Stress Flashcards
What is physiologic homeostasis
Self-regulating mechanisms that occur without conscious thought to defend against change in body’s internal environment:
Primary Control – autonomic nervous system and endocrine system
What is the primary means by which physiologic homeostasis is maintained
Negative-feedback
What is Local Adaptation Syndrome:
a localized response of the body to stress
short-term adaptive response
Involves only a specific body part (such as a tissue or organ)
2 common responses of local adaptation syndrome
Reflex Pain Response
Inflammatory Response
What is Reflex Pain Response
A response of the central nervous system to pain
-rapid and automatic
-protective mechanism to prevent injury
-reflex depends on an intact, functioning neurologic reflex arc that involves both sensory and motor neurons
-e.g. touch something hot with your hand –> info sent to spinal cord via sensory neurons –> an interneuron sends message to motor neuron –> you remove your hand from the heat before your brain gets the message
What is Inflammatory Response
A local response to injury or infection
-serves to localize and prevent the spread of infection and promote wound healing
Symptoms include: pain, swelling, heat, redness, and changes in function
What is General Adaptation Syndrome (GAS)
A biochemical model of stress that describes the body’s general response to stress
- The stress response is physiologic - but it results from either physical or emotional stressors
What are the 3 stages of General Adaptation Syndrome (GAS)
Alarm reaction
Stages of resistance
Stages of exhaustion
What happens during alarm reaction
- Initiated when a person perceives a specific stressor and various defense mechanisms are activated
-Perception of threat may be conscious or unconscious
-The hypothalamic-pituitary-adrenal axis controls the neuroendocrine response
hormone and catecholamine levels rise to prepare body to react
What is Phase 1 of the alarm reaction
Shock phase
sympathetic nervous system initiates the fight-or-flight response
characterized by an increase in energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness
What is phase 2 of the alarm reaction
Countershock phase
the reversal of body changes
What happens during Stages of Resistance
Body now attempts to adapt to the stressor after having perceived the threat and mobilized its resources
Vital signs, hormone levels, and energy production return to normal
Body regains homeostasis if stress can be managed or confined to small area (LAS)
Adaptive mechanisms become exhausted if stressor is prolonged or strong enough to overwhelm the body’s ability to defend itself
What happens during the Stage of Exhaustion
Results when the adaptive mechanisms can no longer provide defense
Depletion of resources that results in damage to the body in the form of wear and tear or systemic damage
Without defense against the stressor, the body may either:
- rest and mobilize its defenses to return to normal
- reach total exhaustion and die
What is Psychological Homeostasis
When safety, love and belonging, or self-esteem needs are not met, homeostatic measures in the form of coping or defense mechanisms help return person to emotional balance
Being able to maintain psychological homeostasis depends on what
person’s age, developmental level, past experiences, support systems, and coping mechanisms
Adaptive responses to psychological stressors include what
mind-body interaction
anxiety
coping or defense mechanisms
What are coping mechanisms
Behaviors used to decrease stress and anxiety
behaviors are learned, based on a person’s family, past experiences, and sociocultural influences and expectations
moderate, severe, and panic levels of anxiety are greater threats
- involve more complex coping mechanisms
Task oriented reactions
Attack behavior
Withdrawal behavior
Compromise behavior
What are typical coping behaviors
crying, laughing, sleeping, cursing
physical activity, exercise
smoking, drinking
lack of eye contact, withdrawal
limiting relationships to those with similar values and interests
What are task oriented reactions
a coping mechanism that involve consciously thinking about the stress situation and then acting to solve problems, resolve conflicts, or satisfy needs
-often used at higher levels of anxiety
What is attack behavior
coping mechanism that occurs when a person attempts to overcome obstacles to satisfy a need
-may be constructive, with a certain problem solving
-may be destructive, with feelings and actions of aggression and hostility
What is withdrawal behavior
a coping mechanism that Involves physical withdrawal from the threat, horrible social reactions such as admitting defeat, becoming apathetic, or feeling guilty and isolated
What is compromise behavior
a coping mechanism that is usually constructive, often involving the substitution of goals or negotiation to partially fulfill needs
What are defense mechanisms
unconscious reaction to stressors that protect a person self-esteem
usually in mild to moderate anxiety
when extreme, they distort reality and create problems within relationships
-mechanism becomes maladaptive instead of adaptive
What is stress
A condition in which the human system responds to changes in its normal balanced state
- results from a change in a person’s internal or external environment that is perceived as a challenge, a threat, or a danger
How do stressors vary
from person to person
from one time to another in the same person
by persons culture, family, genetic inheritance, and life experiences
What is a stressor
anything that is perceived as challenging, threatening, or demanding that triggers a stress reaction
Can be physiologic or psychological
What is an Internal stressors
illness, hormonal change, fear
What is an External stressors
loud noise, cold temperatures
What are Physiologic Stressors
alteration of normal body structure and function
What are factors of physiologic stressors
Chemical agents (drugs, poisons)
Physical agents (heat, cold, trauma)
Infectious agents (viruses, bacteria)
Nutritional imbalances
Hypoxia
Genetic or immune disorders
What are psychosocial stressors
Environment
Interpersonal relationships
Life events
Accidents
Stressful or traumatic experiences
Horrors of history
Current events of history
Fear of aggression or mutilation
Rapid changes in our world and the way we live
What is adaptation
the change that takes place as a result of the response to a stressor
-ongoing process as a person strives to maintain balance in the internal and external environments
necessary for:
-normal growth and development
-the ability to tolerate changing situations
-the ability to respond to physical and emotional stressors
What are coping responses
Immediate response when a person is in a threatening or otherwise stressful situation
Describe Mind-Body Interaction
It is thought that humans react to threats of danger as if they were physiologic threats
a person perceives a threat on an emotional level –> body prepares itself to either resist the danger or run away from it (fight or flight response)
What are Psychosomatic Disorders
physiologic alterations that are thought to be at least partially caused by psychological influences
e.g. stress related diarrhea, nausea, heart palpitations, etc.
-The number of changes a person has in life (both positive and negative) can be correlated with illness
What is fear
a feeling of dread in response to a known threat
What is anxiety
A vague, and easy feeling of discomfort or dread, the source of which is often unknown or nonspecific
-most common human response to stress
-feeling of apprehension caused by anticipating a perceived danger
-A sign that alerts you to impeding danger and enables you to take measures to manage a threat
4 levels of anxiety
mild
moderate
severe
panic
What is mild anxiety
-present in day-to-day living
-increases alertness and perceptual fields (vision and hearing)
-motivates learning and growth
-facilitates problem solving
-manifested by restlessness and increased questioning
-may interfere with sleep
What is moderate anxiety
-narrows a person’s perceptual field so focuses on immediate concerns
-inattention to other communications and details
-manifested by quavering voice, tremors, increased muscle tension, a complaint of “butterflies in the stomach”, and slight increases in respirations and pulse
What is severe anxiety
creates a very narrow focus on specific details
all behaviors to be geared toward getting relief
impaired learning ability and easily distracted
-characterized by extreme fear of a danger that is not real, by emotional distress that interferes with everyday life, and by avoiding situations that cause anxiety
-manifested by difficulty communicating verbally, increased motor activity, a fearful facial expression , headache, nausea, dizziness, tachycardia, and hyperventilation
anxiety is no longer functioning as a signal for danger or motivation for a needed change
-instead results in maladaptive behaviors and emotional disability that signal presence of anxiety disorder
What is panic
-causes person to lose control and experience dread and terror
-disorganized state characterized by increased physical activity, distorted perceptions of events, and loss of rational thought
-person is unable to learn, concentrates only on the present situation, and often experiences feelings of impending doom
-manifested by difficulty communicating verbally, agitation, trembling, poor motor control, sensory changes, sweating, tachycardia, hyperventilation, dyspnea, palpitations, a choking sensation, is sensation of chest pain or pressure
-this level of anxiety can lead to exhaustion and death
What are anxiety disorders
A group of conditions where excessive anxiety is the key feature
High levels of chronic stress are associated with multiple health disorders, such as:
alcoholism
drug abuse
depression
suicide
accidents
eating disorders
What is Caregiver Burden
Stress response from caring for a family member at home for long periods causing prolonged stress
What is developmental stress
Occurs as a person progresses through the normal stages of growth and development from birth to old age
Examples of stages of growth and development include:
the infant learning to trust others
the toddler learning to control elimination
the school aged child socializing with peers
the outer lesson striving for independence
the middle-aged adult accepting physical signs of aging
the older adult reflecting on past life experiences with satisfaction
What is situational stress
can occur at any time, although the person ability to adapt may be strongly influenced by his or her developmental level
Examples of situational stress
illness or traumatic injury
marriage or divorce
loss (of belongings, relationships, family members)
new job
role change
Stressors in nursingNursing
-assuming responsibilities for which you are not prepared
working with unqualified personnel
-working in an environment in which supervisors and administrators are not supportive
-experiencing conflict with appear
-caring for a patient who is suffering, and caring for the patient’s family
-caring for a patient during a cardiac arrest or for a patient who is dying
-providing care to a patient who is disengaged, non adherent, or lacks the resources to participate in his or her care
-moral distress – knowing the correct, right, or ethical course of action in a situation, but being in able to take that action
What is Allostasis
describes the process of achieving stability or homeostasis through physiologic or behavioral change
Allostatic Load
the cumulative negative effects of these physical responses to prolonged environmental and psychosocial stressors
Burnout
becoming overwhelmed and developing symptoms of stress
can be compared with the exhaustion phase of anxiety
Crisis
A disturbance caused by a precipitating event, such as a perceived loss, a threat of loss, or a challenge, that is perceived as a threat to self
Maturational Crisis
Occurred during developmental events that require role change
e.g. when a teenager transitions into adulthood
Situational Crisis
Occur when a life event disrupts a person’s psychological equilibrium
e.g. job loss, death of a loved family member
Adventitious Crisis
include accidental and unexpected events resulting in multiple losses, and major environmental changes that involved not only individuals but also entire communities
Eustress
term used for short-term stress that promotes positive emotional, intellectual, and physiologic adaptation and development
Fight or Flight Response
activated during the alarm reaction of GAS; characterized by an increase in energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness
General Adaption Syndrome (GAS)
A biochemical model of stress that describes the body’s general response to stress
Physiologic response to stress but results from either physical or emotional stressors
Commonly occurring defense mechanisms:
Compensation
Denial
Displacement
Dissociation
Introjection
Projection
Rationalization
Reaction formation
Regression
Repression
Sublimation
Undoing
Compensation
A person attempts to overcome a perceived weakness by emphasizing a more desirable trade or over achieving any more comfortable area
Ex: a student who has difficulty with academics may excel in sports
Denial
a person refuses to acknowledge the presence of a condition that is disturbing
Ex: despite finding a lump in her breast, a woman does not seek medical treatment
Displacement
a person transfers (displaces) an emotional reaction from one object or person to another object or person
Ex: an employee who is angry with a coworker kicks a chair
Dissociation
a person subconsciously protects him or herself from the memories of a horrific or painful event by allowing the mind to forget the incident
Ex: an adult can not recall childhood memory surrounding the traumatic death of a sibling
Introjection
a person incorporates qualities or values of another person it’s his or her ego structure – this mechanism is important in the formation of conscience during childhood
Ex: an older sibling tells his preschool sister not to talk to strangers, expressing his parents values to his younger sister
Projection
a person attributes thoughts or impulses to someone else
Ex: a person who denies any sexual feelings for a coworker accuses him of sexual harassment
Rationalization
a person tries to give a logically or socially acceptable explanation for questionable behavior (“behavior justification”)
Ex: a patient who forgot to keep a health care appointments says “if patients didn’t have to wait three months to get an appointment, they wouldn’t forget them”
Reaction formation
a person develops conscious attitudes and behavior patterns that are opposite to what he or she would really like to do
Ex: a married woman is attracted to her husband’s best friend but is constantly rude to him
Regression
a person returns to an earlier method of behaving
Ex: children often regress to soiling diapers or demanding a bottle when they are ill
Repression
a person voluntarily excludes and anxiety-producing event from conscious awareness
Ex: a father may not remember shaking his crying baby
Sublimation
a person substitutes a socially acceptable role for one who’s normal channel of expressionist blocked
Ex: a person who is aggressive towards others may become a star football player
Undoing
a person uses an act or communication to negate a previous act or communication
ex: a husband who was physically abusive to his wife may bring her an expensive present the next day
