week 8: stress and coping Flashcards

1
Q

how does stress affect your SNS? anterior and posterior pituitary glands?

A

SNS - increased HR, BP, CO, blood perfusion

Anterior and posterior pituitary glands- increased Na and water retention, increased protein synthesis and BP, immunosupression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

is this true regarding stress and coping?
perceived threat - physiological response - coping

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is perceived threat? acute and chronic stress

A

Physiological stressors, psychological stressors
Acute stress: short period of time is the most common
Chronic stress: Perpetual demands or threats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

is this true: Coping are the actions taken to reduce the uncomfortable physiological/ psychological stress response

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

select all that is true regarding chronic stress?
Chronic stress causes an increase in cortisol which can cause brain damage
Chronic stress in early life can predispose children to mental health problems in later life
Chronic stress can hardwire pathways between the hippocampus and the amygdala creating a brain predisposed to fight or flight
Chronic stress causes stem cells to turn into cells that inhibit connections to the prefrontal cortex

A

all true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how are coping strategies used to manage stress?

A

stress neutral-coping effective
challenger/manageable-coping effective: new coping skills may be needed
stress not managed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is an appraisal?

A

An event (something happens or is going to happen)
The event is perceived and appraised for scope and meaning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

select all that is true: Appraisal involves a decision about how threatening the event is
Appraisal of the threat effects the coping strategies used
The coping strategies aim to reduce the experience of stress (sometimes called anxiety) or return the person to homeostasis

A

all true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what falls under Primary appraisal, secondary appraisal and engagement?

A

primary - initial appraisal
secondary - evaluate available resources, overcome eliminate or reduce the stressor
engagement - reappraisal of the stressor
examination of the success of the coping strategy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

select if these are examples of primary secondary and engagement appraisal:
Primary Appraisal: Need to demostration of sterile dressing changes did not practice, did not think about it much
Secondary Appraisal: failed demostration of sterile dressing change
Engagement: My initial stragegy to deal with this stressor by avoiding practicing was not successful

A

all true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what influences appraisal?

A
  • Level of education
  • Past life experiences
  • discrimination, gender constraints, trauma
  • Current coping style
  • Values & expectations
  • Beliefs:
  • culture influences the experience of shame about failing
  • Self-efficacy: The extent to which a person feels they can successfully solve their own problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the appraisal associated with these emotions:
sadness
happiness
anger
fear
disgust

A

sadness: Loss or failure of valued role
happiness: Successful move towards or completion of a goal or valued role
Anger: Blocking or frustration of goal
Fear: Physical or social threat to self or valued goal
Disgust: Elimination or distancing from person, object or idea repulsive to self and valued goal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stress response and implications for physical and mental health:
behaviour - smoking, alcohol abuse, lack or physical activity, drug abuse, missing work

physical and mental health: severe obesity, depression, diabetes, suicide attempt, chronic lung disease, stroke, cancer, heart disease, broken bones

A

all true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the difference coping strategies with challenging situations?

A

Situational selection- choosing an environment that promotes positive emotions Situational modification – using behavior to alter emotional impact
Attentional deployment – distracting one self
Cognitive change – changing your thoughts
Response modulation – altering the experience of an emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does this describe: Requires emotional regulation or the conscious ability of a person to increase or decrease the magnitude or duration of an emotional response

A

Coping with Challenging situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the three different types of coping strategies

A

Problem focused coping:
Steps people take to deal directly with and act on the sources of stress
Eliminate or reduce the underlying cause of the stressor

Emotional focused coping:
Actions are meant to control the stress response

Meaning focused coping
Look for ways to modify a response through talking or reflecting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

true or false: coping strategies to manage stress: Actions taken to minimize or reduce the stressor to get back to a state of homeostasis, well-being, and health.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is the appraisal process related to how a person experiences stress and copes?

A

coping - stress - positive appraisal - neutral or mild stress response (no specific order)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the concepts connected to stress and coping

A

anxiety
sexuality
immunity
cognition
sleep
mood and affect
perfusion
family dynamics
functional ability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sources of stress
physiological
psychological or emotional
now define what they mean

A

physiological - related to physiological trigger i.e , illness or injury

psychological or emotional - may be caused by significant life events, external factors such as occupational ( work - related ) pressures, events, social unrest, environmental emergencies, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of Stress

A

Acute
Episodic
Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the types of stress

A

Acute = typically occurs for a short period of time
Episodic = self inflicted “stress “ i.e taking on unrealistic assignments beyond what is reasonably expected
Chronic = sustained threat/pressure, with loss of hope that the situation can improve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

name what is is describing : typically occurs for a short period of time
self inflicted “stress “ i.e taking on unrealistic assignments beyond what is reasonably sustained threat/pressure, with loss of hope that the situation can improve

A

acute
episodic
chronic

24
Q

definition of coping :

A

cognitive means behavioural actions to manage internal or external situations perceived as difficult and/or beyond the individual’s current resources ( Lazarus and Folkman )

25
Q

Scope of Concept
Coping mechanisms

A

constructive and destructive

26
Q

scope of concept

A

effective/adaptive responses, continuum of coping responses , ineffective/malaptive responses

27
Q

Positive and Maladaptive Coping

Positive Coping Strategies

A

Positive Coping Strategies
Art therapy
Counselling
Distraction and diversion activities
Education
Massage
Music therapy
Physical activity
Praying
Relaxation techniques
Social support
spiritual resources
yoga

28
Q

Maladaptive Coping Behaviours ( name examples )

A

avoidance coping
attacking or bullying
denial
dependency
displacement
dissociation
emotional outburst
excessive eating
regression
rationalization
self- harm
sensitization
social isolation/ withdrawal
substance use
violence

29
Q

Select all that applies with factors affecting coping

individual perception of stressor, and of coping strategy options
education, past life experiences, expectations, self- efficacy, culture, etc
relationship between the individual and the environment
availability of resources
evaluation of the environment by the individual
individual control over internal and external resources

A

all is true

30
Q

name the consequences of poor coping

A

can be physical, psychosocial or both

decline in physical health status

depression and anxiety

reduced functional ability

change in relationships/family dynamics

change in social, financial status

maladaptive coping strategies can affect outcome

31
Q

What undergoes problem focused

A

talking action to manage the situation
eliminate or reduce the underlying cause of the stressor

32
Q

What undergoes emotion focused

A

regulates the emotional response
no attempt to eliminate or reduce the underlying cause

33
Q

What undergoes meaning-focused coping

A

draws on values, beliefs and goals to modify the personal interpretation and response to a problem

modify the interpretation to the stressor

34
Q

Define if these are true or false.

For some older adults, social support may increase

Physical and psychological changes related to the aging process may impact their resilience. As result , an older adult may utilize inaccurate coping that is not matched to the level and duration required

A

false ( it decreases )
true

35
Q

Name some examples for the question below:

On the other hand, older adults may demonstrate resilience o how they cope with stress i.e chronic illness. Examples of resilence of oder adults in response to chronic illness are

A

humour, acceptance, mindfulness, positive reframing intellectual curiosity, and realistic identification of the positive aspects in situations

36
Q

Define if this is a true statement or not.

Resilience is also closely linked to spirituality, hopefulness, and finding meaning in life and losses

A

true

37
Q

Select all that is true :
Name the indications of risk of spiritual distress
feelings of anger or hopefulness
difficulty sleeping
feelings of depression
feelings of anxiety
feeling abandoned by god
questioning the meaning of life or suffering
questioning beliefs or sudden doubt in spiritual or religious beliefs
asking why this situation occurred
seeking spiritual help or guidance

A

all is true

38
Q

What does the acronym FICA stand for in the spiritual history tool

A

F = faith, belief, meaning
I= importance and influence
C = community
A = address/action in care

39
Q

Go more in depth in the acronym FICA

A

F = faith, belief, meaning ( determine whether the patient identifies with a particular belief system or spirituality at all

I= importance and influence ( understand the importance of spirituality in the patient’s life and the influence on healthcare decisions

C = community ( Find out if the patient is part of spiritual community, or if they rely on their community for support)

A = address/action in care ( learn how to address spiritual issues with regards to caring for the patient).

40
Q

What are some questions you could ask patients in fica spiritual history tool ( FICA)

A

F
= do you consider yourself to be spiritual ?

Is spirituality something important to you?

What give your life meaning?
I
= Does your spirituality influenced how you take care of yourself, particularly regarding your health?

Does your spirituality affect your healthcare decision making?

C
= Are you part of a spiritual community?

Is your community of support to you and how ? ( if they dont identify with community, you can ask, is there a group of people you really love or who are important to you?)

A
= How would you like me, as your healthcare provider, to address spiritual issues in your healthcare?

41
Q

Define the characteristics of chronic illness

A

is irreversible but it can be managed
are common among older adults
must be assessed in relation to its effect on functioning
contains elements of both illness and wellness

42
Q

True or false. Being diagnosed with a chronic illness causes stress, however it does not impact an older person’s ability to cope, it can be managed.

A

FALSE, it does impact their ability to cope heavily!!!

43
Q

Shifting perspectives model of chronic illness
what does illness in the foreground and wellness in the foreground mean ?

A

illness in the foreground :
- focus on sickness, suffering, loss and burden

wellness in the foreground
- focus is centered more on the self on the disease and its consequences

44
Q

Adapting to changes in health conditions
Fatigue in chronic illness :
fatigue is not a common complaint by older adults living with chronic illness, either ignored or assumed to be part of the ageing process

A

false, it is a common complaint

45
Q

Adapting to changes in health conditions
Fatigue in chronic illness :
do nurses need to acknowledge and assess fatigue in older adult with chronic illness

A

well no shiii sherlock, we do everything 😁

46
Q

Adapting to changes in health conditions
Fatigue in chronic illness :
Define if these are correct

Identify precipitants of fatigue in the older adult.

A potential helpful intervention is assisting the older adult to keep a health diary:
help the older adult develop increased self-awareness of the chronic illness, also
helpful for the Nurse in understanding the experience of the illness from the older
adult’s perspective.

A

yes both are true

47
Q

*Important to know for clinical practice and final exam
Adapting to Changes in Health Conditions
* Grieving in Chronic Illness

( name the characteristics that undergoes this category )

A

Nurses need to have increased awareness and empathize that an older may have
had multiple life losses such as identity, comfort, social roles, identity as a healthy
person, etc.

As interventions, Nurses can encourage the older adult to talk about their losses,
providing support through active listening, and recognizing the stages of grief that
may be occurring

48
Q

Older adults with anxiety :
Anxiety is normal human reaction part of fear part response, and it is rational if within reason. But how can we tell if its an anxiety disorder? ( abnormal )

A

prolonged and exaggerated anxiety that interferes with function

49
Q

SELECT ALL THAT APPLIES:
factors that reduce the chances of seeking help for and recognizing anxiety
1. non stigmatization of mental illness, comfort when talking about to health care providers about anxiety
2. attribution of psychological symptoms to physical causes
3.non recognition of the impact of symptoms on daily life and functioning
4.labels and words that are used to describe anxiety ( e.g worry, as opposed to “ concerns” or issues )
5.Non ageist attitudes and beliefs
6. Pessimism about treatment effectiveness
7.diagnostic difficulties
8.time constraints in primary care settings

A
  1. this is not a factor ( the correct one would be stigmatization of mental illness, discomfort when talking to health care providers about anxiety
  2. this is also not a factor ( the correct one ageist attitudes and beliefs
50
Q

Adapting to Changes in Health Conditions
* Older adults with Anxiety or Anxiety Disorder (p. 350, Boscart textbook)
 Nursing clinicians need to be aware:

A

(1) Medical disorders that cause anxiety symptoms: cardia arrythmias,
delirium, dementia, COPD, heart failure, etc.

(2) Anxiety may be an adverse effect of medications: anticholinergics, beta
blockers, corticosteroids, etc.

51
Q

what are some NON PHARMACOLOGICAL interventions when dealing with an older adults with anxiety or anxiety disorder ?

A

Interventions:

Non-pharmacological – therapeutic relationship is the foundation of intervention:
family supports, community resources, cultural traditions and practices, etc.

52
Q

what are some PHARMACOLOGICAL interventions when dealing with an older adults with anxiety or anxiety disorder ?

what are some important things to monitor for potential adverse effects?

A

Pharmacological – Antidepressants, short-term benzodiazepines or non-
benzodiazepine anxiolytics.

Important to monitor potential adverse effects:
sedation, falls, cognitive impairment.

53
Q

Are these all important ?
 If possible, reduce stress.

 Support foundation of effective coping strategies

 Help older adult with finding new resources, building
self-efficacy, and reinforcing or guiding new ways of
coping.

 Promote positive coping strategies: physical activity,
social support, spiritual resources, etc.

 Discourage/redirect older adult from maladaptive coping
behaviors.

 Pharmacologic treatment may be utilized to manage
stress: anxiolytics, hypnotics, antidepressants, etc.

 Important for Nursing clinician to be aware of the
pharmacokinetics of pharmacological-based
interventions.

 Need to closely monitor potential adverse effects and
increased risk of negative patient outcomes

A

yes these are all important

54
Q

what are the clinical management when dealing with stress and the ability to cope?

A

intervention categories ( physical, psychological, and behavioural)

Levels of prevention

primary
- health promotion and specific protection

secondary
- early diagnosis and treatment

Disability limitation
tertiary
restoration and rehabilitation

55
Q

Information processing ( scope and meaning ) ( magnitude )

No stress
challenge
threat
name the characteristics

A

easily managed with existing resources and personal capabilities

Manageable with existing resources and personal capabilities

taxing or exceeds existing resources and personal capabilities

56
Q

what is the psychological and physiological response to no stress ?

A

psychological : no stress: potential low for disease manifestation in physical, psychological, social, cultural and spiritual realms of functioning

physiological : health and well being

57
Q

what is the psychological and physiological response to threat ?

A

psychological : potential high for disease manifestation in physical, psychological, social, cultural, and spiritual realms of functioning

physiological : disability and dysfunction