Stress

Question 1

Neuman’s System Model (NSM)

Nursing Theorist Betty Neuman

Answer 1

clients can maintain stability (system stability) if stressors do not exceed the client’s available resources

Question 2

Client resources include (5)

Answer 2

• their healthy body temperature
• stressor response patterns
• physical health
• mental health and emotional characteristics
• genetic makeup

Question 3

A stressor

Answer 3

Any situation that is out of the ordinary

Question 4

Positive effect of stress

Answer 4

Stress in small amounts can be beneficial and heighten a person’s awareness and response

Question 5

Negative effect of stress

Answer 5

Too much stress can cause poor concentration and become detrimental

Question 6

(T or F) When the body responds to stress, it can distinguish between good or bad stress

Answer 6

False

Question 7

Stress response

Answer 7

the way our bodies respond to physically or emotionally to a stressor

Question 8

Physiological Stress

Answer 8

➢affect the body’s structure and function

➢such as diseases, mobility problems

Question 9

Psychological Stress

Answer 9

arise from life events

➢associated with work, personal realtionship/s

Question 10

Situational Stress

Answer 10

random and unpredictable

➢examples include hurricanes, accidents

Question 11

Eustress

Answer 11

beneficial or good stress

➢produces motivating and focused energy

Question 12

Developmental Stress

Answer 12

associated with different stages of life

➢peer pressure, college graduation

Question 13

Distress

Answer 13

can be a threat to health status

•financial worries, Covid pandemic

Question 14

Time related Stress

Answer 14

➢inability to meet demands

➢multiple demands, rushing to appointments

Question 15

Anticipatory Stress

Answer 15

related to upcoming or future event

➢exams, work deadlines

Question 16

Selye’s Stress Response

Answer 16

Characterized by a series of psychological events called the General Adaptation Syndrome (GAS)

Question 17

General Adaptation Syndrome (GAS)

Answer 17

Occurs when certain adaptive hormones are released and cause changes in the structure and chemical composition of the body

Question 18

Alarm Reaction: Alarm phase

Shock & Countershock

Answer 18

Stress stimulates the sympathetic nervous system (SNS)​

Question 19

Alarm phase

Answer 19

SNS- stimulates the hypothalamus​
Hypothalmus – releases corticotropin releasing hormone (CRH)​
CRH- stimulates the anterior pituitary gland to release adrenocorticotropic hormone (ACTH)​
ACTH-stimulates the adrenal cortex to secrete glucocorticoids (cortisol) and mineralocorticoids (aldosterone)

Question 20

Alert phase continued

SNS system

Answer 20

Cortisol- Glucose sparing effect and anti-inflammatory effect​

Aldosterone- promotes fluid retention which increases the BP​

Endorphins- released by the hypothalamus produces a sense of well being ​

Thyroid-Stimulating hormone (TSH)- secreted by the pituitary gland and helps with fat conversion to energy

Question 21

Alert phase x3

More SNS symptoms

Answer 21

Short term effects​
Cardiac: increase HR, Peripheral vasoconstriction- blood flow is diverted to vital organs​

Respiratory : Increase depth of respirations and tidal volume​

Metabolic: Increased glycogen conversion to glucose- more available for energy consumption​

Urinary: Decreased blood flow to the kidneys- sodium and water retention. Secretion of renin causing increased BP​

Musculoskeletal: increased blood flow to the skeletal muscles

Question 22

Resistance phase

Body trying to counteract what happened in alarm phase

Answer 22

Controlled by the ANS

Parasympathetic

Question 23

Resistance ANS effects

Answer 23

Body attempts to return to normal by reducing the amount of cortisol produced.

The heart rate and blood pressure begin to return to normal.

Question 24

Stressful situation comes to an end

Answer 24

the body will then return to normal

Question 25

Stressor remains

Answer 25

The body will stay in a state of alert, and stress hormones continue to be produced

Question 26

Final stage of GAS after an extended period of stress

Answer 26

Exhaustion

Question 27

A person’s body is no longer equipped to fight stress. | They may experience:

Answer 27

* tiredness * depression * anxiety * feeling unable to cope

Question 28

If a person does not find ways to manage stress levels at this stage, they are at risk of

Answer 28

developing stress-related health conditions

Question 29

Both Gas & Las have 3 stages:

Answer 29

- alarm - resistance - exhaustion

Question 30

Local Adaptation Syndrome (LAS)

Answer 30

Local reaction where only one organ or body part reacts is affected

Question 31

Las responses:

Answer 31

Reflex pain response | inflammatory response

Question 32

Compensation

Answer 32

* Occurs during the Alarm phase * Fight or Flight * Stimulation of the Sympathetic Nervous System (SNS)

Question 33

Adaptation

Answer 33

●Occurs during the Resistance phase ●Return to normal ●Stimulation of the Parasympathetic Nervous System ●Body still on alert

Question 34

Monitors the body's physiology, assesses for alteration from normal and counteracts any changes to reverse the situation and return to normal

Answer 34

Negative Feedback system

Question 35

Maintains homeostasis

Answer 35

Negative Feedback System

Question 36

Intensifies a change in the body's physiological condition instead of reversing it.

Answer 36

Positive Feedback System

Question 37

Normal response when there is a definite end piont

Answer 37

Positive Feedback system

Question 38

Stress Management Strategies

Answer 38

``` ●Exercise ●Communicate/ Share feelings ●Relaxation techniques ●Guided Imagery ●Meditation/ Prayer ●Healthy lifestyle ●Involve in enjoyable activities, laugh, a sense of humor ●Counseling ```

Question 39

Nursing Management

Answer 39

●Patient’s stressors: actual or perceived ●Assess personal meaning of stressor/s ●Assess physiological manifestations ●Assess coping strategies, Support system/s

Question 40

Nursing Diagnosis

Answer 40

●Anxiety ●Ineffective coping ●Stress overload

Question 41

Medication management of anxiety, hormonal imbalances

Answer 41

Pharmacological

Question 42

Diet Modification (avoid stimulants), exercise, outdoor activities.

Answer 42

Nutritional and Lifestyle

Question 43

Physical Therapy (for pain management).

Answer 43

Symptomatic treatments

Question 44

Surgical management (e.g., thyroid mass), antibiotic treatment for infection

Answer 44

Disease specific treatments

Question 45

Disease specific treatments

Answer 45

Other plan of care

Question 46

Medical evaluation of disease | Providers plan:

Answer 46

- Medical history - Physical examination - Laboratory and Diagnostic Studies - CBC, Chemistry, Thyroid studies (TSH) - Ultrasound/ Sonogram, CT Scan.