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Asuhan keperawatan pasien Stroke

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Dame Elysabeth

on 10 July 2017

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Transcript of Asuhan keperawatan pasien Stroke

diskusi kelompok
JELASKAN MEKANISME YANG MEMPENGARUHI AlIRAN DARAH OTAK
TIPE STROKE
STROKE ISKEMIK (80% )
INSIDEN DAN faktor resiko stroke
Penyebab kematian no: 4 di Amerika dan Kanada
15%- 30% : Hidup dengan permanent disability
26% : Membutuhkan perawatan jangka panjang
perubahan kehidupan pada pasien dan keluarga
resiko stroke
1. Atrial fibrilasi
2. Katup jantung abnormal
3. Diabetes Melitus
4. What else????
1. Mereview anatomi dan fisiologi dari sistem persarafan

2. Mengidentifikasi patofisiologi, manifestasi klinis, perawatan kolaborasi dan manajemen keperawatan pada pasien stroke (iskemik, perdarahan, transien iskemik akut)

3. Menyusun asuhan keperawatan (pengkajian, analisa data, diagnose perawatan, intervensi, implementasi dan evaluasi) berdasarkan hasil penelitian secara komprehensif bio-psiko-sosiospiritual

4. Mengidentifikasi pencegahan primer, sekunder dan tersier pada stroke (iskemik, perdarahan, transien iskemik akut)



faktor resiko
DAPAT DIMODIFIKASI
1. Hipertensi
2. Penyakit Jantung
3. Serum Kolesterol
4. Merokok
5. Konsumsi Alkohol
6. Obesitas
7. Sleep apnea
8. Sindrom metabolik
9. Kurang latihan fisik
10. Diet yang buruk
11. Ketergantungan obat
KELOMPOK I
bedakan stroke dengan tia (transIent ischemic attack
STROKE..............
tujuan pembelajaran
cara paling efektif :
pencegahan & pendidikan
TIDAK DAPAT DIMODIFIKASI
1. Usia
2. Jenis Kelamin
3. Ras
4. Herediter/Riwayat Keluarga
TIA...................
tROMBOSIS DAN EMBOLI
Insidence
Risk factors
stroke Hemoragik (20%)
Lets watch the video
etiologi dan patofisiologi
stroke
stroke iskemik
stroke hemoragik
1...................
2..................
3.................
1.....................
2.....................
3.....................
perbedaan manifestasi??
deteksi dini
fast stroke
diskusi kelompok
manifestasi
tanda dan gejala
stroke iskemik
stroke hemoragik
manifestasi ???
STUDI diagnosTIK pada pasien stroke
1. Noncontrast CT scan or MRI
Indicate the size and location of the lesion
Differentiate between ischemic and hemorrhagic stroke

2. Other studies
CTA or MRA
Cerebral angiography
Digital subtraction angiography
Transcranial Doppler ultrasonography
Lumbar puncture
LICOX system
Cardiac imaging


peNCEGAHAN kolaboratif, terapi obat, operasi pasien dengan stroke.

1. Manajemen faktor resiko
2. Manajemen thrombus dan emboli pada resiko stroke
FUNGSI MOTORIK
KOMUNIKASI
KEMAMPUAN INTELECTUAL
AFEK/EMOSI
PERUBAHAN PERSEPSI
ELIMINASI
Tindakan operatif pada penyakit carotis:
Carotid endarterectomy
Stenting
Transluminal angioplasty
Extracranial-intracranial bypass
Preserving life
Preventing further brain damage
Reducing disability

MANAJEMEN PERAWATAN AKUT stroke iskemik
Airway
Breathing
Circulation
Neurologic assessment

Kontrol keseimbangan cairan
Manajemen TIK
DRUG THERAPY:
Recombinant tissue plasminogen activator (r-TPA)
Later:
anticoagulants and platelet inhibitors
MANAJEMEN perawatan AKUT
stroke hemoragik
Anticoagulants dan platelet inhibitors merupakan kontraindikasi
Airway
Breathing
Circulation
Manajemen Hipertensi
Pencegahan kejang dan komplikasi hidrocephalus
Operasi:
Resection
Clipping of an aneurysm
Evacuation of hematomas
Manajemen TIK
Pencegahan vasospasme dengan Calcium channel blocker
MANAJEMEN PERAWATAN
REHABILITATIF
NURSING ASSESSMENT
PENGKAJIAN PRIMER
Status kardiovaskular
Status Respiratory
Status Neurologis

PENGKAJIAN SEKUNDER
Tingkat kesadaran - NIH Stroke Scale
Kognitif
Kemampuan motorik

PEMERIKSAAN NEUROLOGIS KOMPREHENSIF
Cranial nerve function
Sensation
Proprioception
Cerebellar function
Deep tendon reflexes

Risk for ineffective cerebral tissue perfusion
Ineffective airway clearance
Impaired physical mobility
Impaired verbal communication
NURSING DIAGNOSIS
lOOK AT nanda, nic,and noc
1. Maintain stable body functions.
2. Maximize communication abilities .
3. Maintain adequate nutrition.
4. Avoid complications of stroke.
5. Maintain effective personal and family coping.

Unilateral neglect
Impaired urinary elimination
Impaired swallowing
Situational low self-esteem
NURSING PLANNING
NURSE'S ROLE : HEALTH PROMOTION!!!!!
NURSING INTERVENTION
KARDIOVASKULAR
RESPIRATORY
NEUROLOGI
MUSKULOSKELETAL
INTEGUMEN
GASTROINTESTINAL
URINARY
NUTRISI
KOMUNIKASI
PERSEPSI- SENSORI
COPING
Nursing Management: Stroke Ambulatory and Home Care
Nursing Management: Stroke
Stroke Survivorship and Coping
ASUHAN KEPERAWATAN PASIEN DENGAN STROKE
medical surgical nursing IIi

resiko stroke
1. Atrial fibrilasi
2. Katup jantung abnormal
3. Diabetes Melitus
4. What else????
diskusi KELOMPOK
bedakan stroke dengan tia (transIent ischemic attack
STROKE..............
TIA................

FAKTOR RISIKO STROKE (Yastroki, 2016)

A stroke is caused by the
interruption
of the blood supply to the brain, usually because a blood vessel
bursts or is blocked
by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue (WHO, 2016)
STROKE IS BRAIN ATTACK so that stroke is medical emergency

Stroke Merupakan Penyebab Kematian dan Kecacatan Global

Di Amerika 7 Juta Penderita Stroke Diatas Usia 20 Tahun

±1.000.000 Kejadian Stroke/Tahun, 1 PASIEN/40 DETIK

Stroke Dapat Terjadi Pada Semua Orang . Wanita> PRIA

2 Juta Sel Otak Mati Setiap Menit Saat Stroke

Cost Expensive
FACTS
Otak membutuhkan oksigen dan glukosa
rata-rata 750 cc/mnt
CT SCAN
HIPODENS
HIPERDENS
Full transcript