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Nursing 2100H > Stress > Flashcards

Stress Flashcards

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1
Q

Stress is…

A

◆ Normal and useful, often perceived as negative but can be positive
–> Appraisal (assessment) of Stressors
◆ If it becomes excessive during early life can profoundly affect lifelong functioning
◆ Stress has long been associated with the development or exacerbation of symptoms of mental illness

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2
Q

What are the 2 stress response factors?

A

person/relationship to the environment & appraisal

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3
Q

What are the two Antecedents to Stress?

A
  • -> a.k.a. precursors to stress
    1. Person-Environment Relationship
    2. Interaction with Environment
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4
Q

Antecedents to Stress: Person-Environment Relationship

A
  • Beliefs, values, goals & commitment

* Personality and behavior patterns

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5
Q

Antecedents to Stress: Interaction with Environment

A
  • Social networks (closeness, give & take)
  • Social support (emotional, resources, information)
  • Demands and constraints (physical environmental demands, beliefs & resources)
  • Sociocultural factors (employment, gender roles)
  • Life events
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6
Q

What are the three types of Appraisal?

A

◆ Cognitive appraisal: increased commitment to a goal that is being threatened means increased stress
–> ex. wanting to be a nurse but unable to vs. NOT wanting to be a nurse and unable to

◆ Primary appraisal: the person evaluates the events as a threat, harm, or challenge

◆ Secondary appraisal: the person explains the outcome of events
–> figure out it isn’t dangerous

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7
Q

Coping

A

a deliberate, planned, and psychological activity; it may inhibit or override the innate urge to act

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8
Q

What are the two types of coping?

A
  1. Problem-focused: attacks the source of the stress and solves the problem
    - -> make changes to affect outcome
  2. Emotion-focused: reinterpreting the situation to change the meaning
    - ->change importance of stressor, may not change outcome
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9
Q

Adaptation

A

capacity to survive and flourish, affects
• Health and illness
• Psychological well-being
• Social functioning

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10
Q

Allostasis

A

regulating process maintaining homeostasis through adaptation achieved through autonomic nervous system

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11
Q

Allostatic Load

A

High load = increase in biological parameters (lab, BP etc), consequence of wear & tear on body & brain leading to ill health
–>figure page 272

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12
Q

Life Change Units

A 
◆  Holmes & Rahe- research on changes within 12 months- frequent examples below (see page 270)
◆  Change in work hours or conditions 30
◆  Change in residence 33
◆  Begin or end school 32
◆  Vacation 29
◆  Change eating habits 29
◆  Change school 28
◆  Christmas 26
◆  Total above = 207

250-400 LCU/yr = minor illness
Over 400 = major illness

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13
Q

Physical Response to Stress

A

◆ General Adaptation Syndrome (GAS) (Hans Selye)
1. Alarm stage

  1. Resistance stage
  2. Exhaustion stage
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14
Q

GAS: Alarm Stage

A

– Threat is perceived
– Prepares a person for “fight or flight”
– Endocrine and immune systems respond creating physical and mental alertness

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15
Q

GAS: Resistance Stage

A

– Threat continues, attempts are made to adapt

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16
Q

GAS: Exhaustion Stage

A

– If threat continues, adaptive hormones are depleted and body succumbs to illness (high allostatic load, ex abuse, lead poisioning)

17
Q

Hypothalmic/Pituitary/Adrenal

A

◆ Sympathetic nervous system activates the HPA axis
• Hypothalamus secretes corticotropin-releasing hormone
• Pituitary increases adrenocorticotropic hormone (corticotropin) which stimulates adrenocortical stimulation of cortisol
Immune response to increased cortisol-initially adaptive but over time depresses immune system
Continuous activation of the sympathetic nervous system leads to problems in memory, immunity, cardiovascular & metabolic function.

18
Q

Stress Physiological Response (Sympathetic)

A
  • release of epinephrine
    • Respirations deepen, shortness of breath
    • Rapid heart rate & increased BP
    • Blood glucose level rises, hyper-reflexia
    • Immune response to increased cortisol
19
Q

Stress Physiological Response (Parasympathetic)

A

– rare opposite
• Pulse & BP decrease, shallow breathing
• Hyperventilate, feel faint, dizzy
• Decreased digestion, nausea, heartburn, diarrhea, need to urinate

20
Q

Hildegard Peplau RN Levels of Anxiety: Mild

A

Mild (day-to-day tensions)
◆ Alertness, minimal distortion, restless, irritable
◆ Motivates learning, produces growth, creativity

21
Q

Hildegard Peplau RN Levels of Anxiety: Moderate

A

Moderate (selective inattention)
◆ Reduced ability to see & hear, grasps less information
◆ Notices physical discomfort

22
Q

Hildegard Peplau RN Levels of Anxiety: Severe

A

Severe (focuses on specific details)

◆ Focus on relieving physical and emotional discomfort,

23
Q

Hildegard Peplau RN Levels of Anxiety: Panic

A

Panic (loss of control)

◆ perceptions blown out of proportion, awe, dread, terror

24
Q

Goals for those with acute stress responses:

A
  • Change the stressful person– environment situations (when possible)
  • Reduce the stress response
  • Develop positive coping skills
25
Q

Goals for those who are at high risk for stress:

A
  • Recognize the potential for stressful situations

* Strengthen positive coping skills

26
Q

Nursing Management: Assessment

A 
◆  Review of body systems 
◆  Physical functioning 
◆  Pharmacological
◆  Coping strategies
◆  Severity of emotions 
◆  Recent life changes 
◆  Social network
27
Q

Nursing Management: Diagnosis

A 
◆  Imbalanced nutrition
◆  Ineffective coping
◆  Powerlessness
◆  Ineffective role performance
◆  Ineffective parenting
◆  Disabled family coping
28
Q

Nursing Interventions

A 
◆  Relaxation
◆  Imagery
◆  Positive self talk
◆  Request support
◆  Humor
◆  Spirituality
◆  Problem solving strategies
◆  Nutrition, exercise
◆  Support family functioning
◆  Assist to expand social network
◆  Patient and family education
29
Q

Outcomes of Stress Intervention

A

◆ Individual, family & network- Improved health, well-being & social functioning
◆ Family- Improved communication or social support
◆ Social network- Modification to improve support

Nursing 2100H (28 decks)

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