Chapter 10 Stress Response and Management Flashcards
What is Stress?
National Institute For Health
the brain’s response to any demand
stress is natural
What is Adverse Childhood Experiences:
How often does it occur?
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
Stressors
any psych or physical stimuli or event that provokes a stress response
ANS- Sympathetic nervous system
Fight or flight response
Acute Stress Response Fight - aggression Flight - withdrawal and Freezing - cannot decide Walter Cannon
GENERAL ADAPTATION SYNDROME. GAS
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
Types of STRESS
Distress - negative, depression anxiety confusion, helplessness, fatigue
EUstress- positive - new job, baby
Critique of GAS
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
Immune System Stress Responses
Nervous system and endocrine system related
cytokines inc with depressive disorder
cancer patients -depression from interlukins
What are two types of stressors
Physical - ie cold
Psychological - ie divorce
What mediates Stress?
Perception - age gender,etc Individual Temperament Social Support Support Groups Culture Spirituality and religion
How do you measure STRESS?
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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List 6 Stress BUSTERS
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
Coping Styles 4
health sustaining
life satisfaction
social support
effective and healthy responses to stress
What conditions may occur with poor management of stress?
Cardiac disease
poor diabetes control
chronic pain
emotional distress
What problems might benefit from relaxation techniques?
anxiety, depression, insomnia, and nightmares
Stress and anxiety reducing techniques can help________
asthma, childbirth, epilepsy, fibromyalgia headache IBS , cardiac disease and symptoms, menopause symptoms, menstruation, nausea, and pain, smoking cessation, TMJ, tinnitus, overactive bladder.
Relaxation Techniques
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
nursing dx stress
altered body image powerlessness hopelessness anxiety altered family process demanding, non-=compliant, anger/agression
Stress
nursing teaching
stress management
coping skills
review of ap interventions - CBT. guided imagery, biofeedback, acupressure, hypnosis, psycodynamic psychotherapy
systemic physical illness
neuro cv gi immune other
psychological stress
and physical stress
immune-inflammatory response. HPA axis, NLRP3 inflammatory proinflammmediatprs
Brain cns adaptations - molecular, cellular, morphological and tissue
psychological illness - depression, anxiety,
Medical conditions - psych responses
Depression Anxiety Substance abuse Grief and Loss Denial Fear of Dependency
Stress Interventions
- Assess psychosocial stressors
- Id and teach coping skills = assertiveness, cognitive reframing, problem-solving skills, social supports
- Stress management techniques - relaxation and breathing.
Medical conditions - nursing care
psychosocial assessment quality of life coping skills spirituality and religion social supports
