STROKE

KEMENTERIAN KESEHATAN REPUBLIK INDONESIA

POLITEKNIK KESEHATAN PONTIANAK
JURUSAN KEPERAWATAN SINGKAWANG
DIII KEPERAWATAN
STROKE
WELCOME TO
OUR
PRESENTATION!
What is the Stroke ?

Definition of Stroke

Stroke is a sudden loss of

neurologic function resulting
from an acute disruption of
blood flow to the brain. This
leads to cellular ischemia and
ultimately, cerebral infarction.
 Type of Stroke
Non Stroke Hemorrhagic (88%)

Thrombosis Embolism

6
 Type of Stroke
Hemorrhagics Stroke

Intraserebral Hemorrhagic Subarachnoid Hemorrhagic

7
Pathway Stroke

Thrombosis, embolism Hypertension Aneurysm

Block of cerebral blood flow

Intraserebral hemorrhagic/ subarachnoid
Decreased cerebral blood flow

Cerebral Tissue ischemia Decreased blood supply to the distal areas

of the brain

Decreased oxygen supply

to cerebral tissue

Cerebral tissue infraction

Loss of neurogical function

Stroke
 Signs and Symptoms

Sensory and
Muscle weakness
motor aphasia Dizzines or
includes the face,
arms, legs, on one Headache
Dysphagia
side of the body
 5 warning signs of stroke

Weakness - Sudden loss of strength or sudden numbness in

the face, arm or leg, even if temporary.
Trouble speaking - Sudden difficulty speaking or
understanding or sudden confusion, even if temporary.
Vision problems - Sudden trouble with vision, even if
temporary.

Headache - Sudden severe and unusual headache.

Dizziness - Sudden loss of balance, especially with any of the

above signs.
Who is risk ?
1 Hypertension 4 Smokers

2 High Cholesterol 5 Diabetes Mellitus

Heart dissease, include Obesity

3 cardiac valve disease
6
 Diagnostic Test

Computedtomography Scaning Blood Test

1 (CT-Scan)
4

2 Magnetic Resonance Imaging 5 Carotid Ultrasound

(MRI)

Cholesterol Test, Blood Pressure

3 Electrocardiogram 6 Test
 How to the Treatment?

Treatment of stroke patients begins with the assesment of airway patency. Breathing rate
and rhythm is controlled within the brainstem and can be affected by brain swelling.
ET intubation may be required to ensure a patent airway.
Oxygen therapy : maintain oxygen saturation of at least 94% using 2 to 3 L nasal cannula
oxygen.
If the patient is hypertensive ( greater than 220 mmHg systolic or 120 mmHg Diastolic),
antihypertensive agents such as nitroprusside (Nipride) should be used.
Antitrohrombotic Theraphy (Aspirin)
Hydration : IV fluids (initially without dextrose) help maintain adequate circulating
blood volume.
Keep HOB greater than 30 degrees.
Begin mobilization as soos as clinically safe.
 Diagnose
1. Impaired physical mobility related to body weakness

Outcomes : Patient will be able to do his/her ADL within their limit

1. Assess functional ability daily

2. Monitor patient vital sign
3. Refer to physiotherapist for ambulation as ordered by doctor
4. Set goals with patient family members for participation in activities exercise and
position changes
5. Encourage patient to assist with movement and exercises using unaffected
extremity to support/move weaker side
6. Placed patient things/ call bell within patient reach for easy access
 2. Altered nutrition less than body reqirement

Outcomes: patient will be show no sign of malnutrition

1. Assess patient nutritional status daily

2. Monitor patient strict intake and output charting
3. Encourage oral feeding if patient is able to swallow
4. Feed patient with small portion and allow time for patient to chew and
swallow. Advice patient to take small amount but frequent meals
5. Refer to dietician if required
6. Start N/G feeding if patient unable to swallow
7. Administered parenteral solution as prescribed if patient unable to tolerate
enteral feeding
 3. Potensial of impaired skin integrity related to immobilisation

Outcomes : Patient will not develops any skin break or pressure ulcer during
hospitalisation

1. Assess and reassess the patient level of pressure ulcer risk according to
the criteria of modifield branden scale ( pressure ulcer risk assesment
from ) during admission and hospitalisation
2. Apply ripple matters
3. Do regular turning every 2 to 3 hourly
4. Ensure lines are clean dry on crumple
5. Maintain patient hygiene by providing oral care, hair shampo and bed
bath
Thats all. Thank you !
Any Questions?