NUR 321 Module 7 Flashcards
Stress
An actual or alleged hazard to balance of homeostasis is called
Stressors
Any physical, psychological, or social stimuli that are capable of producing stress and endangering homeostasis.
Stress appraisal
How a person interprets the impact of the stressor.
General adaptation syndrome
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.
GAS Stage 1
“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.
GAS Stage 2
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.
GAS Stage 3
Exhaustion stage
Continuous stress causes progressive breakdown of compensatory mechanisms.
The body no longer is able to resist. Energy is depleted.
Primary appraisal
Evaluating an event in terms of personal meaning.
Secondary appraisal
The process by which a person considers possible available coping strategies or resources.
Coping
A person’s cognitive and behavioral efforts to manage a stressor.
Post-traumatic stress disorder (PTSD)
Begins when a person experiences or witnesses a traumatic event and responds with intense fear or helplessness.
Crisis implies…
A person is facing a turning point in life. Previous ways of coping are ineffective and change is needed.
Maturational crisis
New developmental stage such as marriage or birth of a child
Situational crisis
External sources such as job change, motor vehicle accident, or illness
Adventitious crisis
A major natural disaster, man-made disaster, or crime of violence
Situational factors
High-acuity patient load, job environment, constant distractions, responsibility, conflicting priorities, and intensity of care, adjusting to chronic illness, difficulty paying for treatment.
Maturational factors
- 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.
Sociocultural factors
- 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
Electronic cigarettes or vaping
Advertised as safer than traditional cigarettes but researchers actually know little about the health risks of using these devices.
Addiction
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.
Risk factors for addiction
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.
Marijuana
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.
Tolerance
Using increasing amounts of a substance over time to achieve the same effect and markedly diminished effect occurs with continued use.
Withdrawal
Develops when a substance is discontinued abruptly after frequent, heavy or prolonged use.
Symptoms of withdrawal include..
Anxiety, irritability, restlessness, insomnia, fatigue. The symptoms differ and are specific to each substance (tobacco, cocaine etc)
BAC levels for KY
0.08
Factors associated with college drinking
Impulsive behavior, depression, family history, and prior drinking history.
Individuals who are genetically predisposed to alcoholism are..
At higher risk of developing an alcohol use disorder.
Alcohol Intoxication
No antidote for alcohol is available.
Supportive care measures – the ABCs
Monitor vital signs and level of consciousness frequently
Alcohol Withdrawal Syndrome
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
Alcohol Withdrawal Delirium
Serious complication
Onset 30 – 120 hours after last drink
Can be fatal
Can be prevented or controlled with benzodiazepine administration
Stimulants
Make people more alert, increase attention, and raise blood pressure, heart rate, and breathing.
Stimulants come in a variety of forms, including:
- amphetamines/ methamphetamines- skin sores seen due to imagined insects crawling on skin, meth mouth due to dry mouth and teeth grinding
- cocaine
- caffeine
- nicotine
Nursing care stimulants:
Overdose
Occurs frequently
No antidotes
Death possible
Nursing care stimulants:
Withdrawal
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
Depressants:
Sedative-hypnotics
Barbiturates (phenobarbital) - no known antagonists, dialysis or gastric lavage for overdose
Benzodiazepines (Xanax, Klonopin, Valium), overdose treated with Romazicon (flumazenil)
Barbiturate-like drugs
Depressants:
Opiods
Heroin
Prescription Opioids- Hydrocodone, Oxycodone, Morphine, Codeine
Opioid nursing care- Narcan (naloxone) for overdose, methadone used to decrease symptoms during detox
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”.
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”.
Symptoms of the triad
Pinpoint pupils
Unconsciousness
Respiratory depression
Naloxone can be administered
IV, IM, and Nasal
