Stroke (CVA) Nursing Care

Overview

A Cerebrovascular Accident (CVA) or stroke occurs when blood flow to the brain is interrupted, leading to brain cell death. It is a medical emergency that requires rapid identification and intervention to minimize permanent disability. Nursing priorities include maintaining the airway, monitoring neurologic status, and preventing complications of immobility.

Key nursing concepts

• A stroke occurs when there is an interruption of blood flow to the brain.
• Ischemic strokes are caused by a thrombus or embolus.
• Hemorrhagic strokes result from bleeding into the brain tissue.
• Left-brain damage often affects speech and language (aphasia).
• Right-brain damage often affects spatial-perceptual orientation and impulsivity.
• The NIH Stroke Scale is the standardized tool for assessing stroke severity.

Important nursing considerations

• Maintain the head of the bed at 30 degrees to prevent aspiration.
• Assess gag reflex and swallowing ability before giving oral intake.
• Perform frequent neurological assessments using the Glasgow Coma Scale.
• Implement seizure precautions for patients with hemorrhagic strokes.
• Use a communication board for patients with expressive aphasia.
• Monitor for signs of increased intracranial pressure such as bradycardia and hypertension.

Patient teaching

• Instruct the patient to tuck their chin when swallowing to prevent aspiration.
• Teach the 'scan' technique to patients with visual field deficits.
• Explain the importance of controlling hypertension to prevent future strokes.

Related practice questions

Real questions from the NursGuru bank, each with the answer and rationale.

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