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80 Cards in this Set

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Objectives that may form test questions-keep these in mind while studying these cards
1.differentiate btw stress & stressors
2. describe the 3 stages of GAS
3.Describe common physiological, behavioral, & cognitive manifestations of stress
4.discuss commonly used coping behaviors and ego-defense mechanims
5. discuss the effects of prolonged stress on physical and spiritual well-being
6. id ex. of nursing diagnoses related to stress
7. describe stress mgmt tech.beneficial for coping with stress
Homeostasis is?
the tendency of the body to maintain a state of balance or equilibrium while continually changing; a mechanism in which deviations from normal are sensed and counteracted
Stress is?
a condition in which the human being responds to
changes in its normal balanced state

see web site:
Coping is?
a process that a person uses to manage events that he/she encounters, perceives and interprets as stressful
Adaptation is?
a person's capacity to flourish and survive even with adversity
Stressor is?
an event or stimulus that causes an individual to experience stress
Adaptation (or LAS) is important in overcoming stress; if not then the stressor will overcome the entire body ex: inflammation
What are the three Modes of Stress?
1. Response based
2. Stimulus based
3. Transaction based

Response based is generally known as?
Fight or Flight:
-Alarm reaction – body alerts the body’s defenses
-Shock phase – stressor is perceived consciously or unconsciously
-Fight or Flight lasting 1 minute to 24 hours.
Stress is considered a response-causes GAS/LAS
How does Fight or Flight work on the physiological?
-Medullar oblongata controls vital functions, which are heart rate, BP & respirations
-Reticular formation controls vital functions and continuously monitors the physiological status of the body
-Pituitary gland produces hormones necessary for adaptation to stress
What are Stimulus Based Models?
Stress as a stimulus- (an event or set of circumstances) that arouse physiologic and/or psychological reactions that may increase an ind.'s vulnerabilty to illness
ex: Holmes & Rahe 1967 rating scale assigned to stressful life events-to predict likelihood of illness
What are Response Based Models?
-definition of stress
-Selye 1956, 1976.. "the nonspecific response of the body to any demand made upon it."
-Shafer 1992...Stress is the "arousal of mind and body in response to demands made on it."
What are Response Based Models? con't
-Stressor=anything that causes stress & disturbs the body's equilibrium
- this nonspecific response of the body is called "The General Adaptation Syndrome (GAS) or Stress Syndrom
What is GAS/LAS
-GAS is a global reaction

LAS..Local Adaptation Syndrome
The body can also react locally; that is, one organ or a part of the body reacts alone
-ex: the inflammatory response
What are the three stages of the GAS?
1. Alarm Reaction
2.Stage of Resistance
3. Stage of Exhaustion
Stage One: Alarm
the initial reaction of the body is the alarm reaction (AR) which alerts the body's defenses against the stressor whether the stressor is heat, bacteria, or a verbal or physical attack from someone "Fight or Flight"
Under Stage One: Neuroendocrine Regulation
1. CNS
2. ANS
3. Endocrine system
The Neuroendocrine Activity under Stage one:
heart rate
Peripheral vasoconstriction
Water retention
STAGE 2: Resistance
is when the body's adaptation takes place. The body attempts to cope with the stressor and to limit the stressor to the smallest area of the body that can deal with it
Stage of Resistance
1. Neuroendocrine activity returns to normal
2. Local adaptation syndrome (LAS)
3. Coping and defense mechanisms
STAGE 3: Exhaustion
1. Adaptation can't be maintained
2. If adaptation doesn't overcome the stressor the effects of the stressor increases and the body may either: Rest and return to normal or Die
Stage of Exhaustion
2.Decreases BP
3. Increases pulse & respirations
4. Panic, Crisis
5. Exhaustion
6. Rest and recovery or death
Ego Defense Mechanisms are?
Mental mechanisms that develop as the personality attempts to defend itself, establish compromises among conflicting impulses, and allay inner tensions (Sigmund Freud)
-Unconscious mind working to protect the person from anxiety. These defense mechanisms precede conscious cognitive coping mechanisms that will eventually solve the problem
Defense mechanisms are?
4. Introjection
6. Rationalization
8. Sublimation
9. Suppression
10. Reaction Formation
What is Compensation?
the attempt to achieve respect or recognition in one activity as a substitute for inability to achieve in another endeavor
What is Denial?
Refusal or inability to accept something as it is but rather as one wishes it to be
What is Displacement?
Transferring emotion away from the person or situation that incited the emotion to an inappropriate person or object
What is Introjection?
taking into one's thoughts, emotions, characteristics, of another
What is Projection?
Attributing one's own thoughts, emotions, characteristics or motives to another
What is Rationalization?
Concealing the motive for behavior by giving some socially acceptable reason for the action
What is Repression?
immersing something in the subconscious or unconscious level
What is Regression?
Return to behaviors more appropriate to an earlier stage of development
What is Sublimation?
release of libido in socially acceptable behavior rather than using it to obtain sexual gratification
What is Suppression?
Conciously dismissing something from the mind and thoughts
What is Reaction Formation?
Behaving in the exact opposite manner to how they really feel
What are Long and Short term coping mechanisms?
1. Long-term: positive, constructive ways of dealing with stress and can be effective over long periods.
-Short-term: temporary measures to reduce stress and tension; however, if used over long periods may have detrimental effects on the person and may lead to maladaptive behavior
What are Types of Stress?
1. Distress
2. Eustress
3. Posttraumatic Stress Disorder (PTSD)
damages health
protects health- motivates energy, such as happiness, hopefulness and purposeful movement
a person witnessing, confronting or experiencing a traumatic event and responding with intense fear and may experience flashbacks, ex: Hurrican Katrina
What are the sources of Stress?
1. Internal Stressors
2.External Stressors
3. Developmental stressors
4. Situational Stressors
What are Internal Stressors?
Cancer, Depression
What are External Stressors?
move to another city, Exams
What are some effects of stress?
-Stress effects every aspect of our being
-Physical as well as Emotional, intellectual, social and spiritual consequences
Two reactions of Psychological Stess:
1. Primary appraisal: identification
2. Secondary appraisal: coping strategies
What are Factors affecting Coping Patterns?
1. Lifestyle-diet, actitivity & exercise, sleep & rest, safety & security
2. Previous Experience
3. Involuntary Relocation
4. Social Interaction
5. Sensory Deficits
What are some Altered Coping Patterns?
1. Addictive Behavior
2. Physical Illness
3. Anxiety & depression
What are Stress Indicators?
1. Anxiety
2. Depression
3. Anger
How to Manage Stress:
1. Lifestyle changes..healthy habits
2. Stop smoking
3. Exercise regulary
4. control weight
5. good nutrition
6. adequate sleep
7. drink in moderation
8. Time management including PLAY
Some Cognitive Approaches to managing stress:
1. control inner dialogue..stop scaring yourself..take one day at a time (hr, min, sec)
2. give up perfection
3. increase self acceptance
4.feed your computer (brain) positive encouraging massages (affirmations)
5. visualize successful outcomes
What are some Relaxation Techniques?
1. guided imagery
2. diaphragmatic breathing
3. progressive muscle relaxation
4. meditation
5. biofeedback
7. music
8. humor
Nursing Process dealing with stress
Subjective/Objective Data
Nursing Diagnoses for Stress
1. Anxiety
2.Ineffective individual coping
3.defensive coping
4.ineffective denial
5.impaired adjustment
6.decisional conflict
7.fear response
9.relocaton stress syndrome
10. caregiver role strain
11. ineffective family coping; disabling or compromised
Planning as deals with stress:
1. Focus on coping strategies that are both realistic and appropriate to pt's needs
ex: pt and/or care giver teaching
collaborate with other disciplines
choose stress mgmt technique which matches pt's stressors
Objectives in dealing with stress
1. LTG
LTG= Long term goals
demonstrate improved ability to manage or cope with stressful events
STO - short term objectives
1. ID sources of stress in life
2. verbalizes new coping strategies for managing stress
3. verbalize effect of stress & coping strategies on ADL's
-LTG: decrease or resolve anxiety/fear
-STO:verbalizes feelings R/T anxiety
-for pt's with more complex problems with stress, coping, and adaptation, the objectives need to be adjusted accordingly along with the time frame in which they can be realized
determine if stress mgmt will be for health promotion or an intervention that modifies a response to illness
Health Promotion:
1. reducing stress
2. addressing perfection
3. using supportive internal messages
4. using assertiveness
5. making lifestyle changes
6. exercising
7. using relaxation techniques
must consider wheather the pt's perception of the stress has declined, whether the pt is able to control factors that contribute to the stress, and whether the pt is able to independently develop stress reduction strategies
The vitial functions necessary for survival, which include heart rate, BP, and respiration, are controlled by the?
Medulla oblongata
While assessing a person for effects of the general adaptation syndrome, the nurse should be aware that:
Blood glucose level increases during the alarm reaction stage
A client avoids emotional conflict by refusing to consciously acknowledge anything that might cause intolerable emotional pain. The client is using the defense mechanism?
When doing an assessment of a young woman who was in an automobile accident 6 mths b4, the nurse learns that the woman has vivid images of the crash whenever she hears a loud, sudden noise. The nurse recognizes this as?
Posttraumatic Stress disorder
A man is adjusting to chronic illness; this is an example of:
a situational factor
A child who has been in a house fire comes to the ER dept. with her parents. The child and parents are upset and tearful. During the nurse's 1st assessment for stress she should say?
Tell me what bothers you the most about this experience?
The nurse is evaluating the coping sucess of a client experiencing stress from being newly diagnosed with multiple sclerosis and psychomotor impairment. The nurse realized that the client is coping successfully when the client says?
I am going to attend a support group to learn more about multiple sclerosis and what I will be able to do
The nurse knows that the client is recovering from the stress of an emergency surgery when the client says?
I am learning progressive relaxation training
A staff nurse is talking with her nursing supervisor about the stress she feels on the job: The supervising nurse recognizes that?
Nurses frequently experience stress with the rapid changes in health care technology and organizational restructuring
Generally a person's crisis is resolved in some way within approximately?
6 weeks
Primary appraisal is?
the ability of the clinet ot evaluate an event for its personal meaning and how the stress will affect the body in the long-term
Secondary appraisal is?
the tool a client uses to identify the appropriate coping strategy for stress that is already present
A developmental crisis is?
associated with changing developmental levels and is not associated with a traumatizing event
A situational crisis is not part of?
Crisis is?
a turning point in life that may be developmental or situational
The fight-or-flight response is arousal of the ? system
Sympathetic nervous system
What does crisis intervention do?
aims to return the client to a precrisis level of functioning and to promote growth
What is a situational crisis?
described as a person facing a turning point in life
Which body system reacts strongly to stress?
The immune system. this is why stress can cause illness
Which phase of GAS is the circulatory system affected?
during the alarm reaction stage