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exam 3 > Stress and Coping EVOLVE > Flashcards

Stress and Coping EVOLVE Flashcards

1
Q

stress response can directly cause damage to

A

body tissues

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2
Q

stress can damage tissue by

A

increasing heart rate and blood pressure and causing the release of powerful stress hormones

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3
Q

third form of stress, sociocultural stress, occurs when

A

social systems are challenged by factors such as racism, economic hardship, or political upheaval

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4
Q

Stress is

A

autonomic psychological or emotional response to an internal or external environmental challenge, which is automatic and typically beyond a person’s resources or ability to respond

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5
Q

Bystritsky & Kronemyer definiton of stress

A

nonspecific response of the body to any demand made upon it.

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6
Q

A stressor is

A

an event or stimulus that disrupts the person’s sense of equilibrium

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7
Q

Stress appraisal is

A

process by which the person interprets a stressor as either a threat or a challenge

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8
Q

People react to stress in different ways
true or false

A

true

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9
Q

The way a person responds to stress determines

A

its impact on the person’s attitude and physiologic response

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10
Q

Stress also may trigger

A

inflammatory bowel disease
cardiovascular disease
chronic pain
autoimmune diseases such as rheumatoid arthritis

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11
Q

In Roy’s theory, people adapt to stress by

A

meeting their physiologic needs
developing a positive identity
performing social role functions
balancing dependence and independence

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12
Q

Stressors disrupt the person’s

A

equilibrium resulting in illness

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13
Q

homeostasis is

A

the body’s regulation of systems to maintain a steady state

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14
Q

fight-or-flight response is activated by

A

excitement or threat

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15
Q

fight-or-flight activates

A

autonomic nervous system

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16
Q

auntonomic nervous system activation result in

A

increase in heart rate, blood pressure, and respirations along with pupil dilation and a decrease in gastric motility and blood flow to the skin

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17
Q

When experiencing the fight-or-flight response, people report

A

rapid heartbeats
palpitations
nausea
anxious feelings.

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18
Q

general adaptation syndrome (GAS) is

A

body responds in the same way to any demand, whether it is physical, emotional, pleasant, or unpleasant

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19
Q

GAS is evoked when

A

the stimulation or stressor is strong enough to activate the autonomic nervous branch of the central nervous system, eliciting an adaptive response

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20
Q

distress is

A

negative stress

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21
Q

eustress is

A

positive stress

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22
Q

GAS consists of three stages:

A

alarm reaction
resistance
exhaustion

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23
Q

Most stressful events involve

A

only the first two stages

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24
Q

when is third stage of stress activatied

A

ongoing demands can exceed the body’s resources and lead to the final stage of exhaustion

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25
Q

when is the alarm stage activated?

A

when homeostasis is threatend

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26
Q

In the alarm stage, the following are activated

A

hypothalamic
pituitary
adrenal
autonomic nervous systems

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27
Q

In the resistance stage the body

A

attempts to adapt to the stressor

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28
Q

some of the initial responses are lessened as

A

the parasympathetic nervous system reverses the sympathetic stimulation and stabilization occurs

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29
Q

When resources are depleted and the body is unable to continue the efforts of adaptation, the body

A

cannot maintain physical function and death may result at a cellular or systemic level

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30
Q

what can stop the body from dying at the last stage

A

medication, nutritional support, or other therapies

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31
Q

tissues of the body more directly affected by stress demonstrate

A

local adaptation syndrome (LAS),

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32
Q

local adaptation syndrome (LAS) is felt as

A

inflammation, reflexive response to pain, or hypoxia secondary to catecholamine release

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33
Q

Hypoxia can negatively affect

A

wound healing as well as the ability to think clearly at times of severe anxiety

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34
Q

GAS and LAS are closely related, but the effects of LAS are most notably manifested by

A

activities in the immune system.

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35
Q

allostasis is

A

alternate term for the stress response

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36
Q

allostasis is

A

how homeostasis is reestablished

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37
Q

the purpose of allostasis

A

is to assist the body in maintaining stability

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38
Q

Chronic high levels of stress can

A

produce atrophic changes in the brain

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39
Q

Richard Lazarus and his colleagues developed a theory of

A

cognitive mediation within emotion

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40
Q

appraisal is

A

unconscious assessment of a demand or stressor

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41
Q

appraisal occurs in how many stages

A

two stages

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42
Q

first stage of appraisal

A

The person measures what is at stake in the stressful encounter

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43
Q

first stage of appraisal factors

A

immediacy of the threat and the degree of ambiguity

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44
Q

second stage of appraisal

A

coping options are evaluated

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45
Q

Primary and secondary appraisals determine whether

A

the stressful situation or transaction is a threat or a challenge

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46
Q

A threat invokes the possibility of

A

harm or loss

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47
Q

challenge holds the possibility of

A

benefit

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48
Q

Current related research is focused on

A

the concepts of conscientiousness and responsibility

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49
Q

sense of coherence (SOC) is

A

characteristic of personality that references one’s perception of the world as comprehensible, manageable, and meaningful

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50
Q

Comprehensible means

A

that the demands of the internal and external environments are understandable and predictable

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51
Q

manageable means

A

that the person recognizes resources that are available to meet these demands

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52
Q

meaningful is

A

the person’s interpretation of the demands as worthy of engagement

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53
Q

Coping has been defined as

A

the dynamic cognitive and behavioral efforts to manage demands that are appraised as exceeding immediately available resources

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54
Q

Examples of bad type of coping

A

denial
suppression
excessive use of alcohol and other drugs

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55
Q

Defense mechanisms are

A

predominantly unconscious, protective coping methods that people may apply in response to a perceived threat

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56
Q

Defense Mechanisms

A

Defense Mechanisms

denial

displacement

intellectualization

projection

rationalization

reaction formation

regression

repression

sunlimitation

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57
Q

Compensation is

A

Focusing on strengths rather than perceived weaknesses

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58
Q

Denial is

A

Ignoring aspects of reality that induce anxiety or contribute to a loss of self-esteem

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59
Q

Displacement is

A

Redirecting negative emotions perceived as unacceptable or threatening to a safer focus

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60
Q

Intellectualization is

A

Overthinking a challenging situation or impulse to avoid dealing with the emotions it elicits

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61
Q

Projection is

A

Attributing one’s own motives, values, desires, situational responses, and personality traits to another person

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62
Q

Rationalization is

A

Explaining personal actions in a way that enhances one’s own self-image

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63
Q

Reaction formation is

A

Responding to negative thoughts or feelings by demonstrating opposite emotions and actions

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64
Q

Regression is

A

Reverting to behavior associated with an earlier stage of development when challenged by thoughts and stressors

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65
Q

Repression is

A

Blocking unacceptable thoughts and feelings from consciousness

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66
Q

Sublimation is

A

Channeling unacceptable emotions or impulses into acceptable actions or responses

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67
Q

Problem-focused coping techniques are aimed at

A

altering or removing the stressor

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68
Q

Studies have shown that successful coping usually involves

A

problem-focused and emotion-focused efforts

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69
Q

Coping strategies may be chosen on the basis of

A

personal experience of success with other mechanisms

the degree of threat

availability of social resources

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70
Q

responses to stress may be understood if the three major systems of the body are recognized what are they

A

The nervous, endocrine, and immune functions

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71
Q

physical signs of stress are

A

those of sympathetic nervous system stimulation

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72
Q

The cerebral cortex interprets

A

somatic, auditory, visual, and other sensory input

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73
Q

temporal areas of the cerebral cortex, when stimulated produce

A

a sensation recognized as fear

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74
Q

Corticotropin-releasing hormone (CRH) released by the hypothalamus stimulates the pituitary to release adrenocorticotropic hormone (ACTH)

what are the effects of these hormones

A

increase the heart rate, resulting in increased cardiac output and elevated blood pressure

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75
Q

A consequence of hypothalamic activation is sympathetic stimulation triggers

A

epinephrine and norepinephrine release from the adrenal medulla

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76
Q

The combined effect of epinephrine and norepinephrine is known as

A

sympathoadrenal response

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77
Q

Psychological as well as physiologic stressors can activate the

A

hypothalamic-pituitary-adrenal complex

78
Q

Endorphins are known to act as

A

analgesics, reducing the sensation of pain

79
Q

ACTH stimulates the secretion of

A

corticosteroids and aldosterone

80
Q

Corticosteroids are important in the stress response because

A

they increase serum glucose levels and inhibit the inflammatory response

81
Q

Catecholamines also have an effect on

A

blood vessels

82
Q

Catecholamines protect the muscles and organs by

A

increased clotting time functions that protect circulation to vital organs when blood loss occurs

83
Q

physiologic changes caused by stress

A

age
nutritional status
genetic inheritance

84
Q

Social Readjustment Rating Scale used to identify

A

stressors and estimate a person’s degree of stress

85
Q

Everyday Hassles Scale is

A

a stress scale

86
Q

Perceived Stress Scale (PSS)-14 is

A

a stress scale

87
Q

Most stress assessment tools are limited due to

A

insensitivity to age, gender, or sociocultural differences

88
Q

Resilience is

A

the ability to adapt and persevere in adverse or challenging situations

89
Q

Resilient people ____ but do not _____ under stress and use a variety of coping strategies

A

bend, break

90
Q

characteristics of resilient people include

A

moral compass
altruism
realistic optimism
social connectedness
commitment to a meaningful cause
belief in something greater than the individual
cognitive and emotional flexibility

91
Q

Coping style refers to a

A

pattern of measures taken to relieve stress

92
Q

Effective coping is validated when

A

adaptive mechanisms maintain stress within manageable limits

enhance physical recovery

and preserve psychological well-being

93
Q

How well each person copes will vary and may be influenced by

A

number of and intensity of stressors

the duration of exposure

past experiences

personality factors

availability of resources.

94
Q

Anxiety is

A

response to stress that causes apprehension or uncertainty

95
Q

Anxiety may manifest as

A

vague nervousness or as a feeling of dread

96
Q

Mild anxiety can be

A

motivational, foster creativity, and actually increase the ability to think clearly

97
Q

Moderate anxiety

A

narrows focus, dulls perception, and may challenge the person to pay attention or use appropriate problem-solving skills

98
Q

what are the normal types of anxity

A

mild and moderate anxiety are considered normal

99
Q

Severe anxiety results in

A

inability to make decisions or solve problems

100
Q

panic is

A

the highest level of anxiety

101
Q

panic is associated with

A

multitude of physiologic changes as well as subjective feelings of extreme dread or terror

102
Q

Panic causes the affected person to become

A

immobilized—unable to concentrate, communicate, or think in a rational manner

103
Q

Panic attacks may be manifested as physical signs—such as

A

diaphoresis, chest pain, difficulty breathing, and palpitations

104
Q

Many types of anxiety are recognized, including

A

generalized anxiety disorder (GAD)
social anxiety disorder
obsessive-compulsive disorder
posttraumatic stress disorder (PTSD)

105
Q

GAD is characterized by

A

unrealistic levels of worry and tension with or without an identifiable cause

106
Q

Social anxiety involves

A

fear of being judged by others and overwhelming self-consciousness in social situations

107
Q

Obsessive-compulsive disorder can

A

be immobilizing or interfere with daily activities by causing the affected person to repeat ritualistic behaviors in an effort to avert unrealistic concerns about harm

108
Q

PTSD is

A

very serious mental health condition characterized by flashbacks and erratic behaviors that results from exposure to a horrifying experience

109
Q

PTSD may develop when

A

person’s ability to cope is exceeded by the trauma that was experienced

110
Q

Anger is

A

an emotion that involves antagonism toward another person or situation

111
Q

Unresolved anger may be expressed through

A

violent, abusive behavior

112
Q

chronically suppressed anger may lead to

A

physiologic changes, such as high blood pressure and gastrointestinal upset, or depression

113
Q

Depression sometimes is described as

A

anger turned inward

114
Q

depression results from

A

experience of loss

115
Q

People experiencing depression may feel

A

worthless
guilty
hopeless

116
Q

depressed person may have

A

difficulty getting out of bed
experience insomnia
lack energy for activities of daily living (ADLs)
display a flat affect
act chronically tired or withdrawn
appear disheveled

117
Q

If initial feelings of depression are not addressed what will happen

A

clinical depression may develop leading to suicide attempts or loss of life

118
Q

Prolonged or severe stress can have

A

physical effects on the body

119
Q

when parasympathetic is the primary even it would cause

A

increased gastrointestinal motility and bronchial constriction may occur, resulting in stress-induced conditions such as irritable bowel syndrome or asthma

120
Q

body immune system response could be altered because of

A

stress

121
Q

Stress has accelerated the progression

A

human immunodeficiency virus (HIV) infection toward active acquired immune deficiency syndrome (AIDS)

122
Q

stress has a positive correlation with high viral loads, making

A

highly active antiretroviral therapy (HAART) less effective

123
Q

High stress levels are known to

A

exacerbate multiple sclerosis and other autoimmune diseases

124
Q

The unrelieved exposure to some stress hormones can lead to

A

organ failure

125
Q

standard for laboratory assessment of physiologic stress

A

Measurement of cortisol found in the blood
urine and saliva

126
Q

what hormone rise in males when there physically stressed

A

Testosterone

127
Q

Nonverbal behaviors of stress include

A

irritability, agitation, anxiety, and poor eye contact

128
Q

Stress may be caused by

A

loss of a job
the death of a family member or friend
the diagnosis of an illness
finances
relationships

129
Q

International Classification for Nursing Practice (ICNP) nursing diagnoses for stress and coping include

A

Difficulty Coping
Anxiety
Caregiver Stress

130
Q

Examples of goals that address concerns related to stress and coping are:

A
  • Patient will discuss possible coping strategies with psychiatric counselor.
  • Patient will report increased ability to concentrate on care instructions before discharge.
  • Caregiver will use respite care for his loved one once a week for the next month.
131
Q

Delegation Approaching Stress-Related Concerns Holistically

A
  • A dietitian can be consulted to assess the patient’s nutritional needs and develop a nutritional plan.
  • To identify appropriate services and resources, a social worker is incorporated into the plan of care.
  • Family members and assistive personnel may be involved in care planning to ensure a comprehensive approach.
  • Pastoral care plays a significant role in addressing stress and anxiety issues when the patient has a preferred religion or strong faith background.
  • If coordination of care between multiple health care disciplines is needed, a case manager is used.
  • Patients with mental health issues related to current health problems or with chronic mental health or psychiatric issues need a referral to a psychologist, psychiatrist, or advanced practice psychiatric nurse.
132
Q

Stress management interventions

A

relaxation therapies and
mind-body therapy

133
Q

Integrating relaxation and mind-body techniques into one’s daily routine has been found to

A

decrease pain
decrease blood pressure
increase a sense of well-being
improve quality of life
and increase the sense of coherence

134
Q

Strategies for stress management must focus on the principles of

A

balance,
relaxation
nutrition

135
Q

The attainment of relaxation is accomplished through

A

active and passive activity
exercise
yoga
biofeedback
guided imagery

136
Q

When stress results from overwhelming perceived work and/or personal responsibilities what is a good intervention

A

time management

137
Q

time management interventions include

A

prioritizing tasks
setting goals
increasing concentration skills
decreasing distractions,
avoiding procrastination
setting boundaries
maintaining self-discipline

138
Q

anger management interventions include

A

expressing feelings in a calm and nonconfrontational manner

exercising

identifying potential solutions,

taking a time-out

forgiving

diffusing the situation with humor,

“owning” the negative feelings

doing deep-breathing exercises

139
Q

stress impact on nurtition

A

stress often leads to unhealthy food choices that affect mood and impact a person’s response to inflammation

140
Q

Stress puts people at a greater risk for

A

infection and delayed wound healing

141
Q

Increasing the intake of? can enhance both psychological and physical responses to stress

A

fruit,
vegetables
legumes
fish
poultry
whole grains

142
Q

support group is

A

an effective intervention to reduce stress related to specific life circumstances

143
Q

Complementary therapies frequently are used in

A

conjunction with medical therapies

144
Q

Alternative therapies are used in

A

place of medical treatment

145
Q

Complementary and Alternative Therapies are useful when

A

patients are experiencing physiologic and psychological responses to stress

146
Q

When coping mechanisms are ineffective or nonexistent it could cause

A

stress-related illnesses (such as gastrointestinal problems, pain, and heart disease)

147
Q

Relaxation techniques decrease

A

the physiologic response by decreasing heart rate

respiratory rate

gastrointestinal motility

148
Q

Psychological responses to relaxation techniques include

A

increased sense of well-being and a decrease in depression and anxiety

149
Q

Benefits of mind-body therapies

A

improved sleep
relaxation
decreased pain

150
Q

Relaxation therapy incorporates

A

the use ofnonpharmacologic techniques to reduce psychological or physiologic distress

151
Q

Relaxation therapy do what

A

increases awareness of muscle tension and incorporates interventions to decrease tension

152
Q

Progressive relaxation is implemented by

A

having patients focus on muscles that are tensed and then intentionally relax those muscle groups

153
Q

Exercise has been found to

A

decrease stress level and cortisol levels and increase a sense of well-being in patients of all ages

154
Q

Other benefits of exercise include

A

improved muscle tone

weight management

improvement of cardiovascular and pulmonary functioning

155
Q

Research supports the use of relaxation therapies to treat a variety of conditions, including:

A
  • Anxiety associated with biopsy procedures, dental treatment, cancer, and chronic illnesses, such as heart disease
  • Insomnia
  • Pain during labor and cancer treatment
  • Nausea during chemotherapy treatment
  • Chronic headaches
  • Chronic pain in children and adolescents
  • Anxiety in older adults
156
Q

Disturbances in sleep patterns can lead to

A

irritability
fatigue
depression
tiredness
decreased ability to concentrate
immunosuppression

157
Q

Nurses can implement interventions to facilitate sleep including

A

limiting interruptions during the night and controlling the environment

lighting
noise
room temperature
limiting screen time 2 hours before sleep.

158
Q

Guided imagery focuses on

A

positive external images, such as a patient’s favorite vacation spot, to create a relaxed state

159
Q

Guided imagery is

A

verbal form of instruction by the nurse or another clinician that directs the patient’s attention away from upsetting thoughts

160
Q

Well-conducted guided imagery improves

A

physiologic functions
such as heart rate
respiratory rate
blood pressure
gastrointestinal motility
hormonal levels

161
Q

Guided imagery can be incorporated into care to

A

boost the immune system
decrease pain
develop positive feelings

162
Q

The practice of yoga includes

A

physical exercises, controlled breathing exercise (pranayama), position selection (asanas), and relaxation exercises to strengthen the body, mind, and soul

163
Q

Engaging in yoga benefits

A

increases flexibility
improves endurance
decreases blood pressure
enhances breathing
promotes relaxation
and reduces stress

164
Q

Meditation involves

A

bringing awareness to the body and the mind by directing one’s focus on a specific word, the breath, a sound, or image

165
Q

During meditation, the breath

A

is the focus in order to bring awareness to the mind and body

166
Q

Meditation can be used to

A

decrease stress and anxiety in adults

167
Q

Meditation affects the _________ nervous system

A

sympathetic

168
Q

Meditation lowers

A

lowering blood pressure, heart rate, breathing, metabolism, and blood flow to the muscles

169
Q

mindfulness is

A

specific meditations and refers to a mental quality, a self-regulation of attention, a choice to respond rather than react to a situation

170
Q

CBT is

A

a form of therapy that helps people become more aware of their thoughts, emotions, and motivating behaviors;

171
Q

cbt benefits

A

reduce levels of anxiety, pain, insomnia, and depression

172
Q

Biofeedback is

A

use of electronic devices to help the patient develop a learned awareness of the body’s physiologic responses to unconscious, involuntary stressors

173
Q

in biofeedback The patient learns

A

the correlation between feelings, thoughts, and physiologic responses to stressors

174
Q

Biofeedback is used to treat problems such as

A

stress
addictions
and back pain

175
Q

Energy Therapy uses

A

the hands of the practitioner as a conduit to manipulate the negative energy fields of the patient and move the congestion or obstruction of the negative energy away from the energy field

176
Q

Energy therapy has been shown to

A

decrease stress,
anxiety
acute and chronic pain
to promote a sense of well-being

177
Q

Reiki is

A

an energy medicine technique in which the hands of the practitioner move and transfer energy from the practitioner to the patient

178
Q

Reiki works by

A

restoring the body’s homeostasis

179
Q

reiki helps patients manage

A

illness
anxiety
stress

180
Q

The use of touch through hand motions enhances

A

energy fields to promote healing

181
Q

Therapeutic touch benefits

A

decreases pain and anxiety

increases the sense of well-being

enhances the functioning of the immune system

promotes relaxation

reduces depressive symptoms

182
Q

TCM stands for

A

Traditional Chinese medicine

183
Q

TCM is based on the

A

balance of yin and yang

184
Q

yin and yang are

A

two opposite forces of nature

185
Q

Imbalance between yin and yang causes

A

illness and disease

186
Q

TCM modalities examples

A

Herbal medicine, massage, acupuncture, and Feng Shui

187
Q

Crisis intervention is

A

short-term assistance provided at a time of physical or emotional upheaval with the goal of helping the person in distress to regain equilibrium

188
Q

Crisis intervention involves

A

immediate action to help reduce the impact of a traumatic event in the affected person’s life

189
Q

Nurses, doctors, clergy, counselors, and community workers (such as firefighters and police) are

A

called on to provide crisis intervention

190
Q

burnout is

A

mental or physical exhaustion due to constant stress or activity

191
Q
A

exam 3 (12 decks)

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