stress & coping Flashcards
stress
an actual or alleged hazard to the balance of homeostasis
homeostasis
the state of steady internal, physical, chemical, and social conditions maintained by living systems
stressors
physical, psychological or social stimuli that can produce stress and endanger homeostasis the force causing the stress in your body
Eustress
a positive form of stress makes you feel accomplished, excited, motivates you, allow for focus, within coping abilities
distress
a negative reaction to stress causes anxiety, concern, decreases performance, not within coping abilities
appraisal
how a person interprets the impact of the stressor one person’s stressor may not cause stress to another
trauma
when symptoms of stress persist beyond the duration of the stressor
acute stress
experienced on a daily basis from minor situations (ex: running late to work)
chronic stress
experienced on an ongoing basis, usually +6mo
PTSD
begins when a person experiences or witnesses a traumatic event and they respond with an intense fear or they feel an intense feeling of helplessness (crashes, natural disasters, military)
secondary traumatic stress
trauma from witnessing the trauma of others, a component of compassion fatigue
how is stress shown in ptsd
nightmares, flashbacks, recurrent and intrusive recollections of the event
crisis
occurs when coping mechanisms are ineffective and a change must be made
developmental crisis
[maturational crisis] occurs when a persons moves through different stages of life (is a normal stressor) gaining independence, marriage, children
situation crisis
external crisis, typically expected trauma medical diagnosis, big job change
adventure crisis
(events of disasters, occurs during a major disaster, man made disaster, crimes of justice covid, hurricanes, 911
primary appraisal
the event in terms of its personal meaning, stress results when a person identifies an event or circumstance as a harm, loss, threat or challenge
secondary appraisal
[concurrently happens w/ primary appraisal] a person considers available resources & coping strategies, stress occurs if the demands placed on the person by the event exceed the ability to cope
coping
cognitive & behavioral efforts to manage a stressor
what impacts coping
goals, beliefs, personal resources, cultural background, age and types of stress experienced
good coping mechanisms
self care that actually takes care of you (exercising, therapy, diet, social, hobbies)
bad coping mechanisms
alcohol, tobacco, workaholic to avoid stressor
factors that influence stress and coping
the appraisal, the amount and type of support, reaction to the stressor, pervious life experiences
what types of stressors place people who are vulnerable at higher risk for prolonged stress
situational and social stressors
situational factors that influence stress and coping
stressors in the workplace, adjusting to a new diagnosis
maturational factors that influence stress and coping
life stages, erikson’s developmental theory, milestones, losing a parent, accepting physical aging, seeing a child leave home
sociocultural factors that influence stress and coping
environmental, social, and cultural stressors (poverty, physical disability, social isolation)
general adaptation syndrome (GAS)
a 3 stage reaction to stress triggered by a physical or psychological event, the body is trying to return to allostasis
what initiates the general response syndrome after encountering a physical demand
the pituitary gland
what is allostasis
a state of balance within the body
GAS: stage 1
(alarm stage) the CNS is aroused, body defenses are mobilized “fight or flight…. or freeze”
GAS: stage 2
(resistance stage) the body stabilizes and responds, the body is compensating for the changes that occurred during alarm stage
GAS: stage 3
(exhaustion stage) continuous stress causes a breakdown of compensatory mechanisms, can longer adapt to the stressor -> associated w/ physiological problems & will see serious health outcomes
what is the immune response for the general adaptation syndrome
stress causes prolonged changes in the immune system that impairs function and increases susceptibility too infection, high blood pressure, diabetes and cancer
compassion fatigue
a state of burnout and secondary traumatic stress resulting from physical and mental fatigue and exhaustion
when does burnout occur
when perceived demands outweigh perceived resources
signs of compassion fatigue / burnout
feelings of irritability, restlessness, inability to focus and engage with others
second victim syndrome
when a medical error occurs that inflicts significant harm on a patient and the patient’s family -> can sustain complex psychological harm that can lead to detrimental outcomes such as suicide (similar symptoms to PTSD)
assessment of stress & coping: subjective findings
-stressors and client’s perception of the event
-available situational supports
-methods of coping
-suicidality / homicidal thoughts
assessment of stress & coping: objective findings
-appearance
-nonverbal behavior
assessment of stress & coping: what to consider
- sensitive topic (establish trust)
- the environment & time
-use open ended questions
planning for nursing care for a person experiencing stress
-set priorities & develop pt centered goals
-set objectives
-SMART
-one behavior per objective
examples of goal outcomes for pts dealing with stress or coping
-“pt will engage in a support group”
-“ family members will be able to discuss a loss together”
-“caregiver participates in respite care”
implementation for stress and coping: health promotion
regular exercise & rest, support systems, time mgt, guided imagery, journal writing, mindful based stress reduction, stress mgt, social isolation/loneliness prevention
implementation for stress and coping: acute care
crisis intervention
implementation for stress and coping: restorative & continuing care
long term impact of a crisis
evalution of stress reducing interventions
-does the pt believe stress has been reduced
-analyze pt outcomes
-empower the patient
