Nursing 120- Test 3- Stress,coping & Adaption

Front 1

Objectives that may form test questions-keep these in mind while studying these cards

Back 1

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

Front 2

Homeostasis is?

Back 2

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

Front 3

Stress is?

Back 3

a condition in which the human being responds to
changes in its normal balanced state

see web site:
http://64.233.169.104/search?q=cache:zqC0WLytv0kJ:www.imperial.edu/jean.stroud/NS110/Stress%2520Anxiety.doc+stimulus+based+model+of+stress&hl=en&ct=clnk&cd=5&gl=us

Front 4

Coping is?

Back 4

a process that a person uses to manage events that he/she encounters, perceives and interprets as stressful

Front 5

Adaptation is?

Back 5

a person's capacity to flourish and survive even with adversity

Front 6

Stressor is?

Back 6

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

Front 7

What are the three Modes of Stress?

Back 7

1. Response based
2. Stimulus based
3. Transaction based

RST

Front 8

Response based is generally known as?

Back 8

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

Front 9

How does Fight or Flight work on the physiological?

Back 9

-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

Front 10

What are Stimulus Based Models?

Back 10

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

Front 11

What are Response Based Models?

Back 11

-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."

Front 12

What are Response Based Models? con't

Back 12

-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

Front 13

What is GAS/LAS

Back 13

-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

Front 14

What are the three stages of the GAS?

Back 14

1. Alarm Reaction
2.Stage of Resistance
3. Stage of Exhaustion

Front 15

Stage One: Alarm

Back 15

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"

Front 16

Under Stage One: Neuroendocrine Regulation

Back 16

1. CNS
2. ANS
3. Endocrine system

Front 17

The Neuroendocrine Activity under Stage one:

Back 17

INCREASED:
heart rate
BP
Peripheral vasoconstriction
Metabolism
Water retention
Glucose
DILATED:
pupils
Bronchi
MENTAL:
Alertness

Front 18

STAGE 2: Resistance

Back 18

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

Front 19

Stage of Resistance

Back 19

1. Neuroendocrine activity returns to normal
2. Local adaptation syndrome (LAS)
3. Coping and defense mechanisms

Front 20

STAGE 3: Exhaustion

Back 20

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

Front 21

Stage of Exhaustion

Back 21

1.Vasodialation
2.Decreases BP
3. Increases pulse & respirations
4. Panic, Crisis
5. Exhaustion
6. Rest and recovery or death

Front 22

Ego Defense Mechanisms are?

Back 22

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

Front 23

Defense mechanisms are?

Back 23

1.Compensation
2.Denial
3.Displacement
4. Introjection
5.Projection
6. Rationalization
Repression
7.Regression
8. Sublimation
9. Suppression
10. Reaction Formation

Front 24

What is Compensation?

Back 24

the attempt to achieve respect or recognition in one activity as a substitute for inability to achieve in another endeavor

Front 25

What is Denial?

Back 25

Refusal or inability to accept something as it is but rather as one wishes it to be

Front 26

What is Displacement?

Back 26

Transferring emotion away from the person or situation that incited the emotion to an inappropriate person or object

Front 27

What is Introjection?

Back 27

taking into one's thoughts, emotions, characteristics, of another

Front 28

What is Projection?

Back 28

Attributing one's own thoughts, emotions, characteristics or motives to another

Front 29

What is Rationalization?

Back 29

Concealing the motive for behavior by giving some socially acceptable reason for the action

Front 30

What is Repression?

Back 30

immersing something in the subconscious or unconscious level

Front 31

What is Regression?

Back 31

Return to behaviors more appropriate to an earlier stage of development

Front 32

What is Sublimation?

Back 32

release of libido in socially acceptable behavior rather than using it to obtain sexual gratification

Front 33

What is Suppression?

Back 33

Conciously dismissing something from the mind and thoughts

Front 34

What is Reaction Formation?

Back 34

Behaving in the exact opposite manner to how they really feel

Front 35

What are Long and Short term coping mechanisms?

Back 35

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

Front 36

What are Types of Stress?

Back 36

1. Distress
2. Eustress
3. Posttraumatic Stress Disorder (PTSD)

Front 37

Distress?

Back 37

damages health

Front 38

Eustress?

Back 38

protects health- motivates energy, such as happiness, hopefulness and purposeful movement

Front 39

PTSD

Back 39

a person witnessing, confronting or experiencing a traumatic event and responding with intense fear and may experience flashbacks, ex: Hurrican Katrina

Front 40

What are the sources of Stress?

Back 40

1. Internal Stressors
2.External Stressors
3. Developmental stressors
4. Situational Stressors

Front 41

What are Internal Stressors?

Back 41

Cancer, Depression

Front 42

What are External Stressors?

Back 42

move to another city, Exams

Front 43

What are some effects of stress?

Back 43

-Stress effects every aspect of our being
-Physical as well as Emotional, intellectual, social and spiritual consequences

Front 44

Two reactions of Psychological Stess:

Back 44

1. Primary appraisal: identification
2. Secondary appraisal: coping strategies

Front 45

What are Factors affecting Coping Patterns?

Back 45

1. Lifestyle-diet, actitivity & exercise, sleep & rest, safety & security
2. Previous Experience
3. Involuntary Relocation
4. Social Interaction
5. Sensory Deficits

Front 46

What are some Altered Coping Patterns?

Back 46

1. Addictive Behavior
2. Physical Illness
3. Anxiety & depression

Front 47

What are Stress Indicators?

Back 47

Psychological:
1. Anxiety
2. Depression
3. Anger

Front 48

How to Manage Stress:

Back 48

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

Front 49

Some Cognitive Approaches to managing stress:

Back 49

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

Front 50

What are some Relaxation Techniques?

Back 50

1. guided imagery
2. diaphragmatic breathing
3. progressive muscle relaxation
4. meditation
5. biofeedback
6.yoga
7. music
8. humor

Front 51

Nursing Process dealing with stress

Back 51

Assessment
Subjective/Objective Data

Front 52

Nursing Diagnoses for Stress

Back 52

1. Anxiety
2.Ineffective individual coping
3.defensive coping
4.ineffective denial
5.impaired adjustment
6.decisional conflict
7.fear
8.post-trauma response
9.relocaton stress syndrome
10. caregiver role strain
11. ineffective family coping; disabling or compromised

Front 53

Planning as deals with stress:

Back 53

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

Front 54

Objectives in dealing with stress

Back 54

1. LTG
2.STO

Front 55

LTG= Long term goals

Back 55

demonstrate improved ability to manage or cope with stressful events

Front 56

STO - short term objectives

Back 56

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

Front 57

Ojectives

Back 57

-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

Front 58

Implementation:

Back 58

determine if stress mgmt will be for health promotion or an intervention that modifies a response to illness

Front 59

Health Promotion:

Back 59

1. reducing stress
2. addressing perfection
3. using supportive internal messages
4. using assertiveness
5. making lifestyle changes
6. exercising
7. using relaxation techniques

Front 60

Evaluation:

Back 60

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

Front 61

The vitial functions necessary for survival, which include heart rate, BP, and respiration, are controlled by the?

Back 61

Medulla oblongata

Front 62

While assessing a person for effects of the general adaptation syndrome, the nurse should be aware that:

Back 62

Blood glucose level increases during the alarm reaction stage

Front 63

A client avoids emotional conflict by refusing to consciously acknowledge anything that might cause intolerable emotional pain. The client is using the defense mechanism?

Back 63

Denial

Front 64

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?

Back 64

Posttraumatic Stress disorder

Front 65

A man is adjusting to chronic illness; this is an example of:

Back 65

a situational factor

Front 66

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?

Back 66

Tell me what bothers you the most about this experience?

Front 67

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?

Back 67

I am going to attend a support group to learn more about multiple sclerosis and what I will be able to do

Front 68

The nurse knows that the client is recovering from the stress of an emergency surgery when the client says?

Back 68

I am learning progressive relaxation training

Front 69

A staff nurse is talking with her nursing supervisor about the stress she feels on the job: The supervising nurse recognizes that?

Back 69

Nurses frequently experience stress with the rapid changes in health care technology and organizational restructuring

Front 70

Generally a person's crisis is resolved in some way within approximately?

Back 70

6 weeks

Front 71

Primary appraisal is?

Back 71

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

Front 72

Secondary appraisal is?

Back 72

the tool a client uses to identify the appropriate coping strategy for stress that is already present

Front 73

A developmental crisis is?

Back 73

associated with changing developmental levels and is not associated with a traumatizing event

Front 74

A situational crisis is not part of?

Back 74

GAS

Front 75

Crisis is?

Back 75

a turning point in life that may be developmental or situational

Front 76

The fight-or-flight response is arousal of the ? system

Back 76

Sympathetic nervous system

Front 77

What does crisis intervention do?

Back 77

aims to return the client to a precrisis level of functioning and to promote growth

Front 78

What is a situational crisis?

Back 78

described as a person facing a turning point in life

Front 79

Which body system reacts strongly to stress?

Back 79

The immune system. this is why stress can cause illness

Front 80

Which phase of GAS is the circulatory system affected?

Back 80

during the alarm reaction stage