NUR2004 NURSING PRACTICE IN CONTEXT 2
Introduction: Page 2.
Pathophysiology: Page 2-6
-Pathophysiology of Ischemic Stroke and Haemorrhagic Stroke. - Risk factors Associated With Ischemic Stroke.
- Clinical Manifestation of an Ischemic Stroke.
- Diagnostic Tests and Investigations.
Collaborative Management: Page 6- 9
- Nursing Management of Mavis.
- Medical Management of Mavis.
- Discharge planning/Rehabilitation.
Pharmacology: Page 9-10
- Medications used in Mavis’s treatment
- Thrombosis Treatment
Conclusion- Page 11.
Word count: 3,350
A Cerebrovascular accident (stroke) is a sudden, non-convulsive focal neurological deficit. Stroke is the second-highest cause of death behind coronary artery disease and is the primary cause of disability in Australia and New Zealand (Craft, Gordon, & Tiziani, 2011). Mavis, a 70 year old woman was admitted to hospital after losing control of her left arm and left leg, which lead to her falling out of bed. After investigations, Mavis was diagnosed with having suffered an acute ischaemic stroke. This essay will discuss the pathophysiology of ischaemic and haemorrhagic strokes and the underlying factors that contributes to Mavis having an acute ischaemic stroke. In regards to the subjective and objective data collected, there are many variables to consider when determining the possible causes of Mavis’s brain attack. The various amount of diagnostic tools used to diagnose an acute ischemic stroke will be discussed, following a management plan to allow Mavis to return home. Education on specific medications used whilst in hospital and when Mavis returns home, needs to be explained to her, to allow her to understand the importance of medication adherence. If Mavis understands her condition, and the signs and symptoms of a stroke, it may prevent a reoccurrence.
Pathophysiology of Ischemic Stroke and Haemorrhagic Stroke
There are two main types of Strokes according to pathophysiology; these include ischaemic stroke, which is what Mavis endured, and haemorrhagic stroke. 80% of all strokes are ischaemic strokes which occur due to a blockage in blood vessels that supply the brain (Craft, Gordon, & Tiziani, 2011). The two main subtypes of ischaemic strokes are thrombotic and embolic. Thrombotic stroke occurs when there is a blockage inside the blood vessel that supplies the brain tissue with oxygen. This can occur in arteries entering the brain or from smaller vessels within the brain. Individuals with high levels of cholesterol have a much higher risk of having an ischaemic stroke due to higher development of atherosclerosis which is a causative factor of a brain attack. Atherosclerosis begins by injuring the endothelial cells that line the artery walls (Craft, Gordon, & Tiziani, 2011). Injured endothelial cells become inflamed and therefore lose the ability of vasodilation, which increases the likelihood of thrombosis. Once a thrombosis (clot) has formed, it can occupy majority of the vessel preventing blood from flowing through the cell .The restricted blood flow to the neurons downstream of the thrombosis are deprived of oxygen and without oxygen, death of neurons occur within a few minutes. Embolic strokes involve fragments that break from a thrombus formed outside the brain, commonly when a fragment in the heart breaks away during abnormal heart function, which travels to the brain (Craft, Gordon, & Tiziani, 2011). The fragments that have travelled to the brain become jammed in small brain vessels which cause obstruction and ischemia to the brain tissue. The longer the occlusion of the vessels continues to deprive neurons of oxygen, the more neurological damage is done. In contrast to ischaemic stroke where the neuronal damage is due to inadequate blood flow, haemorrhagic stroke occurs in response to bleeding in the brain (Craft, Gordon, &...
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