NUR 321 Module 7

Question 1

Stress

Answer 1

An actual or alleged hazard to balance of homeostasis is called

Question 2

Stressors

Answer 2

Any physical, psychological, or social stimuli that are capable of producing stress and endangering homeostasis.

Question 3

Stress appraisal

Answer 3

How a person interprets the impact of the stressor.

Question 4

General adaptation syndrome

Answer 4

A three-stage set of physiological processes that prepare, or adapt, the body for danger so and individual is more likely to survive when faced with a threat.

Question 5

GAS Stage 1

Answer 5

“alarm”

CNS is around and body defenses are immobilized.

This is the fight or flight response.

Hormones levels rise resulting in increased blood volume, blood glucose, heart rate and mental alertness.

Question 6

GAS Stage 2

Answer 6

Resistance stage

Body stabilizes and responds in an attempt to compensate for the changes.

Hormone levels, heart rate, blood pressure return to normal. The body tries to repair damage.

Compensation attempt consume energy.

Question 7

GAS Stage 3

Answer 7

Exhaustion stage

Continuous stress causes progressive breakdown of compensatory mechanisms.

The body no longer is able to resist. Energy is depleted.

Question 8

Primary appraisal

Answer 8

Evaluating an event in terms of personal meaning.

Question 9

Secondary appraisal

Answer 9

The process by which a person considers possible available coping strategies or resources.

Question 10

Coping

Answer 10

A person’s cognitive and behavioral efforts to manage a stressor.

Question 11

Post-traumatic stress disorder (PTSD)

Answer 11

Begins when a person experiences or witnesses a traumatic event and responds with intense fear or helplessness.

Question 12

Crisis implies…

Answer 12

A person is facing a turning point in life. Previous ways of coping are ineffective and change is needed.

Question 13

Maturational crisis

Answer 13

New developmental stage such as marriage or birth of a child

Question 14

Situational crisis

Answer 14

External sources such as job change, motor vehicle accident, or illness

Question 15

Adventitious crisis

Answer 15

A major natural disaster, man-made disaster, or crime of violence

Question 16

Situational factors

Answer 16

High-acuity patient load, job environment, constant distractions, responsibility, conflicting priorities, and intensity of care, adjusting to chronic illness, difficulty paying for treatment.

Question 17

Maturational factors

Answer 17

• Children –> initiative versus guilt; identify stressors related to physical appearance, families, friends, and school. Teaching impulse control and cooperative behaviors is imperative.
• Preadolescents –> self-esteem issues, changing family structure as a result of divorce or death of a parent, or hospitalizations. They can develop a sense of inferiority without proper support for learning new skills.
• Adolescents –> identity with peer groups and separate from their families, they also experience stress. Stressful questions about sex, jobs, school, career choices, and using mind-altering substances, appearance and body image. Strive to develop and accept personal identity.
• Adults –> major changes in life circumstances. Beginning a family, career, losing parents, seeing children leave home, and accepting physical aging. Social development is important.
• Old age –> loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition.

Nurses and other health care providers need to differentiate signs of stress and crisis in older adults from dementia and acute confusion.

Question 18

Sociocultural factors

Answer 18

• Prolonged poverty and physical disability.
• Children become vulnerable when they lose parents and caregivers through divorce, imprisonment, or death or when parents have mental illness or substance-abuse disorders.
• Living under conditions of continuing violence, disintegrated neighborhoods, or homelessness.
• Cultural differences

Question 19

Electronic cigarettes or vaping

Answer 19

Advertised as safer than traditional cigarettes but researchers actually know little about the health risks of using these devices.

Question 20

Addiction

Answer 20

A chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.

It is considered a brain disorder, because it involves functional changed.

It interferes with everyday life.

Question 21

Risk factors for addiction

Answer 21

Aggressive childhood behavior, lack of parental supervision, poor social skills, drug experimentation, availability of drugs at school, and community poverty. Protective factors include good self-control, parental monitoring and support, positive relationships, good grades, school anti-drug policies, and neighborhood resources.

Question 22

Marijuana

Answer 22

According to the CDC using marijuana at an early age can lead to negative health consequences such as damage to memory, learning, and attention.

Marijuana during pregnancy may harm the baby.

It has been linked to anxiety, depression, and schizophrenia.

Smoking any product can damage lungs and cardiovascular system.

Question 23

Tolerance

Answer 23

Using increasing amounts of a substance over time to achieve the same effect and markedly diminished effect occurs with continued use.

Question 24

Withdrawal

Answer 24

Develops when a substance is discontinued abruptly after frequent, heavy or prolonged use.

Question 25

Symptoms of withdrawal include..

Answer 25

Anxiety, irritability, restlessness, insomnia, fatigue. The symptoms differ and are specific to each substance (tobacco, cocaine etc)

Question 26

BAC levels for KY

Answer 26

0.08

Question 27

Factors associated with college drinking

Answer 27

Impulsive behavior, depression, family history, and prior drinking history.

Question 28

Individuals who are genetically predisposed to alcoholism are..

Answer 28

At higher risk of developing an alcohol use disorder.

Question 29

Alcohol Intoxication

Answer 29

No antidote for alcohol is available.

Supportive care measures – the ABCs

Monitor vital signs and level of consciousness frequently

Question 30

Alcohol Withdrawal Syndrome

Answer 30

When abrupt ingestion is stopped

Onset varies with drinking patterns.

Symptoms within 4-6 hours after last drink

May last up to 14 days

Does not always progress in a predictable manner

Question 31

Alcohol Withdrawal Delirium

Answer 31

Serious complication

Onset 30 – 120 hours after last drink

Can be fatal

Can be prevented or controlled with benzodiazepine administration

Question 32

Stimulants

Answer 32

Make people more alert, increase attention, and raise blood pressure, heart rate, and breathing.

Question 33

Stimulants come in a variety of forms, including:

Answer 33

• amphetamines/ methamphetamines- skin sores seen due to imagined insects crawling on skin, meth mouth due to dry mouth and teeth grinding
• cocaine
• caffeine
• nicotine

Question 34

Nursing care stimulants:

Overdose

Answer 34

Occurs frequently

No antidotes

Death possible

Question 35

Nursing care stimulants:

Withdrawal

Answer 35

Monitor vital signs

Craving is intense

Maintain a safe setting that limits potentially negative interactions with the outside environment.

Prescribe medications to manage the acute withdrawal syndrome

Question 36

Depressants:

Sedative-hypnotics

Answer 36

Barbiturates (phenobarbital) - no known antagonists, dialysis or gastric lavage for overdose

Benzodiazepines (Xanax, Klonopin, Valium), overdose treated with Romazicon (flumazenil)

Barbiturate-like drugs

Question 37

Depressants:

Opiods

Answer 37

Heroin

Prescription Opioids- Hydrocodone, Oxycodone, Morphine, Codeine

Opioid nursing care- Narcan (naloxone) for overdose, methadone used to decrease symptoms during detox

Question 38

JUST THE FACTS:

Due to their effect on the part of the brain that regulates breathing, opioids in high doses can cause respiratory depression and death. An opioid overdose can be identified by a combination of three signs and symptoms referred to as the “opioid overdose triad”.

Answer 38

JUST THE FACTS:

Due to their effect on the part of the brain that regulates breathing, opioids in high doses can cause respiratory depression and death. An opioid overdose can be identified by a combination of three signs and symptoms referred to as the “opioid overdose triad”.

Question 39

Symptoms of the triad

Answer 39

Pinpoint pupils
Unconsciousness
Respiratory depression

Question 40

Naloxone can be administered

Answer 40

IV, IM, and Nasal