case study analysis: stroke

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Stroke is defined as an ischemic condition caused by an interruption in blood supply due to any cause. Stroke may be caused by vascular occlusion that may be temporary or permanent. Stroke may be caused by a localized cause, for example, atherosclerosis of the brain (Brito-Brito, Fernandez-Gutierrez, & M. Smith, 2015). The plaque formation of the arteries supplying the brain tissue is the main cause of interruption of blood supply to the brain that is the cause of death of brain tissue causing the signs and symptoms of the stroke (Katan & Luft, 2018). This may also be due to a distant cause known as a thromboembolism. Thromboembolism is caused by the formation of thrombus in distant parts of the body. Then there is dislodgement of the thrombus and it becomes an embolus. The embolus, in turn, travels to the distant part of the body along with the blood flow (Capodanno et al., 2018). The size of thrombus and embolus may vary. The emboli may cause the occlusion of blood vessels of any part of the body if the ambulance is lost in the arteries of the brain the blood flow to the brain decreases and it may result in stroke (Parr, Ferdinand, & Roffe, 2017).

In stroke, a constellation of symptoms may be seen involving loss of vision, slurring of speech, behavioral changes loss of motor function, difficulty in swallowing, disfigurement of the face, paralysis, and much more. Weakness may occur in one side of the body involving arms and legs or the inability to co-ordinate movements and perform coordinated actions like walking, running, standing, uplifting, and sitting, etc (Katsanos et al., 2017). Dysphagia or difficulty in swallowing may occur due to processes of muscles involved in swallowing actions (Brito-Brito, Fernandez-Gutierrez, & M. Smith, 2015). There may be changes and behavior cognition thinking or memory loss. The sense of smell, touch, vision, and hearing may also be affected as a result of the damage to the brain areas or lobes involved in the processing and interpretation of these functions. Fatigue and incontinence of urine and defecation may be seen (MacIntosh et al., 2017). All of these symptoms that can cripple a patient (Jones, Smakowski, O’Connell, Chalder, & David, 2020). Nursing care is very important and prevention of severe outcomes as a result of the stroke. After an acute episode of stroke, the patient may feel fatigued (MacIntosh et al., 2017). Bouts of anxiety and depression may follow stroke. Muscular weakness or muscular spasm may occur solely or intermittently. Alcohol intake is a major risk factor in both ischemic and hemorrhagic stroke (Parr, Ferdinand, & Roffe, 2017). Alcohol intake is strictly prohibited in patients immediately. The patients must abstain from alcohol until three weeks after the episode of stroke. Alcohol can trigger stroke and cause the severity of stroke. Stroke may affect the upper limb. Usually, the upper limb of one side is affected (Katsanos et al., 2017). There may be weakness, subluxation, spasticity, pain, or swelling in the limb. Nursing care can alleviate all the symptoms (Brito-Brito, Fernandez-Gutierrez, & M. Smith, 2015). The care plan must be constructed to decrease the symptoms like swelling or spasticity.  The swelling in the upper limb must be relieved through complete nursing care (Bjartmarz, Jónsdóttir, & Hafsteinsdóttir, 2017). The patient must be advised to comply with the guidelines of the medical team (Nonnenmacher et al., 2016).  Anxiety and depression can be controlled by the reassurance of the patient by the nursing team. 

Due to sedative routine certain diseases are in vogue. In modern days, the prevalence of chronic diseases has increased manifold mainly caused by preventable factors. These factors can easily be prevented and thus, the occurrence of these chronic diseases can easily be controlled. These diseases include diabetes, hypertension, atherosclerosis, ischemic heart disease, ischemic disease of the brain, vasculopathy, and obesity (Katsanos et al., 2017). All these chronic diseases are related to each other in such a way that the occurrence of one disease increases the risk of many other diseases, for example, obesity causes an increased risk of hypertension and in turn, hypertension increases the risk factor of vasculopathy. The most important vasculopathy involved in the general population is atherosclerosis. The pathophysiology of atherosclerosis and related outcomes, like ischemic heart disease and stroke, is complex. The pathophysiology of atherosclerosis involves the damage to the blood vessels and the resulting plaque formation. High cholesterol levels, as seen dyslipidemia, are manifested as high levels of low-density lipoproteins and very-low-density lipoproteins, cause the phagocytosis of oxidized fatty acids and cholesterol by macrophages. The signaling pathway involves the microenvironment (Katsanos et al., 2017). This microenvironment is in favor of plaque formation. When the macrophages are laden with oxidized cholesterol. These macrophages are transformed into pathological cells known as foam cells (Parr, Ferdinand, & Roffe, 2017). Foam cells migrate to inner layers of the blood vessels that are the tunica media and tunica adventitia. When the cells migrate to the inner layers of the blood vessels, the overall thickness of the blood vessel increases and plaque formation leads to pushing the vessel wall into the lumen of the blood vessel (Katsanos et al., 2017). Due to this, there is a constriction of the blood vessel. The constriction of the blood vessel may lead to decreased blood flow to the area of the tissue to which the blood vessel supplies blood.

The blood vessels are unable to supply blood to the affected area in which the vessel is suffering from atherosclerosis (Katan & Luft, 2018). This pathology is the main culprit behind the development of some ischemic conditions that lead to infarction and necrosis of the tissues. The ischemic heart disease is also known as an acute coronary syndrome and the ischemia of the brain tissue is also known as a stroke (Katsanos et al., 2017). All these diseases are related to the pathology of the blood vessels most of the tissues are respectable to even a slight amount of anoxia and hypoxia (Kalkonde, Alladi, Kaul, & Hachinski, 2018). Lack of supply of oxygen and nutrients to the brain and heart can cause serious problems to the body. The nervous system is very sensitive to hypoxia and nutritional deficit (Katsanos et al., 2017). The brain can't bear the hypoxia for or even 20 seconds. After 20 seconds the blood supply lack can cause the death of the neurons. This may lead to a plethora of symptoms depending upon the part of the brain affected. Signs and symptoms of a stroke are manifested by the deficit in the functions like motor function, neuronal function, or cognitive function (Brito-Brito, Fernandez-Gutierrez, & M. Smith, 2015). The neuronal function involves the processing of the brain. So, in stroke, if the areas controlling the neuronal functioning are lost the hemostatic mechanisms of the body can severely be compromised. If the motor area of the body is affected then there can be severe paralysis of any part of the body. The paralysis can occur in various types. These types include the paralysis of one part of the body or may it be occurring on one side of the body or the whole body (Kalkonde, Alladi, Kaul, & Hachinski, 2018)

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