Stroke Bu Cucut.docx

STROKE

Oleh Kelompok 4 S16C : 1. 2. 3. 4. 5.

Ambar Nur Hidayanti Berliana Sukmawati Okta Fiyanti Puput Istu Widodo Tatik Widyastuti

(S16131) (S16137) (S16173) (S16174) (S16184)

PROGRAM STUDI SARJANA KEPERAWATAN STIKES KUSUMA HUSADA SURAKARTA 2019

STROKE A. Definition According to Sofwan (2010), stroke in English means "punch". There are many terminologies and definitions of stroke. One of them, stroke is a syndrome caused by cerebral circulatory disorders (GPDO) with acute onset, accompanied by clinical manifestations in the form of neurological deficits and not as a result of tumors, trauma or central nervous system infections (Dewanto, G, et al, 2009). Asanti (2010) defines stroke as a deficit (disorder) of nervous system function that occurs suddenly and is caused by circulatory disorders of the brain. Circulatory disorders of the brain can be in the form of clogged brain blood vessels or rupture of blood vessels in the brain. WHO defines stroke as a permanent neurological disorder both focal and global (overall) caused by brain blood flow disorders, which result in damage to blood vessels in the brain that last for 24 hours or more (Sutrisno, 2007). So it can be concluded that stroke is a disruption of the flow of blood supply to the brain that occurs suddenly which can cause permanent disability or even death. B. Causative and Risk Factor The cause of a stoke can occur due to : 1. Causes of ischemic stroke : This condition occurs when frozen blood clogs arteries. This type is a type that is common in the elderly. 2. Causes of hemorrhagic strokes : This condition occurs when blood vessel in the brain leak or break so that blood flows into the brain or the surface of the brain. This type of stroke is not as common as ischemic but is more deadly. 3. Causes of mild strokes: This condition occurs when frozen plaques or blood in arteries block the blood vessels that supply blood to the brain. This condition causes blood flow to the brain to become blocked and cause this condition to occur. For more details, these stroke risk factors are described as follows (Wahyu, 2009) and (Pinzon & Asanti, 2010) :

a. Risk factors that cannot be changed. 1. Age Although strokes can affect all ages, it is known that those who are elderly are more at risk of developing potentially deadly diseases and causing permanent disability. After reaching the age of 55 years, the risk of stroke has doubled every 10 years. Two-thirds of stroke cases are suffered by those who are 65 years old. The same thing was expressed by Pinzon & Asanti (2010) that the older the age of a person will be more susceptible to stroke. Stroke can occur at any age, but more than 70% of stroke cases occur at the age of 65 years. 2. Gender Stroke is more common in men. Some studies show that men are at risk of stroke compared to women. However, deaths from strokes are more common in women than men because generally women get a stroke at an older age. Pinzon & Asanti (2010) also said that men are more prone to stroke. This is due to the higher incidence of risk factors for stroke (hypertension) in men. 3. Family History Genetic factors in the family are also risk factors for stroke. Some diseases such as diabetes mellitus and hypertension are known to be genetically inherited from someone to their offspring. Hertzberg et al. In Pinzon & Asanti (200) revealed that stroke risk was increased in someone with a family history of stroke. A person with a family history of stroke is more likely to suffer from diabetes and hypertension. This supports the hypothesis that an increase in the incidence of stroke in families with stroke is due to reduced risk factors for stroke. 4. Race or Ethnicity The incidence and mortality from stroke in the United States is higher in the African-American racial group than in the EuropeanAmerican race. However, in Indonesia the influence of racial factor differences on stroke is not known with certainty. Pinzon & Asanti

(2010) say that the incidence of stroke in the race of colored skin is higher than that of the caucasoid. b. Changeable Risk Factor 1. Hypertension Under certain conditions, blood pressure can increase beyond normal limits. This condition is known as hypertension. Hypertension that lasts for a long time and is not treated can be at risk of causing various diseases, such as congestive heart failure, eye nerve abnormalities, kidney failure or stroke (Wahyu, 2009). 2. Smoking Various studies link smoking habits with an increased risk of vascular disease (including strokes). Smoking promotes increased blood viscosity, hardening of the walls of blood vessels, and accumulation of plaque on the walls of blood vessels. Smoking increases the risk of stroke by two-fold. There is a linear relationship between the number of cigarettes smoked per day with an increased risk of stroke. According to Olsen in Pinzon & Asanti (2010), the risk of stroke will increase 1.5 times per addition of 10 3.

cigarettes per day. Heart disease The type of heart disease or disorder that increases the risk of stroke is cardiac arrhythmias. Arrhythmia is a disorder characterized by an irregular heartbeat. This heartbeat disorder has the potential to cause a platelet cell clot (thromboembolism), which can migrate from the heart and clog arteries in the brain, causing

4.

thromboembolic ischemic stroke. Diabetes Mellitus Type 2 diabetes mellitus (type 2 DM) increases the risk factors for stroke. This is caused by this metabolic disease resulting in damage to the arterial wall, both large (makroangiopati) and small (microangiopathy). The walls of the arteries that are damaged will be the location of fat deposits, platelet cells, cholesterol, and thickening of the smooth muscle layer in the

5.

arterial wall. This condition is referred to as atherothrombotic. Dyslipidemia

Cholesterol is formed in the body, which consists of two main parts, LDL cholesterol and HDL cholesterol. LDL cholesterol is called "bad cholesterol", which carries cholesterol from the liver into cells. The high amount of LDL cholesterol will cause accumulation of cholesterol in cells. This will spur the emergence of the atherosclerosis process (hardening of the arterial artery wall). The process of atherosclerosis will cause complications in the target organs (heart, brain, and kidneys). This process in the brain will increase the risk of stroke (Pinzon & Asanti, 2010). 6.

Obesity A person who is overweight has a high risk of suffering a stroke. Oki, et al. (2006) concluded that a person with a body mass index indeks30 had a stroke risk of 2.46 times compared to a body mass index <30 (Pinzon & Asanti, 2010).

C. Symptomps A stroke can occur suddenly, but the signs can actually be detected. Experts say, the eralier the stroke is recognized and treated, the more likely it is to recover and avoid the risk of paralysis.        

Sudden headaches Loss of balance, problems with walking Fatigue Loss of consciousness or coma Vertigo and dizziness Blurred and blackened vision Weakness or numbness on one side of the body on the face, hands, feet Problems with speech hearing

D. Handling or Treatment 1. Treatment If the symptoms of a stroke that occur are caused by a blood clot, a stroke drug that can be used is a medicine to melt the blood. To be effective, this stroke medication treatment must be carried out immediately within a period of 3 to 4 ½ hours after the first symptoms

appear. In addition, doctors can also provide other stroke drugs that can dilute blood such as Heparin, Warfarin (Coumadin), Aspirin or Klopidogrel (Plavix). 2. Therapy There are several ways to do stroke therapy. Therapy plans or treatments can be done depending on the body part or the type of ability that is weakened because this condition occurs.Physical therapy includes: Exercise motor skills. These exercises can help increase the strength and coordination of your muscles again. Usually people who do this therapy are people whose tongue muscles weaken. This therapy can streng then your muscles to talk or swallow. Mobility therapy. You may need to learn to use mobility aids, such as walking aids, sticks, wheelchairs or ankle restraints. The ankle brace can stabilize and strengthen your ankles to help support your weight when you learn to walk. Constraint-induced therapy. This therapy is carried out by other limbs that are not affected by this condition. Members of the body that are not affected must help other limbs to improve their function. This stroke therapy is sometimes called forced use therapy. Range-of-motion therapy. These exercises and treatments aim to reduce muscle tension (flexibility) and help you regain flexible body movements. Mind and emotional therapy is also possible with the following types: Therapy for cognitive disorders. Occupational therapy and speech therapy can help you with lost cognitive abilities, such as memory, processing, problem solving, social skills, assessment, and selfawareness Therapy for communication disorders. Speech therapy can help you regain lost abilities in speaking, listening, writing, and understanding

the

words

of

the

other

person.

Psychological treatment. Your emotions may be tested. You may also have counseling or participate in support groups that have also experienced

this

condition.

Your

doctor

may

recommend

antidepressants or drugs that affect alertness, anxiety or movement.

Alternative medicine. Treatments such as massage, acupuncture, and oxygen therapy may be one of the therapies for sufferers of this condition. E. Suggestion Patients who experience this condition, must undergo certain dietary principles according to their conditions. There are several types of this condition from mild to severe strokes. Pr course, each type of condition will require different foods. Following are the rule tips : 1. Limitsalt consumption For those of you who have a history of this disease, then you should avoid using execessive salt and consumption of foods or drinks that contain high sodium. The high amout of sodium in salt and packaged food is one of the triggers for the appearance of vascular disorders that occur in you. 2. Choose foods with healthy fats. High saturated fats in the body will only make cholesterol level rise. This then make a person vulnerable tothis condition or a sudden heart attack. Therefore, from now on avoid foods that contain high saturated fats, for example foods that are fried in deep frying, gajih on meat, innards, and chicken skin. Isntead foods for this condition that are good consumption are nuts that good fats, such as almods. 3. Set the portion of the meal accordingly. If indeed you are having trouble eating, then you should reduce the portion but increase the frequency of your meal in one day. adjust the food consumed with the calorie needs you have. If confused, you can consult a nutritionist in planning the correct diet during and after therapy. Here is a lifestyle and stroke medication at home that can help you deal with stroke : Quit smoking, Take the medicines given by your doctor, Exercise according to your doctor’s intructions.