Week 11 ~ Challenging situations

Question 1

What is stress?

Answer 1

Natural physical, psychological, and spiritual response to stressor. Flight, fight, or freeze response. Occurs when person has limited control over situation.

Question 2

What are stressors?

Answer 2

Demand, situation, internal stimulus, and circumstance that threatens persons personal security and integrity. Can be actual or imagined. Can be positive (new job, wedding, child) or negative (illness, relationship loss, decreased income).

Question 3

What are the sources of physical, psychological, and spiritual stress?

Answer 3

Physical- Aging process, active and chronic illness, impacts of illness (sleep, pain), injury to body
Psychological- relationships, mental health disorder, loose person/job, finances, work stress, change in residence
Spiritual- loss of purpose/hope, question values and meaning, disenchantment with religious affiliation

Question 4

What is distress and eustress?

Answer 4

D- negative stress, cause increased level of anxiety, exceeds persons coping abilities
E- short term, mild level, has ability to cope, positive response with protective and adaptive functions

Question 5

What are the 3 levels of stress?

Answer 5

1. Mild stress- help people stay focused and alert, motivator
2. Moderate stress- inability to change desired outcome through own efforts
3. High stress- make choices, take action, exhibit anger and anxiety, have trouble envisioning possibilities

Question 6

Stress in healthcare?

Answer 6

Fear death, uncertain about outcomes, disrupts family life, financial concerns, stressful in admission/discharge, pain, noises.

Question 7

How can we reduce stress in healthcare?

Answer 7

Provide information and guidance, allow client to process feelings, priority setting and develop realistic goals. Provide comfort and assistance. Social support.

Question 8

Nursing assessment for stress?

Answer 8

Assess coping skills (what relieves stress), asses social support (family and friends), identify sources of hope and strength (social network, community resources), assess impact on family relationships (assists family in processing information).

Question 9

What is hostility?

Answer 9

Cry for help in coping with stress. they need comfort and understanding and caring. Empathy is needed as well.

Question 10

What are emergency codes?

Answer 10

Tool that reduces confusion during emergencies. Informs staff without causing concern or panic to public. Has colours to represent each type.

Question 11

What are the types of emergency codes?

Answer 11

Red- fire, orange- mass causality, green- evacuation, brown- hazardous material, black- bomb threat, white- violent act, yellow- missing patient, blue- cardio/respiratory arrest, purple- hostage taking, and silver- active assailant.

Question 12

What are the types of crisis?

Answer 12

1. Private crisis- affects individuals and family but not community like secured, car crash, death of family member
2. Public crisis- affects community or large group of people like floods, terrorist attack, pandemic
3. Existential crisis- questions meaning of life and whether it has value, midlife crisis
4. Environmental crisis- major changes in ecosystem like global warming

Question 13

What are developmental, situational, and adventitious crisis?

Answer 13

D is crisis r/t developmental stages of life (marriage, birth of child, retirement). S crisis is persons experience of stressful life event (unexpected illness, car accident, loss of job). A crisis is not part of everyday experience and its unplanned and horrific (flood, fire, riots, war, crimes).

Question 14

What are some client responses to crisis?

Answer 14

Adaptive response- learn new coping skills, expand support system

Maladaptive response- develop acute/chronic psychiatric symptoms that require professional treatment

Shock- anger, laughter, hysterics, cry

Recoil- 2 to 3 weeks, behavior normal to outsiders but person could have nightmare/phobia/flashbacks of crisis

Restoration/reconstruct- take actions to face and resolve reality of issues present in crisis

Question 15

How do we support kids in crisis?

Answer 15

Provide safety, be aware of signs of distress, decrease exposure to media, and support parents in child’s adjustment.

Question 16

What are intervention strategies for crisis?

Answer 16

Goals: stabilize distress symptoms and decrease them, restore functional capabilities, and referral for follow up support care

Debrief: those involved and witness and care for victims, process facts first then feelings

Question 17

What are principles of trauma informed practice?

Answer 17

Safety, trustworthy/transparency, empowerment, peer support. It’s a patient centered care approach that develops trusting therapeutic relationships. Requires awareness and sensitivity.

Question 18

What are the 8 steps for trauma informed nursing care?

Answer 18

1. Introduce yourself
2. Open body position
3. Anticipatory guidance
4. Ask before touching every time
5. Protect privacy
6. Clear consist messages on info, expectations, and rules
7. Use plain language and teach back method
8. Universal precaution approach

Question 19

How can we address sexual behaviour?

Answer 19

Provide feedback immediately, communicate that behaviour is not acceptable, communicate your feelings, set boundaries, inform superior and report, and develop safety plan for high risk situations.