Cerebrovascul ar Accident with Hemiparesis

Health Assessment BSN 2A-1 GROUP 5

Alba, Calvin Benedicto, Cynthia Dulalia, Julius Zeasar Javier, John Michael Lim, Jamie Rosemarie Royer, Rachel Solomon, John Karl Castro Sombilla, Kelsey S. Taher, Raisanie Dimalna Teodoro, Melanie V.

CEREBROVASCULAR ACCIDENT

Cerebrovascular accident is a sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is also referred to as a stroke. It is an abnormal condition of the brain characterized by occlusion by an embolus, thrombus, or cerebrovascular hemorrhage or vasospasm, resulting in ischemia of the brain tissues.
Two types of cerebrovascular accident (CVA): 1. Ischemic stroke the blood supply to parts of the brain is decreased leading to the dysfunction of the brain tissue in that area. It accounts for nearly 80 percent of all strokes. a. Thrombotic (large vessels) stroke Cause by a blood clot that forms in a narrow artery. It accounts about 2 percent of all strokes and most common for those people who have diabetes. b. Embolic Move from a location outside the brain, such as the heart or a carotid artery. It blocks the blood flow and cause stroke. Occlusion of a cerebral artery by an embolus or blood clot. 2. Hemorrhagic stroke - Cause by a rupture of small blood vessels that supply blood into the brain tissue. It is common in those people who have high blood pressure. Manifestations: Stroke manifestations can be correlated with the cause and with the area of the brain in which perfusion is affected. Manifestations of embolic stroke develop over minutes to hr.\ours to days (slow onset is related to the increase size of the thrombus). In embolic stroke occurs suddenly and without warning. Hemorrhagic stroke occurs rapidly with manifestations developing over minutes to hours. The general findings unrelated to specific vessel sites includes headaches, vomiting, seizures, and changes in mental status. Early warnings of impending ischemic stroke are transient hemiparesis, loss of speech and hemisensory loss. Risk factors: The most important modification of risk factors for CVA is High blood pressure (accounts 3550 percent of stoke risk) and atrial fibrillation. The patients with atrial fibrillation have a risk of 5 percent each year to develop stroke. Other risk factors are high cholesterol level associated to ischemic stroke, diabetes mellitus, cigarette smoking, heavy consumption of alcohol and drugs, obesity, and unhealthy diet. Complications: The complications in CVA are aspiration pneumonia, decubitus ulcers, dementia, difficulty in speaking and swallowing, arm and leg weakness, facial weakness, inability to live independently,

urinary incontinence, bowel incontinence, memory loss, muscle spasms, osteoporosis, chronic pain, recurrent stroke and tremor.

HEMIPARESIS
Slight paralysis or weakness affecting one side of the body. It is also called hemiamyosthenia. It is a result in stroke and commonly involves muscle in the face, arm and leg on one side of the body. The effects of hemiparesis are loss of motor skills, loss of using or understanding speech, loss of ability to distinguish left from right, loss of short term memory and/or attention span. It is related to a condition called hemiplagia involving paralysis of one side of a person's body, instead of weakness. Types of hemiparesis: 1. Right-sided Hemiparesis injury at the left side of the brain. People who have this type of hemiparesis are experiencing difficulty in talking and understanding what other people says and determining left from right. 2. Left-sided Hemiparesis injury at the right side of the brain. People who have this type of hemiparesis are talking excessively, have short attention spans, and memory problems. 3. Ataxia injury at the lower portion of the brain. People who have ataxia have difficulty in walking, balance, and posture. 4. Pure motor Hemiparesis most common type of hemiparesis. People who experience this have weakness in legs, arms, and face. It may affect the persons body parts equally or affect one body part more than the other. 5. Ataxia Hemiparesis syndrome: it involves weakness on one side of the body. The legs are is more affected than the arms. It happens a period of hours to days.

PATIENTS PROFILE
NAME: Patient X ADDRESS: Lagro, Quezon City AGE: 56 years old GENDER: Male CHIEF COMPLAINT: Weakness of the left lateral side of the body accompanied with loss of coordination. MEDICAL DIAGNOSIS: Right Cerebrovascular Accident with Left Hemiparesis

HISTORY OF PRESENT ILLNESS:

2 days PTA, patient experienced headache and dizziness and considered it as normal related to high blood pressure. The patient began feeling tingling sensation to his left lateral side of his body. A day PTA, the headache is still present and the tingling sensation disappeared. Instead, the patients left lateral side of the body became weaker and unable to keep his balance. The patient became more distracted and has poor judgment related to his impulsive behavior. The patient became irritable due to loss of grip or unable to hold on things on his left arm and hands.

HISTORY OF PAST ILLNESS:

Patient X was diagnosed to have hypertension in 1991 at Ease Avenue Medical Hospital Been smoking for forty years.

FAMILY HISTORY:
Father: Was diagnosed with hypertension at the age of forty-five. Has been on medication since then and was advised to change his lifestyle. Been eating more legumes and more conscious about diet. Mother: Diagnosed with hypertension at the age of forty. Changed eating habits and been eating more legumes and less fatty foods. Arthritis since 2000 to present.

PHYSICAL ASSESSMENT
BODY PARTS SKIN NORMAL FINDINGS

ACTUAL FINDINGS Redness Numbness of the face Shiny Glossy

INTERPRETATIO N Abnormal

Smooth and firm to touch with no evidence of dryness or excessive oiliness. Thick and Dense Fine and silky which means not oily or rough

HAIR & SCALP

Normal

NAILS

Have pink appearance Flexible Rarely break Smooth Round Symmetrical Its consistency is hard Theres no tenderness in the scalp. Straight Blink response is bilateral. Eyeballs are symmetrical Bulbar conjunctiva is clear Odor of the ears are racial tone which is brown Symmetrical The pinnas are elastic and recoil when folded. Nasal membrane have hair and moist Pink in color Moist Soft texture Smooth with no lesions No dental carriers

Smooth Flexible Pinkish

Normal

HEAD

Round Symmetrical

Normal

EYES

Deviation towards the lesion

Abnormal

EARS

The patients ears are color brown and its symmetrical

Normal

NOSE Mouth LIPS

There is flow of blood Pale lips

Abnormal Abnormal

TONGUE TEETH

Smooth with no lesion Yellowish Some cavities Smooth skin surface

Normal Abnormal

BREAST

Smooth skin surface

Normal

 UPPER EXTREMITIES (Right & Left) ABDOMEN

Flat areola No masses

Flat areola No masses

Rounded, symmetrical contour No distention No peristaltic movement No scars No lesions

GENITOURINA RY LOWER EXTREMITIES (Right & Left)

Left hemisphere of abdomen is weaken

Abnormal