavaScript.
Coggle requires JavaScript to display documents.
Cerebrovascular Accident (CVA) - Coggle Diagram
Cerebrovascular Accident (CVA)
Pathophysiology
A cerebrovascular accident is the death of brain tissue caused by a lack of oxygen due to a disruption in blood flow through the cerebral arteries. There are two kinds of CVAs: ischemic and hemorrhagic.
Hemorrhagic CVA
It is caused by the rupture of an artery in the brain, which disrupts blood flow.
Ischemic CVA
It is caused by a thrombus or embolus, which blocks the arteries in the brain, disrupting blood flow.
Diagnostics
Magnetic Resonance Imaging
: This type of diagnostic imaging uses a magnetic field and radio waves to create a detailed image of the brain. This type of imaging can show the extent of damaged tissue in the brain caused by the CVA.
Cerebral Angiogram
: This type of diagnostic imaging uses a catheter to inject dye into the arteries to make them visible during imaging. This type of imaging can show how the blood flows through the cerebral arteries in order to visualize where the clot or hemorrhage is.
Treatments
Tissue Plasminogen Activator (tPA)
: tPA is a thrombolytic drug that dissolves blood clots that cause ischemic CVAs. This drug must be used within four and half hours of the onset of CVA symptoms and can only be used once a hemorrhagic CVA has been ruled out.
Surgery
: Surgery can be used to treat both ischemic and hemorrhagic CVAs. The goal of surgery when treating an ischemic CVA is to remove the blood clot in order to restore blood flow through the affected artery. Surgery to treat hemorrhagic CVAs aims to reduce intracranial pressure by evacuating the blood and repairing the damaged artery to restore blood flow to the affected area of the brain.
Nursing Diagnoses and Interventions
Diagnosis One
: Impaired physical mobility related to recent cerebrovascular accident as evidenced by one-sided weakness.
Intervention One
: RPN to provide passive range of motion exercises on the client's weak side every shift to prevent muscle atrophy and contractures.
Diagnosis Two
: Risk for impaired skin integrity as evidenced by prolonged bed rest.
Intervention Two
: RPN is to complete a thorough skin assessment within twenty-four hours of admission to obtain a baseline Braden Scale evaluation.
Intervention Three
: RPN is to reposition the patient every two hours to prevent skin breakdown related to immobility and pressure.
Diagnosis Three
: Impaired verbal communication related to a recent cerebrovascular accident as evidenced by slurring and aphasia.
Intervention Four
: RPN is to call the physician within twenty-four hours of admission for a referral for a speech-language pathologist to implement a plan of care.
Signs and Symptoms
Aphasia
: Occurs when the left frontal lobe is deprived of oxygen due to a lack of blood flow.
Vision Loss
: Occurs when the occipital lobe is deprived of oxygen due to a lack of blood flow.
Weakness
: Occurs when the brain cannot communicate with the muscles due to oxygen deprivation.
Confusion
: Occurs when the frontal lobe is deprived og oxygen due to a lack of blood flow.
Sudden Headache
: Occurs most often with hemorrhagic strokes due to a sudden increase in intracranial pressure.
Numbness
: Occurs when the part of the brain that controls the affected area does not have adequate blood flow.
Risk Factors
Diabetes
: Can cause plaque to build up on the artery walls, which causes them to narrow.
Combination of Oral Contraceptives and Cigarette Smoking
: Can increase the chances of developing blood clots.
Hyperlipidemia
: Can cause plaque to build up on the artery walls, which causes them to narrow.
Heart Disease
: Can cause plaque to build up on the artery walls, which causes them to narrow.
Atherosclerosis
: Causes plaque to build up on the artery walls, which causes them to narrow.
History of Transient Ischemic Attacks
: Transient ischemic attacks can be a presucrsor for having a CVA.
Hypertension
: Can cause damage to the arteries resulting in them rupturing and can result in the formation of blood clots.
Increased Age
: Increases the chances of developing other risk factors that can cause CVAs.