Chpt 42 Stress & Coping

Question 1

Define stressor

Answer 1

Any event or stimulus that causes an individual to experience stress

Question 2

What are some sources of stress?

Answer 2

Internal stressors: within a person; infection or depressing.
External stressors:outside the individual;big move to diff city,death in family.developmental stressors. And situational stressors.

Question 3

Define stress

Answer 3

A condition in which the person experiences changes in the normal balanced state.

Question 4

define coping 
and 
coping strategy(coping mechanism)

Answer 4

dealing with change;

a natural or learned way of responding to a changing environment or specific problem/situation.

Question 5

what are some disorders that can be caused by stress?

Answer 5

• skin disorders(exzema,psoriasis)
• respiratory disorders(asthma, hay fever, TB)
• CVD(CHF, Hypertension)
• Gi disorders(constipation, diarrhea,anorexia,obesity)
• Menstrual irregularities

Question 6

What are some effects of stress?

Answer 6

Physical
Emotional
Intellectual
Social
Spiritual
impacts

Question 7

Effects of Stress

cont :

Answer 7

• Usually are mixed because stress affects the whole person
• Even good stress can be hard on your health
• Cumulative stress increases risk of health impacts

Question 8

Stess models

Answer 8

• Assist nurses to predict stressors
• Helps nurse to understand individual’s response
• May use models to assist clients in developing healthy coping strategies

Question 9

General Adaptation Syndrome(GAS)

Answer 9

• Developed by Selye
• Stress is a nonspecific response of the body to any kind of demand made upon it (physical, social, psychological)
• Stress can be observed only by the changes it produces in the body
• Occurs with the release of adaptive hormones and changes in the body
• 3 stages-alarm reaction,stage of resistance, stage of exhaustion

Question 10

Alarm Reaction

Answer 10

alerts the body’s defenses
Shock Phase—full tilt “fight or flight”, cascade of “stress” hormones flood the blood stream
Countershock Phase—recovery and normalization

Question 11

Stage of Resistance:

Answer 11

body adapts and attempts to limit response to the smallest possible (stress ulcers, stress headaches)

Question 12

Stage of Exhaustion:

Answer 12

adaptation cannot be maintained, extensive generalized consequences to health, physical exhaustion, death if not “rescued” (learn to cope, reduce the stress, etc)

Question 13

Selye’s General Adaptation Syndrome

Answer 13

Homeostasis—alarm—resistance—exhaustion—death or recovery

Question 14

what are some indicators of stress?

Answer 14

• Physiologic
• Cognitive
• Psychological

Question 15

Physiologic Indicators of Stress

Answer 15

-THINK SNS-Sympathetic&neuroendocrine systems)
-Pupils dilate
Sweat production increases
Heart rate and cardiac output increase
Skin is pallid
Sodium and water retained
Rate and depth of respiration increase
Urinary output decreases
Mouth may be dry
Peristalsis of the intestines decrease for serious threats
Mental alertness improves
Blood sugar increases

Question 16

Psychological Indicators of Stress

Answer 16

Angry
Short Tempered
Depressed
Defensive
Anxious
Fearful
Withdrawn

Question 17

Anxiety

Answer 17

A state of mental uneasiness
Source may or may not be identifiable
Vague
Result of psychological or emotional conflict

Question 18

Fear

Answer 18

An emotion or feeling of apprehension
Source is identifiable
Definite
Result of a specific physical or psychological entity

Question 19

Defense Mechanisms

Answer 19

Compensation Projection
Rationalization 
Reaction formation
Regression
Repression
Sublimation
Substitution
Undoing
Denial
Displacement
Identification
Intellectualization
Introjection
Minimization

Question 20

Cognitive Indicatorsof Stress

Answer 20

Problem solving
Structuring, controlling environment
Self-control or self-discipline
Suppression
Fantasy

Question 21

Coping strategy is

Answer 21

natural or learned way of responding to changing environment or specific problem or situation

Question 22

Types of Coping

Answer 22

Problem-focused
Emotion-focused
Both types usually occur together

Question 23

Problem-focused coping

Answer 23

Efforts to improve situation by making changes or taking action

Question 24

Emotion-focused coping

Answer 24

Thoughts and actions that relieve emotional distress
Doesn’t improve situation but person feels better
Change thinking around the situation

Question 25

Coping Mechanisms

Answer 25

Lifestyle changes
Medication
Therapy

Question 26

Nursing Diagnoses Related to Stress

Answer 26

Anxiety
Caregiver Role Strain
Compromised Family Coping
Decisional Conflict (Specify)
Defensive Coping
Disabled Family Coping

Fear
Impaired Adjustment
Ineffective Coping
Ineffective Denial
Post-Trauma Syndrome
Relocation Stress Syndrome

Question 27

Interventions to Minimize and Manage Stress

Answer 27

Physical Exercise
Optimal Nutrition
Adequate Rest and Sleep
Time 
Management

Question 28

Physical exercise

Interventions

Answer 28

Promotes physical and emotional health

60 minutes/day recommended

Question 29

Optimal nutrition

interventions

Answer 29

Essential for health
Increases resistance to stress
Avoid excesses of caffeine, salt, sugar, fat
Avoid vitamin deficiencies

Question 30

Sleep

interventions

Answer 30

Restores body’s energy level
May need to use relaxation techniques
Need deep, full cycle sleep

Question 31

Time management

Interventions

Answer 31

Must address what is important and achievable

Reexamine “should do”, “ought to do”, “must do”

Question 32

Reducing Client Stress

Answer 32

Other methods include:
Listen attentively
Provide atmosphere of warmth and trust
Convey sense of caring and empathy
Include client in plan of care

Question 33

Reducing Client Stress cont

Answer 33

Other methods include:
Promote feeling of safety and security
Minimize additional stressors
Help with recognition of stressors and coping mechanisms