Stress Flashcards
Neuman’s System Model (NSM)
Nursing Theorist Betty Neuman
clients can maintain stability (system stability) if stressors do not exceed the client’s available resources
Client resources include (5)
- their healthy body temperature
- stressor response patterns
- physical health
- mental health and emotional characteristics
- genetic makeup
A stressor
Any situation that is out of the ordinary
Positive effect of stress
Stress in small amounts can be beneficial and heighten a person’s awareness and response
Negative effect of stress
Too much stress can cause poor concentration and become detrimental
(T or F) When the body responds to stress, it can distinguish between good or bad stress
False
Stress response
the way our bodies respond to physically or emotionally to a stressor
Physiological Stress
➢affect the body’s structure and function
➢such as diseases, mobility problems
Psychological Stress
arise from life events
➢associated with work, personal realtionship/s
Situational Stress
random and unpredictable
➢examples include hurricanes, accidents
Eustress
beneficial or good stress
➢produces motivating and focused energy
Developmental Stress
associated with different stages of life
➢peer pressure, college graduation
Distress
can be a threat to health status
•financial worries, Covid pandemic
Time related Stress
➢inability to meet demands
➢multiple demands, rushing to appointments
Anticipatory Stress
related to upcoming or future event
➢exams, work deadlines
Selye’s Stress Response
Characterized by a series of psychological events called the General Adaptation Syndrome (GAS)
General Adaptation Syndrome (GAS)
Occurs when certain adaptive hormones are released and cause changes in the structure and chemical composition of the body
Alarm Reaction: Alarm phase
Shock & Countershock
Stress stimulates the sympathetic nervous system (SNS)
Alarm phase
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)
Alert phase continued
SNS system
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
Alert phase x3
More SNS symptoms
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
Resistance phase
Body trying to counteract what happened in alarm phase
Controlled by the ANS
Parasympathetic
Resistance ANS effects
Body attempts to return to normal by reducing the amount of cortisol produced.
The heart rate and blood pressure begin to return to normal.
Stressful situation comes to an end
the body will then return to normal
Stressor remains
The body will stay in a state of alert, and stress hormones continue to be produced
Final stage of GAS after an extended period of stress
Exhaustion
A person’s body is no longer equipped to fight stress.
They may experience:
- tiredness
- depression
- anxiety
- feeling unable to cope
If a person does not find ways to manage stress levels at this stage, they are at risk of
developing stress-related health conditions
Both Gas & Las have 3 stages:
- alarm
- resistance
- exhaustion
Local Adaptation Syndrome (LAS)
Local reaction where only one organ or body part reacts is affected
Las responses:
Reflex pain response
inflammatory response
Compensation
- Occurs during the Alarm phase
- Fight or Flight
- Stimulation of the Sympathetic Nervous System (SNS)
Adaptation
●Occurs during the Resistance phase
●Return to normal
●Stimulation of the Parasympathetic Nervous System
●Body still on alert
Monitors the body’s physiology, assesses for alteration from normal and counteracts any changes to reverse the situation and return to normal
Negative Feedback system
Maintains homeostasis
Negative Feedback System
Intensifies a change in the body’s physiological condition instead of reversing it.
Positive Feedback System
Normal response when there is a definite end piont
Positive Feedback system
Stress Management Strategies
●Exercise ●Communicate/ Share feelings ●Relaxation techniques ●Guided Imagery ●Meditation/ Prayer ●Healthy lifestyle ●Involve in enjoyable activities, laugh, a sense of humor ●Counseling
Nursing Management
●Patient’s stressors: actual or perceived
●Assess personal meaning of stressor/s
●Assess physiological manifestations
●Assess coping strategies, Support system/s
Nursing Diagnosis
●Anxiety
●Ineffective coping
●Stress overload
Medication management of anxiety, hormonal imbalances
Pharmacological
Diet Modification (avoid stimulants), exercise, outdoor activities.
Nutritional and Lifestyle
Physical Therapy (for pain management).
Symptomatic treatments
Surgical management (e.g., thyroid mass), antibiotic treatment for infection
Disease specific treatments
Disease specific treatments
Other plan of care
Medical evaluation of disease
Providers plan:
- Medical history
- Physical examination
- Laboratory and Diagnostic Studies
- CBC, Chemistry, Thyroid studies (TSH)
- Ultrasound/ Sonogram, CT Scan.
