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NUR 226 stress Flashcards

1
Q

What process helps the body achieve homeostasis by altering se-points based on the situation?

A

allostasis

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2
Q

T/F: Allostasis has the ability to anticipate the demands of the body in order to return to homeostasis

A

t

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3
Q

T/F: the short-term stress response is meant to be helpful to the body

A

t

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4
Q

Which stress is POSITIVE, and can increase motivation/focus/mood?

A

eustress

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5
Q

Which stress is NEGATIVE, and increases anxiety, decreases performance, and is outside of one’s coping abilities?

A

distress

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6
Q

SATA: Things that affect our coping mechanisms.
a. genetics
b. culture
c. prior experiences
d. environment
e. health status
f. allostatic state

A

all

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7
Q

What are the 3 stages of the stress response?

A

alarm, resistance, exhaustion

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8
Q

The (SNS/PNS) has to do with fight or flight

A

sns

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9
Q

What does the hypothalamus release in the HPA axis?

A

CRH

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10
Q

When the hypothalamus releases CRH, this stimulates 2 things

A

SNS, Anterior Pituitary

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11
Q

When the SNS is activated in the HPA axis, what is stimulated?

A

adrenal medulla

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12
Q

What does the adrenal medulla release in the HPA axis (3)?

A

catecholamine, norepinephrine, epinephrine

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13
Q

What does catecholamine/norepinephrine/epinephrine cause?

A

fight or flight (SNS, increased energy)

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14
Q

What does the anterior pituitary release in the HPA axis?

A

ACTH

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15
Q

What does ACTH cause in the HPA axis?

A

adrenal cortex releases glucocorticoids (cortisol)

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16
Q

What happens to the pupils, HR, bronchi, peristalsis, glucose production in fight or flight (SNS) response?

A

pupils dilate, HR increases, bronchi dilate, peristalsis slows, glucose increases (fuel)

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17
Q

Rest and Digest is the activation of the…

A

PNS

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18
Q

Name 2 Catecholamines

A

Norepinephrine and Epinephrine

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19
Q

T/F: Norepinephrine develops memory

A

T

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20
Q

Which neurotransmitter is being described?
catecholamine, constricts smooth muscle, regulates perfusion, maintains pressure, pupils dilate, decrese gastric/insulin secretions, develops memory

A

norepinephrine

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21
Q

Which neurotransmitter is being described?
catecholamine, increases venous return/CO/HR, dilates airways, increase in glycogenolysis, decrease in insulin

A

epinephrine

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22
Q

T/F: HPA Axis is a POSITIVE feedback loop

A

F

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23
Q

What happens to the HPA axis when we administer Cortisol?

A

shuts off

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24
Q

Name a glucocorticoid

A

cortisol

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25
Q

T/F: Cortisol promostes synthesis of epinephrine

A

T

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26
Q

Which hormone is being described?
glucocorticoid, increase CO/BP, inhibits hormones of female reproductive system, increase in glucose/amino acids, atrophy of lymph, releases in response to ACTH

A

cortisol

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27
Q

Name a mineralcorticoid

A

aldosterone

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28
Q

Which hormone is being described?
mineralcorticoid, works in kidneys, absorb Na, excrete K and H, increase fluid retention (increase volume and BP)

A

aldosterone

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29
Q

In what stage is there continued hormone and catecholamine release?

A

resistance stage

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30
Q

What happens in the resistance stage if the stressor is removed?

A

relaxation, PNS takes over, cholinergic response (increse in acetylcholine)

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31
Q

What happens in the resistance stage if the stressor is NOT removed?

A

stress continues (decreased supply of glucose/energy/norep/epinephrine/cortisol)

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32
Q

T/F: the body can still achieve homeostasis in the exhaustion stage

A

F

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33
Q

Which part of the body experiences hypertrophy in the exhaustion stage?

A

adrenal cortex

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34
Q

Which part of the body experiences atrophy in the exhaustion stage?

A

lymph tissue

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35
Q

State whether the following INCREASES or DECREASES with Chronic Stress.
a. cortisol
b. risk for infection
c. T cells
d. catecholamines

A

a. decrease
b. increase
c. decrease
d. increase

36
Q

Is the following Allostatic Load or Allostatic Overload?

alters organs and tissues, stress-induced disease, increases aging process, failed adaptation

37
Q

S/S of Allostatic Overload

A

hair loss, tension, asthma, palpitations, tics, digestive disorders, anorexia, acne, irritable bladder, irregular periods, impotence (e.d.), sleep disturbances

38
Q

What influences our response to stress

A

Genetics
* Culture
* Prior experiences/ Environment
* Pre-existing health status
* Allostatic state
* Ability to manage stress

39
Q

Glucocorticoids
Cortisol Function

A

-Increase cardiac output and
blood pressure
* Decrease luteinizing
hormones,
estradiol, progesterone, and
testosterone
* Increase levels of amino acids
* Atrophy of lymph tissues
* Limited increase in WBC
response

40
Q

Mineralocorticoids
* Aldosterone function

A

Absorb Na+
* Excrete K+ (and H+)
* Water follows Na+

41
Q

Glucocorticoids promote synthesis of

A

epinephrine

42
Q

Sleep deprivation can impair one’s memory

43
Q

Name some diseases that can occur with increased stress

A

Coronary artery disease
Hypertension
Stroke
Tension headaches
Rheumatoid arthritis
Autoimmune diseases
Irritable bowel syndrome
Ulcers
Sexual disorders
Type 2 DM
This Photo by Unknown Author is licensed under CC BY-NC

44
Q

Sleep deprivation
causes…

A

IRRITABILITY AND
MOODINESS
APATHY IMPAIRED
MEMORY
POOR
JUDGEMENT
HALLUCINATIONS
CAN DEVELOP

45
Q

in the exhaustion stage Body can no longer achieve homeostasis which leads to

A

Hypertrophy of adrenal cortex
* Atrophy of lymphatic tissue
* Bleeding ulcers

46
Q

Immunosuppression from
cortisol leads to

A
  • Decreased response of
    WBCs
  • Atrophy of thymus and
    decreased T-cells
47
Q

Allostatic Load

A

chronic stress
* Long term dysregulation

48
Q

Allostatic overload

A
  • Exhaustion
  • Stress-induced disease or
    disorder
49
Q

overload can cause

A
  • Hair loss
  • Tension
  • Mouth sores
  • Asthma
  • Palpitations
  • Tics
  • Digestive disorders
  • Irritable bladder
  • Acne
  • Irregular periods
  • Impotence
  • Sleep disturbances
50
Q

Over production of Stress hormones
leads to

A

-Effects memory Major depressive disorders
-Immunosuppression
Increased risk of infection
Autoimmune disorders
Decreased healing
Prolongation of existing infections

51
Q

What is considered the primary stress hormone?

52
Q

Cortisol (increases/decreases) the amount of glucose in the body

53
Q

If glycogen increases, does glucose increase or decrease?

A

decrease

Glucose levels decrease: As glucose is converted into glycogen for storage, circulating glucose levels in the blood decrease.

54
Q

Increased cortisol levels can lead to what disease?

A

hyperglycemia

55
Q

Where is cortisol released from?

A

adrenal gland (cortex)

56
Q

Cortisol metabolises what

57
Q

Anabolic

58
Q

Catabolic

A

break down

-Muscle
* Adipose and lymph tissue
* Skin and bone

59
Q

Cortisol promotes the redistribution of what

60
Q

What is the term for fat breakdown in extremities?

61
Q

What is the term for fat redistribution to the face and trunk?

A

Lipogenesis

62
Q

Protein Metabolism and Fat redistribution are linked to this hormone…

63
Q

What happens to the cardiovascular system when there is an adrenal insufficiency with glucocorticoids (Cortisol)?

A

decreased BP, decreased vasoconstriction, increased permeability, edema

64
Q

What happens to the MSK system when there is an adrenal insufficiency with glucocorticoids (Cortisol)?

A

decreased perfusion, weakness in extremities

65
Q

T/F: With an adrenal insufficiency of glucocorticoids, hyperglycemia can occur with increased stress

A

F (HYPOglycemia)

66
Q

What hormone is decreased when dealing with an adrenal insufficiency of mineralcorticoids?

A

aldosterone

67
Q

Hyponatremia is a decrease in…

68
Q

T/F: renal failure can occur with decreased aldosterone and adrenal insufficience of mineralcorticoids

69
Q

T/F: ACUTE adrenal insufficiency is a medical emergency

70
Q

What occurs when you abruptly take someone off steroids?

A

adrenal failure, decreased cortisol (adrenal gland needs time to adjust and start making its own cortisol)

71
Q

A patient comes in who abruptly stopped taking their steroids. They are experiencing hypotension, dehydration, weakness, and have nausea. How will you cure this patient?

A

fluid replacement (increase volume), increase glucose, administer steroids

72
Q

T/F: Steroids do NOT have anti-inflammatory properties

73
Q

With increased stress, you can (increase/keep) the dose of steroids. when stress passes you should..

A

increase

titrate it down to normal dose

74
Q

With what situations do we give steroids for?

A

allergies, asthma, COPD, inflammatory bowel disease, lupus, edema, post-transplant

75
Q

steriods can be adminstered in cases of

A

Excessive or extreme stress
* Trauma
* Sepsis

76
Q

Adrenal
insufficiency:
mineralocorticoids

A
  • Hyponatremia
  • Hyperkalemia
  • Cellular dehydration
  • Decreased ECF volume
  • Renal failure
77
Q

What drug is considered to be synthetic cortisol and has no AE at low doses?

A

Hydrocortisone

78
Q

Name 3 glucocorticoid steroids

A

hydrocortisone, prednisone, dexamethasone

79
Q

When do we administer Prednisone?

A

chronic diseases (COPD)

80
Q

AE of glucocorticoids

A

adrenal insufficiency, infection, fat redistribution, muscle wasting, weight gain, immunosupression, depression, glucose intolerance

81
Q

T/F: Steroids are replacement drugs

82
Q

Dexamethasone is administered to get an idea of how well this gland is functioning…

A

adrenal gland

83
Q

Name a mineralcorticoid steroid

A

Fludrocortisone (Florinef)

84
Q

high levels of Hydrocortisone is

85
Q

Teaching with Glucocorticoid

A

Taper dose
* Don’t stop abruptly

86
Q

Fludrocortisone acts like

87
Q

?Fludrocortisone can be used with?

A

glucocorticoids

nur 225 exam 2 (3 decks)

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