Stress + Anxiety Flashcards
Positive way to deal with stress
relaxation techniques
Stress is not always bad. When is this the case?
When it motivates us
Stress can affect….
mental status, emotional status, spiritual status
Diseases associated with stress
hypertension, insomnia, cardiovascular disease, etc, asthma, GI problems
Stimulus causing stress
Stressor
Anything an individual may perceive as threatening,
demanding, or a challenge
Stressor
Stressors are…
individualized
Stressors tend to do what over time?
change
Internal stressors
Menopause, andropause, fear, apprehension, anxiety
External stressors
Noise, people, objects
Physiologic stressors have an affect on the…
body. specific + general effect; specific leg, arm, etc.)
Psychosocial stressors have an affect on the…
mind, emotions, psychological part of body.
Real and perceived threats
Psychosocial
Two types of stress
Situational
Maturational/developmental
Dependent on situation you are in; individualized.
Situational stress.
Stress that everyone goes through as we are developing
Maturational/developmental stress
Long term stress may lead to…
Physical + emotional damage
Changes in your ability to adapt
Longer healing time for illness (decreased immune system)
How does stress play a role on he family?
May make them stressed, may make them anxious. Family must understand stress, must understand persons response to stress.
Crisis that somebody may have as they are developong (mid-life crisis)
Maturational Crisis
personal crisis, individualized.
Situational Crisis
a rare accidental and unexpected tragedy that may affect an entire community or population, such as an earthquake, flood, or airplane crash. In addition to injuries, loss of life, and property damage, an adventitious crisis often results in long-term psychological effects.
Adventitious Crisis
Ineffective coping mechanisms
Drinking, drugs, unhealthy habits
Immediate and involuntary coping response to the
stress
Adaptation
changes that take place as a result to…
the response of the stressor
Adaptation can occur at…
the individual level as well within the
family and groups the individual may be apart of
Needed for normal growth and development,
response to emotional and physical stressors, and
the ability to cope with change
Adaptation
Body interaction with ever constantly changing
environment; External and internal environments
Homeostasis
Internal environment must maintain consistency
and remain balanced
Homeostasis
physiologic mechanisms within the
body responding to the internal changes
Homeostasis
The major systems to maintain homeostasis
Autonomic Nervous System and Endocrine System
Autonomic Nervous System and Endocrine System have both a ______ + _______ response
Sympathetic + Parasympathetic
Reflex pain response, Inflammatory response
LAS-Local Adaptation Syndrome
Alarm reaction, Stage of resistance, Stage of exhaustion
GAS-General Adaptation Syndrome
Localized response to
pain
Local Adaptation Syndrome
Involves the specific
body part rather than the
whole body
Local Adaptation Syndrome
Central nervous
system response to
pain
Reflex Pain Response
Short-term adaptive
response to traumatic or
pathologic stress
Local Adaptation Response
Local response to
injury or infection
Inflammatory Response
General response to stress
General Adaptation Syndrome
Physical or emotional stressor causing the
physiologic response
General Adaptation Syndrome
Occurs as a result of physical or psychological
damage
General Adaptation Syndrome
Also known as “shock phase”
Alarm Reaction
End of ALarm reaction is known as…
Countershock phase
Alarm reaction has…
Specific stressors + various defense mechanisms
The Stage of Resistance
Adaption of the stressor, Vital signs, hormones, energy levels return to normal
GAS has 3 phases
Alarm reaction, stage of resistance, stage of exhaustion
Stage of Exhaustion
Results as adaptive mechanisms can no longer provide a defense mechanism
Feelings of love, sense of belonging, feeling safe,
and having self-esteem; Needed to maintain mental wellbeing
Psychological Homeostasis
When needs of psychological homeostasis are not met…
coping mechanisms
promote return to emotional balance
Without the proper resources…
adaptation cannot take place (leads to increased feelings of stress)
Connection between physiologic stressors and the
physiologic stress response; how the body perceives stress.
Mind-Body Interaction
Examples of mind-body interaction
Throwing up, frequently using bathroom, crying, choking feeling, heart palpations
Mind-Body interaction is…
individualized (duration of stress, adaptation mechanisms, life changing events
Alliterations in health status related to prolonged stress; Nausea, heart palpitations
Psychosomatic Disorders
Most common response to stress
Anxiety
Vague, uneasy feeling of dread or discomfort; Usually the source is unknown, which can make it more difficult to
treat
Anxiety
A feeling of dread with a known threat
Fear
Anxiety is apprehension related to…
Anticipation of Danger
Anxiety can be used as…
a protective mechanism .
Causes of anxiety?
Unexpected life events, fear of unknown, etc.
______ anxiety may have a positive effect.
Mild
Levels of anxiety?
Mild
Moderate
Severe
Panic
Prolonged anxiety can lead to…
decreases in functional abilities (OCD, PTSD, ETC)
Day-to-day life situations; Increases alertness, senses, and learning
Mild Anxiety
Can be a motivator for learning and growth and
development
Mild Anxiety
May interfere with sleep but can promote problem
solving
Mild Anxiety
Clinical manifestations of Mild Anxiety
Restlessness, Increased questioning, Irritability.
Narrowing of the individuals perceptual field; Focus and concern is on the immediate problem
Moderate Anxiety
Clinical Manifestations of Moderate Anxiety
Quavering voice Tremors ^ muscle tension Butterflies in stomach Slight increase in HR, Pulse and Resp Tension Pounding heart
Narrower perceptual field; Focused on the specific details of the problem, but problem solving is not possible
Sever anxiety
No longer a motivator or signal of danger
Severe Anxiety
Characteristics of Severe Anxiety
Impaired learning and easily distracted
Extreme fear of dangers that are not real
Emotional distress which interferes with daily living
Avoidance of situations that cause anxiety
Clinical Manifestations of Severe Anxiety
Difficulty with verbal communication
Increased motor activity
Nausea/vomiting
Physical Assessment for Stress
Cardiac arrhythmias Chest pain Headache Hyperventilation Diarrhea Tense muscles Skin lesions Disheveled appearance Postural changes Poor eye contact Restlessness Wringing of hands Expressionless Changes in vocal tone and speech patterns Lack of facial expression
Total loss of control; Unable to learn, focus is only on the situation
Panic
Experiences feelings of dread and terror
Panic
Characteristics of Panic
- Increased physical activity
- Distorted perception
- Loss of rationale thinking
Clinical Manifestations of Panic
- Difficulty with verbal communication
- Agitation and trembling
- Poor motor control
- Sensory changes
Conscious behaviors used to combat stress and anxiety
Coping Mechanisms
How are coping mechanisms learned?
within the family, past experiences, or sociocultural affiliations
Coping mechanisms may be positive or negative
Crying Laughing Sleeping Swearing Physical activity Smoking or drinking Withdrawal
Attack behaviors
may be constructive or deconstructive; how to attack this problem? may lead to hostility.
Unconscious reaction to the stressor
Defense Mechanism
Defense mechanisms protect the individual’s…
self-esteem
Withdrawal can be
positive or negative
Defense mechanisms are used with
mild to moderate anxiety
Defense mechanisms can
distort reality and create social problems (maladaptive rather than adaptive)
I’m not good at school, so I’ll excel in sports.
Compensation Defense Mechanism maladaptive)
Failing to realize a condition or a situation
Denial (maladaptive)
Placing your traits and beliefs onto someone else. (we have to eat dinner before dessert)
Introjection Defense Mechanism
Wrongly placing your feelings on another. (taking out emotions on another)
Displacement Defense Mechanism
Blaming outcome of situation on a reason that is not actually at fault. (kid’s fault for divorce)
Projection Defense Mechanism
Trying to make something unacceptable into something acceptable. (Everyone else is doing it)
Rationalization Defense Mechanism
Making yourself like or do something that you do not like or do. (hate kids, so work with kids)
Reaction Formation Defense Mechanism
Going back to earlier stage of development (dementia)
Regression Defense Mechanism
Voluntarily not thinking about anxiety/stress
Repression Defense Mechanism
Substituting a social unacceptable thought, trait, behavior for something that is acceptable.
Sublimation Defense Mechanism (always constructive)
Denial of disturbing situation or experience (seeing blood in urine, ignoring it)
Suppression Defense Mechanism (only conscious defense)
Trying to fix something we have said or done, taking something back.
Undoing Defense Mechanism
Failed coping mechanisms may lead to
Crisis phase
Trial and Error attempts may or may not work, which can lead to increased anxiety
Crisis Phase
Anxiety becomes overwhelming; Leads to serious maladaptive personality degeneration.
Crisis Phase
With the crisis continuing, the individual finds new ways
to cope, potentially leading to the resolution of the crisis. If not, _______ may occur.
Death.
Suicide, physical problems r/t panic
Steps of Crisis Intervention
- Identify Problem
- List ways to problem solve
- Choose btwn alternatives
- Implement plan
- Evaluate
Crisis resolution is temporary, and lasts
4-6 weeks
Resolution may cause a
decrease in functional ability
Resolution depends on
the individual, the situation, and the environment
In a crisis, nurses need to…
take an active role + intervene early.
During a crisis, individuals are assumed to be
mentally healthy but in a
state of disequilibrium
During a crisis, you must set
Realistic goals, focused on the present problem
Stress Effects on an Ill Client
Attempts to maintain self-esteem, relationships,
and prepare for an uncertain future
Stress Effects on an Ill Client illness-related)
-Loss of independence, adjustments to pain and symptom
control, new environments,
-Develop relationships with strangers
-Economic and family problems may arise
Stress Effects on an Ill Client’s Family
-Changes in role, status, or structure
-Care giver role strain
-Isolation from loved one
-Loss of control on environment and routine
-Anger, helplessness, guilt
-Lack of knowledge regarding disease, treatment,
outlook
-Concern over financial stability
Prolonged Effects of Stress
- Disruptions in homeostasis
- Failure of adaptive mechanisms
- Increasing difficulty to return to normal functioning
- Threat to mental health function