Stress & Coping

Question 1

What is stress?

Answer 1

An actual or alleged hazard to the balance of homeostasis

Question 2

What is homeostasis?

Answer 2

The state of steady internal, physical, chemical, and social conditions maintained by living systems

Question 3

What are stressors?

Answer 3

Physical, psychological, or social stimuli that can produce stress and endanger homeostasis

Question 4

What is eustress?

Answer 4

Good stress

Question 5

What is distress?

Answer 5

A negative reaction to stress. Decreases performance.

Question 6

What is appraisal?

Answer 6

How a person interprets the impact of the stressor (the meaning of an event)

Question 7

What is trauma?

Answer 7

When symptoms of stress persist beyond the duration of the stressor

Question 8

What are the two types of stress?

Answer 8

Acute and chronic

Question 9

What is acute stress?

Answer 9

Stress experienced on a daily basis from minor situation (ex: being late to work, going to an exam)

Question 10

What is chronic stress?

Answer 10

Stress experienced on an ongoing basis (typically >6 months)

Question 11

What is post-traumatic stress disorder (PTSD)?

Answer 11

Traumatic events can include motor vehicle crashes, natural disasters, violence/assault. Common among military personnel, veterans, first responders, and health care providers.

Question 12

What is secondary traumatic stress?

Answer 12

The trauma a person experiences form witnessing suffering of others. A component of compassion fatigue. Common among health care providers and first responders.

Question 13

What is crisis?

Answer 13

Occurs when coping mechanisms are ineffective and a change must be made.

Question 14

What is developmental crisis?

Answer 14

Occurs as a person moves through different stages of life. AKA maturational crises.

Question 15

What is situational crisis?

Answer 15

External crisis, typically unexpected trauma

Question 16

What is adventitious crisis?

Answer 16

Occurs during a major natural disaster, man-made disaster, crimes of violence. AKA events of disaster.

Question 17

What is primary appraisal?

Answer 17

Appraising 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.

Question 18

What is secondary appraisal?

Answer 18

Concurrently happens with primary appraisal. A person considers available resources and coping strategies. Stress occurs if the demands placed on the person by the event exceed the ability to cope.

Question 19

What is coping?

Answer 19

Cognitive and behavioral efforts to manage a stressor. Coping is unique for everyone, and can be impacted by goals, beliefs, personal resources, cultural background, age, and types of stress experienced.

Question 20

Describe good coping mechanisms vs bad coping mechanisms.

Answer 20

Good coping mechanisms: self care that actually takes care of you (exercise, therapy, time with friends or loved ones, eating healthy, detaching through hobbies).
Bad coping mechanisms: substance use, workaholic personality.

Question 21

What are situational factors influencing stress and coping?

Answer 21

Stressors in the workplace, adjusting to a new diagnosis

Question 22

What are maturational factors influencing stress and coping?

Answer 22

Stressors based on life stage. Erickson’s developmental theory. These stressors include many milestones, such as beginning a family and a career, losing parents, seeing children leave home, and accepting physical aging.

Question 23

What are sociocultural factors influencing stress and coping?

Answer 23

Environmental, social, and cultural stressors. Examples: poverty, physical disability, social isolation.

Question 24

Describe General Adaptation Syndrome (GAS).

Answer 24

A 3-stage reaction to stress that describes how our body physiologically reacts to stress. Triggered by a physical or psychological event. The pituitary gland initiates the GAS after encountering stress. Involves several body systems in responding to the stress. The body is trying to return to allostasis.

Question 25

What are the 3 stages of the general adaptation syndrome (GAS)?

Answer 25

Alarm, resistance, exhaustion

Question 26

Describe the alarm stage of GAS.

Answer 26

The central nervous system (CNS) is aroused. Body defenses are mobilized. “Fight or flight”

Question 27

Describe the resistance stage of GAS.

Answer 27

The body stabilizes and responds. The body is compensating for the changes that occurred during the alarm stage.

Question 28

Describe the exhaustion stage of GAS.

Answer 28

Continuous stress causes breakdown of compensatory mechanisms. Can no longer adapt to the stressor. This stage is associated with physiological problems (chronic hypertension, depression, chronic fatigue, etc.)

Question 29

Describe the immune response to GAS.

Answer 29

The stress response directly influences the immune system. Stress causes prolonged changes in the immune system. Impairs immune function. Increases susceptibility to infection, high blood pressure, diabetes, and cancer.

Question 30

Describe compassion fatigue.

Answer 30

A state of burnout and secondary traumatic stress resulting from physical and mental fatigue and exhaustion. Burnout occurs when perceived demands outweigh perceived resources.

Question 31

Describe second victim syndrome.

Answer 31

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. Can lead to symptoms that are similar to PTSD.

Question 32

Describe the assessment of stress and coping.

Answer 32

• Sensitive topic- need to establish a trusting nurse-client relationship first.
• Assess (subjective findings): stressors and client’s perception of the event, available situational supports, methods of coping, suicidality/homicidal thoughts.
• Assess (objective findings): appearance, nonverbal behavior
• Consider the environment
• Use open-ended questions

Question 33

Describe health promotion ways to implement coping.

Answer 33

Regular exercise and rest, support systems, time management, guided imagery and visualization, progressive muscle relaxation therapies, assertiveness training, journal writing, mindfulness-based stress reduction (MBSR), stress management in the workplace, social isolation and loneliness prevention.