Stroke is Australia’s single greatest killer and a leading cause of disability. Stroke is a serious and deadly condition involving cerebral circulation within the brain and can seriously affect a person maintaining a safe environment, communication and mobility as well as other activities of living. The case of Mr Shaw, a 73 year old male admitted to the stroke unit of his local hospital following a left sided ischaemic stroke is presented in this essay. The ischaemic stroke has left Mr Shaw with right sided hemiparesis, neglect of affected limbs, dysphasia and right sided hemianopia. The purpose of this essay is to give an overview of the Pathophysiology of ischaemic stroke and Mr Shaw’s symptoms in order to understand what happens in the brain when an ischaemic stroke occurs. The nursing care required for Mr Shaw will also be discussed as well as the rationale behind it.
Stroke, previously known as cerebrovascular accident (CVA) is defined as ‘a sudden impairment of cerebral circulation in one or more of the blood vessels supplying the brain. It interrupts or diminishes oxygen supply, causing serious damage or necrosis in brain tissues’ (Pathophysiology made Incredibly Easy 2006). A person suffering a stroke can present one or more of the following symptoms, weakness or numbness or paralysis of the face, arm or leg on either or both sides of the body, difficulty speaking or understanding dizziness, loss of balance or an unexplained fall, loss of vision, sudden blurring or decreased vision in one or both eyes, headache and difficulty swallowing (National Stoke Foundation 2012). There are two types of stroke, haemorrhagic stroke and ischaemic stroke. In the case of Mr Shaw he has experienced a left sided ischaemic stroke. An ischaemic stroke is ‘a cerebrovascular disorder caused by deprivation of blood flow to an area of the brain, generally as a result of thrombosis, embolism or reduced blood pressure’ (Harris, Nagy & Vardaxis 2010). Ischaemic stokes occur as a result of an obstruction within a blood vessel supplying blood to the brain with the underlying condition for this type of obstruction being the development of fatty deposits lining the vessel walls. Atherosclerosis is the name given to this condition. These fatty deposits can cause two types of obstruction; cerebral thrombosis or cerebral embolism. Cerebral thrombosis refers to a blood clot that develops at the clogged part of the vessel. Cerebral embolism refers to a blood clot that forms at another location in the circulatory system, usually the heart and large arteries of the upper chest and neck. A portion of the blood clot breaks loose and enters the blood stream, travelling through the brains blood vessel until it reaches a blood vessel too small to let it pass through (American Stroke Association 2012). As a result of suffering an ischaemic stroke Mr Shaw has right sided hemiparesis of his arm and leg, neglect of affected limbs, dysphasia and right sided hemianopia. Hemiparesis is muscular weakness of one half of the body (Harris, Nagy & Vardaxis 2010). As Mr Shaw had a left sided ischaemic stroke, the right side of his body has been affected. Neglect of affected limbs is when a patient does not look at the affected side, leaves food on their plate on the affected side, has a inability to protect the affected side, has an inability to perform self-care and pays consistent inattention to stimuli on the affected side (Comer 2005, p. 106). Another symptom Mr Shaw is experiencing is dysphasia. Dysphasia is defined as, ‘a partial loss of language; usually due to cerebral infarct(s), a cerebrovascular accident (CVA) or traumatic brain injury (TBI) (Harris, Nagy & Vardaxis 2010). Lastly the symptom of hemianopia is defined as, ‘blindness in half of the normal visual field’ (Harris, Nagy & Vardaxis 2010). With the symptoms that Mr. Shaw is experiencing it is possible to say that the ischaemic stroke has occurred in either the...
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