INTRODUCTION Cerebrovascular accident: The 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. Symptoms of a stroke depend on the area of the brain affected. The most common symptom is weakness or paralysis of one side of the body with partial or complete loss of voluntary movement or sensation in a leg or arm. There can be speech problems and weak face muscles, causing drooling. Numbness or tingling is very common. A stroke involving the base of the brain can affect balance, vision, swallowing, breathing and even unconsciousness. A stroke is a medical emergency. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The causes of stroke: An artery to the brain may be blocked by a clot (thrombosis) which typically occurs in a blood vessel that has previously been narrowed due to atherosclerosis ("hardening of the artery"). A cerebral hemorrhage (bleeding in the brain), as from an aneurysm (a widening and weakening) of a blood vessel in the brain, also causes stroke. The reason for choosing of this case is to be able to acquire knowledge on how to deal or manage a patient with Cerebrovascular Accident. CURRENT TRENDS

OBJECTIVES (nurse centered)

1. To thoroughly assess the clinical manifestations of patient with CVA based on the patients history. 2. To formulate comprehensive nursing diagnosis for a client with CVA. 3. To formulate a plan of care for patients with CVA. 4. To formulate appropriate nursing interventions that can be applied for a patient with CVA. 5. To evaluate the plan of care for a patient with CVA.

II. NURSING HISTORY 1. PERSONAL HISTORY

a. Patient initial is B.L. He is 42 years old. He was born on Jan 28, 1970. He currently residing at Angeles Pampanga. He is Filipino, pure Roman Catholic and married with 5 children. He was admitted at ONA hospital last July 4, 2012 with a diagnosis of CVA intact with bleeding and seizure disorder.

b. Socio economic and cultural factors According to his son, his father was an electrician, and he has a monthly income of 7,200 pesos. His father is a graduate of highschool.

2. FAMILY HEALTH-ILLNESS HISTORY The clients father has a history of hypertension and the her mother has a history of myocardial infarction

3. HISTORY OF PAST ILLNESS - The patient has a history of epilepsy . The client commonly had cough and fever. The childhood diseases that she acquired are mumps, measles, and chicken pox and sore eyes .There were no known food or medication allergy. Client has no history of accidents or injuries. He does not smoke or drink alcohol.

4. HISTORY OF PRESENT ILLNESS Few minute PTA, patient was riding bicycle when he was noted to experience nausea followed by a loss consciousness. He was brought immediately to the hospital for consultation.

III. PHYSICAL ASSESSMENT

DIAGNOSTIC PROCEDURE AND LABORATORY PROCEDURES Diagnostic/ laboratory Procedure HEMATOLOGY CREATININE Indications or Purpose Date ordered/ Date results were release Ordered: July 4,2012 Results Normal values (units used in that hospitals) 0.7 - 1.2 mg/dl Analysis and interpretation of results

serum creatinine is a simple test and it is the most commonly used indicator of renal function.

1.2 mg/dl

Normal

Date Released: July 5,2012

NA (SODIUM)

Blood sodium testing is used to detect abnormal concentrations of sodium, termed hyponatremia (low sodium) and hypernatremia

Ordered: July 4,2012

147.3 mmol/l

135 145 mg/dl

Slightly increase,

Date Released: July 5,2012