Chapter 18 - Stress Flashcards
Acute Stress
Fight or flight
What part of the brain determines if something is a threat?
Amygdala
Hippocampus
What hormones does the fight or flight response secrete?
Adrenaline
Epinephrine
Cortisol
Chronic Stress
Ongoing stress that results in wear and tear and negative health results
Eustress
Good stress
Distress
Bad stress
General Adaptation Syndrome
Alarm
Resistance
Exhaustion
Alarm Phase
A threat is perceived and body reacts
Resistance Phase
Coping mechanisms are used to try to reestablish homeostasis
Exhaustion Phase
Occurs if homeostasis is not achieved
Allostatic Load
The consequence of the wear and tear on the body and brain and leads to ill health.
Appraisal
The perception that an event or situation is a threat
Primary Appraisal
Evaluation of events as a threat, harm, or challenge
Secondary Appraisal
Explanation of outcome of events
Diathesis-Stress Model
Early experiences of stress/trauma can impair the stress response and increase risk for mental illnesses
Type A personality
Competitive, aggression, ambitious, impatient, alert, tense, and restless
Type B personality
Relaxed, easygoing, easily satisfied
Type C personality
Introvert, respectful, conforming, complaint, and eager to please
Type D personality
increased negative emotions, pessimism, non-sharing of emotions
Functions of Social Support
Emotional
Tangible
Infomational
Emotional Support
Attachment, reassurance, being able to rely on and confide in a person
Tangible Support
Direct aid such as loans or gifts, services such as taking care of someone who is ill, doing a job or chore
Informational Support
Providing information or advice, giving feedback about how a person is doing
Fight or Flight Physiological Changes
Increase glucose Increase CO and BP (RAAS) Increase O2 and Hematocrit Increase immune response Heightened vigilance in brain Hyperactive coagulation
Negative emotions
Anger Fright Anxiety Guilt Shame Sadness Envy Jealousy Disgust
Positive Emotions
Happiness
Pride
Relief
Love
Borderline Emotions
Hope, Compassion Empathy Sympathy Contentment
Nonemotions
Confidence
Awe
Confusion
Excitement
Problem-Focused Coping
The person attacks the source of stress and solves the problem (eliminating it or changing its effects), which changes the person–environment relationship
Emotion Focused Coping
The person reduces the stress by reinterpreting the situation to change its meaning (Accepting the problem and looking on the “sunny side”)
Adaptation (resilience)
Person’s ability to survive and flourish
Adaptation effect 3 areas
Healthy coping
Psychological well-being
Social functioning
Overall goals for pt. who is stressed
Resolve stressful person-environment situations
Reduce the stress response (Deep breathing)
Develop positive coping skills (“what has worked in the past?”)
Goals for pt. high risk for stress
Recognize the potential for stressful situations
Strengthen positive coping skills
When pt. comes to hospital they must be __ __ before they can be admitted to psych unit
Physically cleared
If the pt. has pancreatitis and is irritable and acting out. What is priority goal here.
Tx of pancreatitis - this could be causing the irritability and may fix it w/o having to admit to psych unit
Psychological Assessment
Emotions
Coping strategies
Pt. on the psych unit, the nurse should make sure they eat at least ___ amount of their meals
At least 75% of all of their meals
Interventions for stressed pt.
ADLs Nutrition Exercise Relaxation techniques Referral for hypnosis or biofeedback
Psychosocial assessment
Severity of emotions
How the pt. acts on emotions (aggressive, angry)
Coping strategies
What is usually the most effective Tx for psychiatric pt.
Med + Therapy
Social Assessment
Network and extent Recent changes (new added stress) Degree of interconnectedness in social network
Social interventions
Facilitation of family functioning Assistance in expanding social network Support of family unit Parenting education Family therapy
Individual Outcomes
Improved health, well-being, and social function
Family Outcomes
Improved communication/social support
Social network outcomes
Modification of social network to increase support
