Stress and Adaptation (Final) Flashcards
Stressors
a challenge that the person perceives as a challenge, physical, or emotional threat
internal or external
developmental or situational
physiological
psychological
Epinephrine (Alarm/Shock Phase)
tachycardia
higher myocardial contractility
bronchial dilation
blood clotting
higher metabolism
fight or flight
Norepinephrine (Alarm/Shock Phase)
decreased blood to kidney
higher renin
Cortisone (Alarm/Shock Phase)
protein
catabolism
gluconeogenesis
Counter shock Phase
resistance…adaptation (recovery) OR stage of exhaustion (*body can no longer compensate, recurs)
failure to adapt leads to increased pain, decreased wound healing
Increased Sympathetic Activity
increased heart rate and stroke of volume of heart contraction
increased cardiac output
constriction of vessels in blood reservoirs
increased systolic BP, increased blood circulation, blood redistributed from less to more active organs
dilation of vessels in skeletal muscles
decreased secretion by digestive glands, decreased peristalsis, decreased digestion
rapid marked increase of adrenal medulla secretion, increased epinephrine in blood
increased liver glycogenolysis, increased blood glucose
Cellular Injury
hypoxia
nutritional imbalance
temp extremes
radiation and electrical shock
mechanical trauma
chemical and infectious agents
Inflammatory Response
vascular response
cellular response
exudate formation
healing
Cardiovascular
particular vulnerable
several disorders
MI
strokes
BP
GI
disrupt system
irritate large intestine
exacerbate conditions
Immune
slower wound healing
increased susceptibility
impair response to immunizations
Endocrine
insulin resistance (diabetes)
hinders GH (insulin like growth factor)
Reproductive
inhibits gonadotropin-releasing hormone
directs reproduction and sexual behavior
Cancer
no evidence that stress causes cancer, may affect outcomes of patients with certain cancers
Pain
may intensify chronic pain, tension HA, migraines
Eating Problems
varying effects
calorie rich foods
cortisol promotes abdominal fat
stress cascades causes hunger
Sleep Disturbances
insomnia
Memory, Learning, Concentration
distraction, disorganization
working memory decline
Failure to Adapt (Somatoform Disorders)
hypochondriasis
somatization
pain disorder
malingering
Coping Strategies Affected by…
cultural background
workplace culture
acculturative stress
Stress
any disturbance in a persons normal balanced state
Internal Stressors
physical diseases, anxiety, anticipation
External stressors
DEATH!!!
natural disaster, heat
Alarm Phase
stressor causing stimulation of sympathetic nervous system (fight or flight)
Resistance Stage
coping with stressors; either they cope or symptoms get worse (parasympathetic)
Physiological Responses
dilated pupils
dry mouth
elevated BP, HR, RR, blood glucose (elevated glucose r/t stress impacts wound healing!)
nausea
bowel changes
chest pain
sleep pattern changes (insomnia)
Emotional Responses
anxiety
anger
lethargy
Behavioral Responses
crying
poor job performance
substance abuse
Ways to decrease patient anxiety and stress
- establish trusting relationship
- tell pt what to expect (fear potentiates pain and may make it worse, causing stress)
- teach deep breathing
- PCC
- involve pts and their families in care
Failure to adapt to stress
- elevation of hormones (cortisol, ADH, aldosterone)
- create additional stress on body
- diseases (HTN, diabetes, infection/inflammation, IBS, tension HAs)
- BURNOUT IN NURSES
