Chapter 10 Stress Response and Management

Question 1

What is Stress?

National Institute For Health

Answer 1

the brain’s response to any demand

stress is natural

Question 2

What is Adverse Childhood Experiences:

How often does it occur?

Answer 2

ACE’s= Adverse Childhood Experiences

Psychological, physical or sexual abuse
Violence against a parent, esp a mother
Living with people that have substance use disorders, mental illness or were incarcerated

50% have at least one
25% have more than one

Question 3

Stressors

Answer 3

any psych or physical stimuli or event that provokes a stress response
ANS- Sympathetic nervous system

Question 4

Fight or flight response

Answer 4

Acute Stress Response
Fight - aggression
Flight - withdrawal
and Freezing - cannot decide 
Walter Cannon

Question 5

GENERAL ADAPTATION SYNDROME. GAS

Answer 5

Hans Selye 1936

Alarm -Sympathetic, Adrenelaline released, HR, RR, BP, pupils dilate, dig slows down, then HPA. - cortisol

Resistance - Adaptation valuable resources may be used up

Exhaustion - anxiety disorders, sleep disorders, digestive, heart, weight gain

Question 6

Types of STRESS

Answer 6

Distress - negative, depression anxiety confusion, helplessness, fatigue
EUstress- positive - new job, baby

Question 7

Critique of GAS

Answer 7

degree of stress more important
males different than females (tending and befriending)
females more likely to have stress disorders
exhaustion - not just depletion of reserves, ie slower wound healing

Question 8

Immune System Stress Responses

Answer 8

Nervous system and endocrine system related
cytokines inc with depressive disorder
cancer patients -depression from interlukins

Question 9

What are two types of stressors

Answer 9

Physical - ie cold

Psychological - ie divorce

Question 10

What mediates Stress?

Answer 10

Perception - age gender,etc 
Individual Temperament
Social Support
Support Groups 
Culture
Spirituality and religion

Question 11

How do you measure STRESS?

Answer 11

Social Readjustment Scale 1967

Recent Life Changes Questionnaire 6 month score of 300 or year score of 500 high stress
Change = stress
peoples thresholds are different
culture affects stress

Perceived Stress Scale - 10 questions

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Question 12

List 6 Stress BUSTERS

Answer 12

Sleep 7-9 hours 30-60 min earlier. dont sleep in later
Exercise. 150 min/week. 3h before bed
Caffeine Intake. max 4 cups/day
Music
Pets 
Massage

Question 13

Coping Styles 4

Answer 13

health sustaining
life satisfaction
social support
effective and healthy responses to stress

Question 14

What conditions may occur with poor management of stress?

Answer 14

Cardiac disease
poor diabetes control
chronic pain
emotional distress

Question 15

What problems might benefit from relaxation techniques?

Answer 15

anxiety, depression, insomnia, and nightmares

Question 16

Stress and anxiety reducing techniques can help________

Answer 16

asthma, childbirth, epilepsy, fibromyalgia headache IBS , cardiac disease and symptoms, menopause symptoms, menstruation, nausea, and pain, smoking cessation, TMJ, tinnitus, overactive bladder.

Question 17

Relaxation Techniques

Answer 17

Biofeedback
Deep-breathing exercises
Guided imagery
Progressive Relaxation
Meditation hypometabolic state quiets sympathetic NS.
Mindfulness here and now
Physical exercise Yoga
Cognitive reframing
Journaling 
Humor

Question 18

nursing dx stress

Answer 18

altered body image
powerlessness
hopelessness
anxiety
altered family process
demanding, non-=compliant, anger/agression

Question 19

Stress

nursing teaching

Answer 19

stress management
coping skills
review of ap interventions - CBT. guided imagery, biofeedback, acupressure, hypnosis, psycodynamic psychotherapy

Question 20

systemic physical illness

neuro
cv
gi
immune
other

psychological stress
and physical stress

Answer 20

immune-inflammatory response. HPA axis, NLRP3 inflammatory proinflammmediatprs
Brain cns adaptations - molecular, cellular, morphological and tissue
psychological illness - depression, anxiety,

Question 21

Medical conditions - psych responses

Answer 21

Depression
Anxiety
Substance abuse
Grief and Loss
Denial
Fear of Dependency

Question 22

Stress Interventions

Answer 22

1. Assess psychosocial stressors
2. Id and teach coping skills = assertiveness, cognitive reframing, problem-solving skills, social supports
3. Stress management techniques - relaxation and breathing.

Question 23

Medical conditions - nursing care

Answer 23

psychosocial assessment 
quality of life
coping skills
spirituality and religion
social supports