Unti 14 Stress/Adaptation/Relaxation

Question 1

What response can consistent stress provoke?

Answer 1

“Flight or Fight” emergency response which is inappropriate to today’s psychosocial stresses that persist over long periods of time

Question 2

What influences stress?

Answer 2

• Genetic influences
• Past experiences
• Existing conditions

Question 3

What is biological responses to stress?

Answer 3

• Fight or Flight

- Hans Selye: “nonspecific response by the body to any stressor placed on it”

Question 4

What is the SRRS (Social Readjustment Rating Scale)?

Answer 4

List of possible events that calculates stress

Question 5

What is Primary appraisal? Secondary?

Answer 5

Primary: Personally, based on my thoughts “I look at this stress/stressor, and I make decision, is this good, bad, or indifferent?”

If action/change is needed you move to….
Secondary: “what are my coping skills?”

Question 6

What can prolonged exposure to stress lead to?

Answer 6

Exhaustion when energy is depleted and immune system compromised resulting in disease

Question 7

What are the two major response patterns to stress?

Answer 7

Anxiety and Grief

Question 8

How is adaptation determined?

Answer 8

Adaptation is determined by the degree to which thoughts, feelings, and behaviors interfere with an individual’s functioning

Question 9

Definite anxiety.

Answer 9

Associated with feelings of uncertainty and helplessness

Question 10

Describe the different anxiety levels.

Answer 10

Mild Level: eating, drinking, sleeping, exercise, smoking, crying, talking. (Keeps you functioning well, perform better)

Mild-Moderate: Ego Defense Mechanisms are called on for protection

Moderate-Severe: psychological changes that may exacerbate symptoms, delay recovery, or interfere with treatment of medical conditions such as Cardiovascular, Neurological.

Severe: Neurosis and psychiatric disturbances characterized by excessive anxiety or depression, disruption of bodily functions, behaviors that disrupt routine functions, and poor interpersonal relationships

Panic: may result in psychotic behavior. Psychosis are serious psychiatric disturbances characterized by delusions and/or hallucinations. Schizophrenia, schizoaffective, and delusional disorders.

Question 11

What are common characteristics of people with Neurosis?

Answer 11

• Aware that they are experiencing distress
• Aware that their behaviors are maladaptive
• They feel helpless to change their situation
• They experience no loss of contact with reality

(Ex: Anxiety disorders)

Question 12

What are common characteristics of people with psychoses?

Answer 12

• They exhibit minimal distress, emotional tone being flat or bland.
• Unaware that their behavior is maladaptive
• Unaware of any psychological problems
• They exhibit a flight from reality into a less stressful world or into one in which they are attempting to adapt

(Ex: schizophrenia)

Question 13

Define the following ego defensive mechanisms. Which is the only conscious one? sublimation, suppression, reaction formation, introjection, isolation, intellectualization, repression.

Answer 13

Suppression- is the only conscious one

Sublimation- bad reaction that then turns good

Reaction formation- bad reaction resulting in another bad reaction

Introjection- you think someone is putting thoughts in your head

Isolation- separating certain stressors from other parts of your life

Intellectualization- instead of feeling, you’re thinking

Repression- unconscious pushing away of thoughts

Question 14

What is Grief?

Answer 14

Subjective state of emotional. physical, and social responses to the loss of a valued entity, anticipated loss, etc.

Question 15

What is the response to grief characterized by emotions and behaviors called?

Answer 15

Mourning

Question 16

What is the normal mourning process? What is considered maladaptive?

Answer 16

Feelings of sadness, guilt, anger, helplessness, and despair.

An absence of mourning after a loss may be considered maladaptive

Question 17

What are Kubler-Ross’s 5 stages of the response to loss, either real or perceived?

Answer 17

Stage 1: Denial
Stage 2: Anger
Stage 3: Bargaining
Stage 4: Depression
Stage 5: Acceptance

Question 18

Explain the following grief responses:
Anticipatory
Maladaptive
Exaggerated

Answer 18

Anticipatory- process of grieving before the loss occurs

Maladaptive can be either,
Delayed or inhibited- person does not deal with the reality of loss
Prolonged- no resumption of ADL’s within 4-8 weeks

Exaggerated: Fixed at anger stage, depressive mood disorder is a type of exaggerated grief response

Question 19

What are stress management coping strategies?

Answer 19

• EXERCISE
• Music
• Pets
• Meditation
• Relaxation
• Awareness (able to pinpoint issues)
• Good Nutrition

Question 20

Describe physiological manifestations of stress.

Answer 20

Increased HR, respirations, BP, Glucose, and metabolism

Question 21

Describe behavioral manifestations of stress.

Answer 21

Restlessness, irritability, insomnia, and anorexia

Question 22

Describe cognitive manifestations of stress.

Answer 22

Confusion, difficulty with concentrating, problem solving, and learning

Question 23

What are methods of achieving relaxation?

Answer 23

Deep breathing exercises:

Progressive relaxation: tense muscles for 5-7 secs then relaxed for 20-30.

Modified (passive) progressive relaxation: thinking about relaxing your muscles

Meditation: to gain mastery over attention

Mental Imagery

Biofeedback: use of instrument to become aware of the processes of the body that usually go unnoticed

Physical exercise

Question 24

What is the role of the nurse regarding stress?

Answer 24

To provide opportunities for the PT to have reduced stress.