Universal Experiences - W10

Question 1

What is involved in the universal experiences in the PNUR CF ?

Answer 1

• Crisis; stress & anxiety
• Comfort; pain
• Hope; hopelessness
• Loss; grief
• Power; powerlessness
• Resiliency; coping & strengths
• Integrity; dying, death, acceptance

Question 2

What is stress?

Answer 2

Stress is the response or reaction to stressors, which are the stimuli
- It can be caused by internal or external factors
- It occurs on a continuum with anxiety and crisis

Question 3

What is apart of the stress response ?

Answer 3

1. Physiological component
2. Cognitive component
3. Emotional component

Question 4

Physiological Component:

Answer 4

Fight/flight response:
1. External event seen as a threat
2. The response is activated
3. Adrenaline, noradrenaline and cortisol are released
- Increasing HR and breathing
- Immune system suppressed
- Perspiration increased
4. Threat is removed
5. Acetylcholine is released
6. Adrenaline, noradrenaline and cortisol levels lower
7. Body returns to normal

Question 5

What are the stages of general adaptation syndrome ?

Answer 5

Stage 1 = Alarm reaction
Stage 2 = Resistance stage
Stage 3 = Exhaustion stage

Question 6

Cognitive Component:

Answer 6

It considers the appraisal of stressors and how they influence the stress response

Question 7

What is the Cognitive Appraisal Theory ?

Answer 7

It was created by Lazarus and Folkman
The belief that the person is under stress only if they perceive themselves to be
It involves PRIMARY APPRAISAL; what does this situation mean to me?
and SECONDARY APPRAISAL; Can I cope with it?

Question 8

Emotional Component:

Answer 8

The cognitive triangle, with emotions, thoughts, and behaviours*

Question 9

What is anxiety ?

Answer 9

It is the apprehension or dread in response to internal/external stimuli that can be experienced in physical, emotional, cognitive, and/or behavioural ways.
- It ranges from mild to severe/panic level
- It is NORMAL and generally not dangerous
- It can be adaptive

Question 10

What are the levels of anxiety ?

Answer 10

MILD; Slight arousal that enhances perception, learning, and productivity
MODERATE; Increased arousal with tension, nervousness, and perception is narrowed
SEVERE/PANIC; It is consuming, uncomfortable, there is poor focus, and requires intervention. It is overpowering and frightening

Question 11

What is adaptive coping ?

Answer 11

These are strategies that minimize, reduce, or eliminate the stress response
- These help the problem

Question 12

What is maladaptive coping ?

Answer 12

It may temporarily be “effective” but will cause longer term negative consequences and results in worsening distress
- These make the problem worse

Question 13

Comfort & Pain:

Answer 13

The 5 variables influence the experience of pain
- It is not the same as PITY

Question 14

Hope & Hopelessness:

Answer 14

“Hope is the anticipation of a continued good or of an improvement in, or lessening of something unpleasant”

Question 15

Power:

Answer 15

It is the perception and process of gaining or maintaining control or influence over aspects on one’s environment
*We need to recognize and minimize the power differential in our practice as RPNs
THE GOAL IS TO EMPOWER PATIENTS

Question 16

What are the types of crises?

Answer 16

Developmental:
- Retirement
- Puberty
- Empty nest
Situational:
- Illness
- Death in the family
- Separation/Divorce
- Traumatic experience
- Moving

Question 17

What is grief?

Answer 17

It is the emotional response to the perception of loss

Question 18

What is actual loss?

Answer 18

A loss of a person or object that can no longer be felt, heard, known, or experienced

Question 19

What is perceived loss?

Answer 19

It is a loss that cannot be seen by others

Question 20

What is bereavement?

Answer 20

It is the response to the loss or death of a loved one

Question 21

What impacts grieving ?

Answer 21

THE GRIEVING PROCESS DOES NOT FOLLOW A LINEAR CONTINUUM*
The bereaved person feels responsible in some way for the loss.
- The nature of the loss (sudden, traumatic)
- The amount of support available
- The number of previous losses (grief is cumulative)

Question 22

“Normal” functioning of grief includes:

Answer 22

• Shock & Denial
• Anger
• Depression & Detachment

Question 23

What is involved in the return to meaningful life ?

Answer 23

• Acceptance (exploring new options, putting a new plan in place)
• Dialogue and Bargaining
  (the desire to tell one’s story, reaching out)

Question 24

What are key differences between grief and depression ?

Answer 24

Normal Grief
- Self esteem intact
- Maintains feelings of hope
- Accepts comfort from others
Depression
- Self esteem is disturbed
- Feelings of hopelessness
- Does not respond to support from others

Question 25

What are the other forms of grief ?

Answer 25

Complicated grief and anticipatory grief

Question 26

What is complicated grief?

Answer 26

It is defined as unhealthy mourning following a death, this lasts at least 6 months.
The patient doesn’t progress through the stages of grief and is preoccupied with the deceased or death

Question 27

What is anticipatory grief?

Answer 27

It is the emotional experience of the normal grief response before the loss actually occurs