STROKE

Oleh Kelompok 4 S16C :

1. Ambar Nur Hidayanti (S16131)

2. Berliana Sukmawati (S16137)
3. Okta Fiyanti (S16173)
4. Puput Istu Widodo (S16174)
5. Tatik Widyastuti (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 European-
American 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
cigarettes per day.
3. 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
thromboembolic ischemic stroke.
4. 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
arterial wall. This condition is referred to as atherothrombotic.
5. 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 self-
awareness 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.