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Cerebro-vascular accident

Introduction

Outcome 1 – Understand the causes of infection

1:1 Identify the differences between bacteria, viruses, fungi and parasites

The differences between bacteria, viruses, fungi and parasites are;

• Fungi have cell walls made up of chitin (found in outer skeleton of insects, shrimps and lobsters – also used in healing agents). Fungi and parasites are multi cellular (Ref: www.euchis.org)
• Viruses are not living, they are only made of complex proteins and nuclear acids
• Bacteria are unicellular micro-organisms
• Parasites and bacteria are animals

(Bacteria, fungi and parasites are living organisms) (Dundas & Welsby 2002, pp99-106)

1:2 Identify common illnesses and infections caused by bacteria, viruses, fungi and parasites

Common illnesses and infections caused by bacteria, viruses, fungi and parasites are;

Viruses…

• Chicken pox
• Shingles
• Laryngitis
• Pneumonia
• Mumps
• Common cold
• Aids
• Whooping cough
• Measles

Parasites…

• Malaria
• Intestinal
• Scabies
• Ringworm
• Tapeworm
• Crab louse

Fungi…

• Conjunctivitis
• Athletes foot
• Ringworm
• Thrush
• Fungal nail
• Intertrigo (yeast)

Bacteria…

• Colds
• Flu
• Fevers
• Meningitis
• Pneumonia
• Gastroenteritis
• Impetigo
• MRSA
• Severe gastrointestinal (caused by E-coli)
• Acne

(Brooker &Nicol 2003, pp254-255)

1:3 Describe what is meant by “infection” and “colonisation”

The meaning of colonisation occurs when micro-organisms inhabit on a part of the body for example, skin but don’t cause signs and symptoms of infection colonised pathogens have the potential to cause infection if spread to a different parts of the body depending on the micro-organism colonised pathogens which can be passed on from person to person from touching objects or not washing hands. This is a major route of colonisation within the health care facilities. Colonisation of micro-organisms can inhabit the host by being in or being on, they don’t cause damage or invade the tissue, yet if they do invade tissue this can make the person sick, which in turn will turn into an infection.

Even though the host may not show signs of illness, they can still pass it on to others. (Lister & Dougherty 2008, pp1112-1113)

1:4 Describe what is meant by “systemic infection” and “localised infection”

The skins function is to protect the body from infectious organisms, but when there has been a break in the skin infections can pose a threat. The meaning of localised infection is an infection that is limited to a specific body region. The meaning of systemic infection is when the pathogen is distributed throughout the whole body by the bloodstream.

Systemic infection:

• Conjunctiva infection can cause lasting damage if not treated in time
• Low immune systems due to diabetes, kidney failure etc.
• The elderly or children may cause complications with infection due to their age

Localised infection:

• Swelling
• Redness
• Temperature changes in infected area

1:5 Identify poor practices that may lead to the spread of infection

Covered on ECA course Training centre

Outcome 2 – Understand the transmission of infection

2:1 Explain the conditions needed for the growth of micro-organisms

The conditions needed for the growth of micro-organisms are nutrients for them to reproduce. It also requires warmth and moisture. They are not visible with the naked eye. The factor that encourages the growth of micro-organisms is nutrition, oxygen, temperature, PH and moisture. The PH and temperature determines the rate of growth. The moisture carry’s foods into the cell, and carry’s the waste away from the cell to maintain the content of cytoplasm (ground substance in where different components are found). All micro-organisms have a PH at which they can grow. (Brooker & Nicol 2003, pp.254-255)

2:2 Explain the ways an infective agent might enter the body

An infective agent might enter the body through the mouth, stomach, intestines. The digestive tract. It can also be through broken skin.

Areas of infection:

The respiratory system – nose, lungs, windpipe.

The digestive system – spoiled food, unclean hands or objects.

The urinary tract – urethra, bladder, kidneys.

Wounds on the skin – cuts, grazes, trauma to the skin.

There is also secondary infective agent:

Genital – sexually transmitted, non-sexual PH imbalance (soaps, sprays, creams).

Conjunctival – to the eye (dust, viruses, bacteria, contact lenses)

The ways that gains entry to the person is by infecting the cells:

Trauma bite – infected animal, human, insect

Congenital – unborn baby (developed through pregnancy. Rubella, chickenpox, herpes, syphilis)

2:3 Identify common sources of infection

The best source for infection is poorly chilled, heated or contaminated food. Contaminated laundry on a low heat setting, clinical waste, and contaminated equipment, others that may be infected. Unclean work surfaces in kitchens. We all come into contact with hands, some just don’t take hand hygiene seriously and will spread the infection further afield.

2:4 Explain how infective agents can be transmitted to a person

Airborne – inhalation of pathogens (microorganism disease producing agent such as bacteria, virus). The common cold and flu spread the infection to another person, either sneezing into the air, nasal droplets; this may be from a nebuliser. Infected dust particles containing skin scales may cause a respiratory virus.

Direct contact – this would be person to person contact, such as dirty hands upon a patient or other way around. Sexual intercourse, chicken pox/shingles (herpes zoster) with the rash and until the last blister has dried up. Impetigo (staphylococcus aureus) which mainly affects children and immune suppressed people.

Hands – are the main part of cross-infection. This can be transferred by microbes to other body areas, for example: hand to face to phone (communal), to shared computers, to person with a handshake. They in turn have now picked up everything you have touched. If they don’t wash their hands, the cycle of cross infection will multiply too many others. With the ambulance cross contamination can be spread from person to equipment including steering wheels, radios, door handles. Your body’s blueprint may have a good resistance to bacteria in your genes, but others you treat or touch may not and could potentially make them very ill.

Indirect contact – can be spread by fomites – an inanimate object that becomes contaminated with infectious organisms and then transports those organisms to another person. This can include children’s toys, chopping boards, baby’s nappies, oxygen masks, Entonox breathing adaptors. They can live for a few minutes or a few hours. Indirect contact can also be spread by crawling or flying insects these are examples of vectors these are organisms that transmits pathogens and parasites (person, insect, animal). Insect bites may cause a variety of infections, one being malaria.

Ingestion – the organisms that infect the gastro-intestinal tract are ingested through the mouth by objects such as the hands, in drink, uncooked food, faecal/oral spread, eating food with unclean hands. Cross infecting would be to eat food while sharing communual keyboards/laptops who would in turn pass on to others by contracting sickness and diarrhoea and by not following hand washing techniques, this will continue until the cycle is broken.

Inoculations – there may be a chance of a “needle stick” injury caused by infected needles that may contain Hepatitis B virus, and as the inoculation has been put directly into the blood stream of the patient, an infection is high.

2:5 Identify the key factors that will make it more likely that infection will occur

The key factors that will make it more likely that infection will occur are individuals susceptible to infection; these would include older people with lowered immunity due to other illnesses or conditions, children or babies. Compromised circulation secondly to peripheral vascular disease. People with diabetes have a risk of developing infections if their blood sugar is lower than normal. Urinary catheters or percutaneous endoscopic gastrostomy tubes (PEGS). IV lines if kept in too long (when a paramedic inserts a needle to administer drugs, you should note the time and date it was inserted and place on the surrounding site of the needle, this keeps hospital staff aware the length of time it has been in). Poor personal hygiene can be a factor and open to infections. Areas around skin folds due to obesity, as infections build up in moist areas such as the groin, stomach and under the breasts, infections can multiply rapidly in these areas. Young and premature babies with under developed lungs and heart, this is due to the lungs not being fully developed affecting the oxygen levels in the cells. Infection may be more if the patient or person is contact with contagious agents.

Referencing using Harvard/RefME

Brooker, C. & Nicol, M., 2003. Nursing Adults: The Practice of Caring, United Kingdom: Mosby Elsevier Health Science.

Dundas, S. & Welsby, P., 2002. Common Hospital Infections Unknown. E. Sheppard, ed., London: Science Press.

European Chitin Society, 1996. What is chitin? https://www.google.co.uk/webhp?gws_rd=ssl#q=chitin. Available at: http://euchis.org/ [Accessed October 26, 2014].

Hateley, P., 2003. Infection Control. In C. Brooker & M. Nicol, eds. Nursing Adults: The Practice of Caring. United Kingdom: Mosby Elsevier Health Science.

Hendry, C., 2011. Function of the immune system. Nursing Standard, 27.

Lister, S. & Dougherty, L., 2008. The Royal Marsden Hospital Manual of Clinical Nursing Procedures, Student Edition 7th ed., United Kingdom: Wiley-Blackwell (an imprint of John Wiley &; Sons Ltd).

Professor Carlos Andrés Peniche Covas, 2007. Natural polymer Chitin shows great healing properties. https://www.google.co.uk/webhp?gws_rd=ssl#q=chitin+medical+uses. Available at: http://www.news-medical.net/news/2007/07/16/27582.aspx [Accessed October 26, 2014].

Robinson, J., 2012. Fungal skin infections in children. Nursing Standard, 27.

Unkown, 2008a. Barrier Nursing: nursing the infectious or immunosuppressed patient. In L. Dougherty & S. ListerUnknown, eds. The Royal Marsden Hospital Manual of Clinical Nursing Procedures, Student Edition. United Kingdom: Wiley-Blackwell (an imprint of John Wiley &; Sons Ltd).

Unkown, 2008b. Infection Control. In S. Christopher, ed. NVQ/SVQ Level 3 Health Award for healthcare assistants. United Kingdom: Heinemann.

Weller, B., 2009. Baillière’s nurses’ dictionary: for nurses and health care workers 25th ed. B. Weller, ed., United Kingdom: Elsevier/Baillière Tindall.

Wright, D., 2000. Human Physiology and Health for GCSE: Student Book unknown. A. Clayton, ed., United Kingdom: Heinemann Educational Publishers.

• Sharon H Ferguson-Guy

Cerebrovascular accident or CVA as it is commonly called is defined as the unforeseen death of some of the cells of the brain because of lack of the supply of oxygen to the brain. This occurs when the flood flow to the brain is hindered by blockage or some rupture of an artery going to the brain another common term used to denote a cerebro vascular accident (CVA) is stroke.

The most common symtoms of a cerebro vascular accident vary depending upon the area of the brain affected. The commonly presenting symptoms of a stroke are weakness and/or paralysis of any one side of the body with either partial or complete loss of wilful movement or sensation in the arm or leg or both. Other associated problems can be speech difficulties and weakness of facial muscles which causes drooling. Tingling sensations and numbness of the limbs is a common occurrence. Cerebrovascular accidents which involve the base of brain can cause imbalance, visual imparity, trouble in swallowing, breathing difficulties and loss of consciousness.

Patho-physiology

A cerebrovascular accident or stroke can be classified into two broad categories-

1. Ischemic stoke
2. Haemorrhagic stroke

Ischaemic stroke

When a blood vessel like an artery supplying to the brain is hindered by a blood clot resulting in obstruction of the blood flow to the brain, ischemic stroke is said to have occurred. This occurs in two ways. One, called as a thrombotic stroke, occurs in an artery that has already narrowed. A clot may form in this artery causing stroke.this accounts for 80% of all cases of cerebro vascular accidents.

Second, called as an embolic stroke or central embolism occurs when a clot breaks off from another part of the body and travels thrugh the circulation to reach the brain. 10-15% of people diagnosed with CVA fall under this category.

Haemorrhagic shock

Sometimes a blood vessel in the part of brain becomes weak and bursts causing blood to leak in the brain cavity. This can occur in patients with certain defects in the blood vessels of brain and is called as haemorrhagic shock. Such defects include- arterio-venous malformation (AVM) or aneurysms. The cause of vessel bursts can be high blood pressure. Haemorrhagic strokes might even occur in patients on blood thinners.

A patient who has ischemic stroke can develop bleeding and change to haemorrhagic shock.

Signs and symptoms

The side effects of stroke rely on upon which some piece of the cerebrum is harmed. Sometimes, an individual may not realize that a stroke has happened.

More often than not, side effects grow abruptly and all of a sudden. Be that as it may, manifestations may happen on and off for the first day or two. Manifestations are normally most extreme when the stroke first happens, yet they might gradually deteriorate.

A cerebral pain may happen if the stroke is brought about by draining in the cerebrum. The cerebral pain:

• Starts abruptly and may be extreme
• May be more regrettable when you are lying level
• Wakes you up from slumber
• Gets more terrible when you change positions or when you twist, strain, or hack

Different manifestations rely on upon how serious the stroke is and what a piece of the cerebrum is influenced. Manifestations may include:

• Change in readiness (counting lethargy, obviousness, and trance state)
• Changes in hearing
• Changes in taste
• Changes that influence touch and the capacity to feel torment, weight, or diverse temperatures
• Clumsiness
• Confusion or loss of memory
• Difficulty gulping
• Difficulty composing or perusing
• Dizziness or strange feeling of development (vertigo)
• Eyesight issues, for example, diminished vision, twofold vision, or aggregate loss of vision
• Lack of control over the bladder or insides
• Loss of offset
• Loss of coordination
• Muscle shortcoming in the face, arm, or leg (normally just on one side)
• Numbness or shivering on one side of the body
• Personality, temperament, or passionate changes
• Trouble talking or comprehension other problems

Stroke and nervous system

When you have an ischemic stroke, the oxygen-rich blood supply to some piece of your cerebrum is diminished. With a hemorrhagic stroke, there is draining in the mind.

After around 4 minutes without blood and oxygen, mind cells get to be harmed and may bite the dust. The body tries to restore blood and oxygen to the cells by augmenting other veins (corridors) close to the territory.

Recuperating after a stroke may feel like an overwhelming errand. In addition to other things, your mind must relearn aptitudes it lost when it was harmed by the stroke. Late research, however, demonstrates that the mind is amazingly strong and equipped for adjusting after a stroke. This implies that recuperation is more conceivable than beforehand suspected.

On the off chance that blood supply isn’t restored, lasting harm ordinarily happens. The body parts controlled by those harmed cells can’t work.

This loss of capacity may be mellow or serious. It might be transitory or perpetual. It relies on upon where and how a significant part of the cerebrum is harmed and how quick the blood supply can be come back to the influenced cells. Life-debilitating complexities might likewise happen. This is the reason it’s critical to get treatment at the earliest opportunity.

Recovery relies on upon the area and measure of mind harm created by the stroke, the capacity of other sound ranges of the cerebrum to assume control for the harmed regions, and restoration. As a rule, the less harm there is to the mind tissue, the less inability results and the more prominent the possibilities of an effective recuperation.

Stroke is the most well-known apprehensive system–related reason for physical inability. Of individuals who survive a stroke, half will even now have some handicap 6 months after the stroke.

You have the best risk of recovering your capacities amid the initial couple of months after a stroke. Recovering a few capacities, for example, discourse, comes gradually, if by any means. About a large portion out of every other person on earth who have a stroke will have some long haul issues with talking, comprehension, and choice making. They additionally may have changes in conduct that influence their associations with family and companion.

Right sided hemiplagia and resolving dysphagia

Hemiplagia

Hemiplegia is loss of motion of one side of the body. Hemiparesis is shortcoming of one side of the body and is less extreme than hemiplegia. Both are a typical symptom of stroke or cerebrovascular mishap. One may consider how stand outside of the body can get to be incapacitated or powerless after a stroke. Uneven loss of motion or shortcoming happens when a stroke influences the corticospinal tract of one side of the mind. The right half of the mind controls the engine capacity of the left half of the body. The left half of the cerebrum controls the engine capacity of the right half of the body. Therefore when one side of the mind is harmed, it causes stand outside of the body to be influenced.

Dysphagia

Dysphagia is a regularly reported grimness after stroke, yet its accounted for frequencies are broadly discrepant; going somewhere around 19% and 81%.The vicinity of dysphagia has been connected with an expanded danger for aspiratory complications and even mortality. There is rising confirmation that early discovery of dysphagia in patients with intense stroke decreases these muddlings as well as diminishes length of clinic stay and general medicinal services expenditures. A precise appraisal of the occurrence of dysphagia and its expanded danger for pneumonic outcomes in the stroke populace will be basic to guide the outline of future exploration meaning to survey advantages of dysphagia mediations.

Cerebral, cerebellar, or mind stem strokes can debilitate gulping physiology. Cerebral sores can intrude on intentional control of rumination and bolus transport amid the oral phase.Cortical injuries including the precentral gyrus may create contralateral hindrance in facial, lip, and tongue engine control, and contralateral bargain in pharyngeal peristalsis. Cerebral injuries creating debilitations in subjective capacity, for example, focus or specific consideration might likewise impede control of swallowing.Brain stem strokes are less normal than cortical injuries yet bring about the biggest gulping trade off. Cerebrum stem sores can influence vibe of the mouth, tongue, and cheek, timing in the trigger of the pharyngeal swallow, laryngeal height, glottic conclusion, and cricopharyngeal relaxation. Regardless of injury area, in light of the fact that stroke is more basic in the elderly, typical age-related gulping could further compound stroke-related dysphagia. The elderly poststroke patient may never again have the capacity to make up for ordinary changes in skeletal muscle quality that diminish mastication or lessen lingual pressure. Therefore, single or numerous parts of the swallow may be debilitated relying upon stroke sort and patient age.