Chapter 37: Stress And Coping Flashcards
________ Regression ego defense mechanism is coping with a stressor through actions and behaviors associated with an earlier developmental period.
What ego defense mechanism is this?
Regression ego defense mechanism
If stress is present, ______ appraisal focuses on possible coping strategies. Balancing factors contribute to restoring _______.
Secondary
Equilibrium
Nurses need to recognize the signs and symptoms of stress and understand _______ techniques to aid personal coping and design interventions for their patients and families.
stress management
Patients ______ your advice and counsel and gain confidence from your belief in their ability to move past the stressful event or illness. Patients overwhelmed by life events are often unable, at least initially, to act on their own behalf and require either _______.
respect
direct intervention or guidance
______ is a physical, emotional, or psychological demand that often leads to growth or overwhelms a person and leads to illness.
stress
In ______ stressors include the loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition.
Old age
The medulla oblongata, located in the lower portion of the brainstem, controls what three physiological changes? Impulses traveling to and from the medulla oblongata increase or decrease these vital functions.
heart rate,
blood pressure,
respirations.
Potential stressors that affect any age-group but are especially stressful for young people include _______ and ________ .
Prolonged poverty and Physical handicap
Nursing ____ frequently results from intense caregiving and manifests as emotional exhaustion, loss of a sense of personal identity, and feelings of failure.
Burnout
The fight-or-flight response to stress, which is arousal of the __________ nervous system, prepares a person for action.
Sympathetic
________ is transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute. (Example: A person transfers anger over an interpersonal conflict to a malfunctioning computer.)
What ego defense mechanism is this?
Displacement ego defense mechanism
The _______ is a small gland immediately beneath the hypothalamus.
pituitary gland
The _______ and _________ of the psychological threat and the ________ of other stressors that occur at the same time affect the person’s response to the threat.
Intensity
Duration
Number
Evaluating an event for its personal meaning is _______.
Primary appraisal
Coping mechanisms include psychological ______ behaviors. Such behaviors are often ______-oriented, involving the use of direct problem-solving techniques to cope with _____ threats.
Adaptive
Task
_______ includes work, family, chronic, and acute stress; daily hassles; trauma; and crisis.
Stress
_______ begins when a person experiences, witnesses, or is confronted with a traumatic event and responds with intense fear or helplessness.
Posttraumatic stress disorder (PTSD)
A _____ implies that a person is facing a turning point in life. This means that previous ways of _____ are not effective and the person must change.
crisis
Coping
The vital questions for a person in ______ are, “What does this mean to you; how is it going to affect your life?” What causes extreme stress for one person is _____ always stressful to another.
Crisis
Not
__________ is based on the concepts of stress and reaction to it. This views the person, family, or community as constantly changing in response to the environment and stressors and helps explain individual, family, and community responses to stressors.
The Neuman Systems Model
However, when physiological, psychological, sociocultural, devel- opmental, or spiritual resources are unable to buffer stress, the normal line of defense is broken, and _____ often results.
Disease
_________ is making up for a deficiency in one aspect of self-image by strongly emphasizing a feature considered an asset. (Example: A person who is a poor communicator relies on organizational skills.)
What ego defense mechanism is this?
Compensation Ego Defense Mechanisms
Recognize the need for collaboration and consultation; inform the patient about potential resources; and make arrangements for interventions such as ______, ______, or _______.
consultations
group sessions
therapy
________ stress arises from personal or family job changes or relocation. Stressful job changes include promotions, transfers, downsizing, restructuring, changes in supervisors, and additional responsibilities.
Situational
The general adaptation syndrome is a three stage reaction to stress, describes how the body responds to stressors through the ________reaction, the _______ stage, and the ________ stage.
Alarm
Resistance
Exhaustion
________ is based on the belief that a person significantly reduces stress with imagination. It is a relaxed state in which a person actively uses imagination in a way that allows visualization of a soothing, peaceful setting. Typically the image created or suggested uses many sensory words to engage the mind and offer ______ and ______.
Guided imagery
distraction and relaxation
Begin your assessment with an ______ question such as, “What is happening in your life that caused you to come today?” or “What happened in your life that is different?” This requires some focusing by the patient. Next assess the patient’s _______ of the event, available situational _______, and what he or she usually does when there is a problem that he or she cannot ______. Determine if a person is suicidal or homicidal by asking ________. For example, ask, “Are you thinking of killing yourself or someone else?”
open-ended perception supports solve directly
Stressors vary with life stage. _______ identify stressors related to their physical appearance, their families, their friends, and school.
Children
Be ______ in the belief that you and your patients can effectively manage stress. Patients who feel overwhelmed and perceive events as being beyond their capacity to cope rely on you as an _______.
confident
Expert
Assessment of a patient’s stress level and coping resources requires that you first establish a ______ nurse-patient relationship because you are asking a patient to share personal and ________ information.
trusting
sensitive
Often the patient has _______ expressing exactly what is most bothersome about the situation until there is an opportunity to discuss it with someone who has time to listen.
difficulty
Take time to understand a patient’s ________ of the precipitating event and the ways in which stress is _______ his or her life.
Meaning
Affecting
People experience _____ as a consequence of daily life events and experiences. It stimulates thinking processes and helps people stay alert to their environment. It results in personal growth and facilitates development.
Stress
- What is bothering you most right now?
- What do you think about when you’re lying awake?
What stage is this in the nursing process?
Assessment of the patients Perception of Stressor
_______ is how people interpret the impact of the stressor on themselves or on what is happening and what they are able to do about it.
Appraisal
Nursing diagnoses for people experiencing stress generally focus on ______. Specifically major defining characteristics of ineffective coping include verbalization of an inability to cope and an inability to ask for help. To identify defining characteristics, ask the patient what is of ______ at the time of the interview. It is important to allow him or her sufficient ____ to answer.
coping
most concern
time
________ for persons experiencing stress frequently include effective coping, family coping, caregiver emotional health, and psychosocial adjustment: life change.
Desirable outcomes
___________ assist the patient in readapting and can include relaxation training and time-management training. The nurse and the patient assess the level and source of the existing stress and determine the appropriate points for intervention to reduce it.
What level is this nursing intervention?
Tertiary Level nursing Interventions
_______ identify multiple nursing diagnoses from the assessment database and show how they are related. In addition, this shows the relationship among the nursing diagnoses chronic low self-esteem, ineffective coping, anxiety, and caregiver role strain.
Concept maps
Stress in a ______ is sometimes from a critically ill family member, the sudden loss of a job, a move, or becoming homeless.
Family
Just as the nursing _________ of the patient’s stress and coping depends on the patient’s perception of the problem and coping resources, the interventions focus on a ______ with the patient and support system, usually the family.
assessment
partnership
When assessing a patient’s level of stress and coping resources, create a _______ physical environment for the interaction. Assume the same ______ as the patient, arranging the interview environment so you can maintain or avoid eye contact ________. You do this by placing chairs at a _____ angle or ______ to reduce the intensity of the interaction.
Nonthreatening Height Comfortably 90 degree Side by side
______ with occupational therapists, dietitians, pastoral care professionals, and health care professionals from other clinical specialties, depending on the patient’s stressful situation.
Collaborate
Three primary modes of intervention for stress are?
- decrease stress-producing situations,
- increase resistance to stress
- learn skills that reduce physiological response to stress.
A regular _______ improves muscle tone and posture, controls weight, reduces tension, and promotes relaxation.
exercise program
Other potential threats to _______ include nutritional deficits; insomnia; self-care deficits; and poor judgment and impulsiveness that possibly lead to unsafe decisions about sex, drugs, money, or damage to personal relationships that the person might later regret.
safety
Obtain __________ findings related to stress and coping through observation of the appearance and non-verbal behavior of a patient. Observe grooming and hygiene, gait, characteristics of the handshake, actions while sitting, quality of speech, eye contact, and the attitude of the patient during the interview.
Objective
A _______ of family, friends, and colleagues who listen, offer advice, and provide emotional support benefits a patient experiencing stress.
support system
Give utmost attention to determining the patient’s ______ of the situation and his or her ability to cope with the stress.
perception
In many cases setting _____ helps individuals identify tasks that are not necessary or can be delegated to someone else.
priorities
You also help the person become ______ of present feelings such as anger, grief, or guilt to help him or her reduce feelings of tension. In addition, you help the patient explore coping mechanisms, perhaps identifying new __________. Finally you help the person increase __________ if he or she has been isolated and overly self-focused.
Aware
methods of coping
social contacts
In the presence of anxiety- provoking thoughts and events, a common physiological symptom is _______. Diminish ______ tension through a systematic approach to releasing tension in major muscle groups. Typically an individual achieves a relaxed state through deep chest breathing. Once the patient is breathing deeply, direct him or her to alternately tighten and relax muscles in specific groupings.
muscle tension
physiological
________ includes skills for helping individuals communicate effectively regarding their needs and desires.
Assertiveness
For many people keeping a private, personal journal provides a therapeutic outlet for _______. Suggest that patients keep journals, especially during difficult situations. In a private journal patients are able to express a full range of emotion and vent their _______ feelings without hurting anyone else’s feelings and without concern for how they appear to others.
stress
honest
The patient’s clinical condition and perception of stress determine which nursing diagnosis has the greatest ________. As in all areas of nursing, safety of the patient and others in his or her environment is the _______ priority
priority
first
________ experience stress related to self-esteem issues, changing family structure as a result of divorce or death of a parent, or hospitalizations.
Preadolescents
Some individuals or families emerge from a crisis state functioning more _____, whereas others find themselves weakened, and still others are completely _______.
effectively
dysfunctional
When stress overwhelms a person’s usual coping mechanisms and demands mobilization of all available resources, it becomes a ______.
crisis
The ________, a small cluster of neurons in the brainstem and spinal cord, continuously monitors the physiological status of the body through connections with _______ and ________ tracts.
reticular formation
Sensory and motor
___________ is experiencing a subjective sense of numbing and a reduced awareness of one’s surroundings.
What ego defense mechanism is this?
Dissociation ego defense mechanism
________ techniques include developing lists of prioritized tasks. For example, help patients list tasks that require immediate attention, those that are important and can be delayed, and those that are routine and can be accomplished when time becomes available.
Time management
If desired outcomes have been met, the patient reports feeling better now than 6 months ago.
evaluation
A person under stress _________ when the stress is removed or coping strategies are successful.
Recovers
A patient recovering from acute stress often spontaneously reports feeling better when the stressor is _____. The recovery from chronic stress occurs more gradually as the patient emerges from the strain. In ______ situations reassess the patient for the presence of new or recurring stress-related symptoms.
gone
Both
