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NUR151 - Stress
Stress
| Question | Answer |
|---|---|
| Stress | a state produced by a change in the environment that is perceived as challenging, threatening or damaging to one’s well-being; body’s arousal response to any demand, change, or perceived threat |
| Stressors | disruptive forces operating within or on any system – things that cause stress. |
| Appraisal | how one interprets the impact of the stressors on themselves; |
| Anxiety | a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat whose actual source is unknown or unrecognized |
| Fear | a reaction to a specific danger |
| Endorphins | peptides - hormones that act on the mind producing a sense of well-being - act like morphine or opioids – exercise kicks in too |
| Homeostasis | a relative constancy in the internal environment of the body, naturally maintained by adaptive responses that promote healthy survival |
| Adaptive response | an appropriate reaction to an environmental demand |
| Trauma | if stress persists beyond duration of stressor, person has experienced a trauma. |
| Fight or flight response | rxn prepares person for action by increasing hr, divert blood from intestines to brain & muscles; increasing bp, resp rate, & blood sugar– arousal of symp NS |
| Neurophysiological responses to stress | function through negative feedback & triggers an adaptive response |
| Major mechanisms of response to a stressor are controlled by | Medulla Oblongata, Reticular Formation, and Pituitary Gland |
| Medulla Oblongata | controls vital functions through NS – controls HR, BP, & resp – HR increases in response to sympathetic fibers & decreases w/parasympathetic fibers. |
| Reticular Formation | helps control vital functions through neurons – cause sleeping person to wake or increases level of consciousness when needed |
| Pituitary Gland | produces hormones necessary for adaptation to stress & regulates other hormones like ACTH which in turn produces cortisol - regulates thyroid, gonadal, & parathyroid hormones – plays role in epinephrine & norepinephrine |
| Stress-Adaptation Model | General Adaptation Syndrome (GAS) - Theory states a “stressor” can be pos or neg - Stressors produce same symptoms in a variety of individuals without regard to the individual stressor |
| General Adaptation Syndrome | Stress signals pituitary gland & hypothalamus – endorphins secreted - 3-stage rxn to stress – describes how body responds to stress |
| Alarm reaction involves several body systems | especially autonomic NS & endocrine system - rising hormone levels incr blood vol, blood glucose, epinephrine & norepinephrine amounts, HR, blood flow to muscles, fight or flight – lasts 1 min – hours |
| When body encounters physical demand like injury, __ initiates GAS | pituitary gland |
| Alarm Stage | Increased level of alertness, Increased level of anxiety, Task-oriented, defense-oriented, inefficient or maladaptive behavior may result |
| Resistance stage | Body stabilizes & responds in opposite manner to alarm rxn - Optimal adaptation to stress; body stabilizes; hormone levels, HR, BP, & CO return to normal; body repairs any damage |
| Exhaustion Stage | Individual’s ability to resist stress is lost, Body resources depleted: decreased immune resp; suppression of T cells; depletion of adrenal glands & hormone production; enlarged lymph nodes. |
| If exhaustion stage not stopped | can progress to cardiac failure, renal failure and death. |
| Primary appraisal | person evaluates the event, decides if it is personally significant |
| Secondary appraisal | person ID event as harmful, potential for loss, threat, or challenge = stress; OK, how do I cope? |
| Coping | process by which a person deals with stress, solves problems, and makes decisions |
| Coping mechanism | way of adjusting to environmental stress w/o altering goals or purpose (conscious or unconscious |
| ego defense mechanism | Freud – everyone unconsciously protects against feelings of worthlessness and anxiety |
| Distress | damaging stress |
| Acute | traumatic event; fear |
| Chronic | prolonged reaction to the event; may have “flashbacks” |
| PTSD | Begins w/Acute stress disorder (ASD) – person witnesses or is confronted w/traumatic event & responds w/intense fear, helplessness, or horror. |
| Eustress | stress that produces (protects) health (happiness, hopefulness, etc) – motivating energy – purposeful movement |
| Crisis | When person facing a turning point in life where their previous ways of coping are not effective and person must change. |
| Developmental | As person moves through life |
| Situational | stress arising from job change/chronic illness such as obesity, hypertension, DM, asthma, etc. – car accident |
| Maturational | stresses varying w/life stage such as death of parent/child; teenagers, growing older |
| Sociocultural | prolonged poverty, physical handicap, violence, imprisonment, etc. |
| Medical conditions such as __ that are common in older adults initially present symptoms that mimic the consequences of stress and anxiety | hypoxia and thyroid dysfunction |
| Assertiveness training | helps individuals communicate their needs effectively. |
| Normal Anxiety | Health life force necessary for survival - Provides energy needed to carry our daily tasks, striving for goals, making survival changes, promotes constructive behaviors |
| Acute anxiety | Precipitated by imminent loss or change that threatens ones sense of security and self concept – called state anxiety |
| Chronic anxiety | anxiety a person has lived w/for a period of time, trait anxiety |
| Symptoms of Chronic Anxiety | Chronic fatigue – pt might sleep all the time, Insomnia, Discomfort in daily activities, Discomfort in daily relationships, Poor concentration |
| Secondary Anxiety | Due to physiological abnormalities, Need to determine if anxiety is due to medical condition, Up to 40% of anxiety may be warning of underlying physiological process |
| Mild | Occurs in normal experience of daily living, Person’s ability to perceive reality is brought into sharp focus, Person sees, hears & grasps more information & problem solving - becomes more effective |
| Moderate Anxiety | Perceptual field narrows & some details are excluded from observation, Selective inattention: certain things in the environment observed unless brought to attention |
| Learning and problem solving are not possible at this level and the person may be dazed and confused | severe anxiety |
| Severe Anxiety | Perceptual field greatly reduced, may focus on one particular detail or many scattered details – may be oblivious |
| Severe Anxiety: Physical Symptoms | increased severity in somatic symptoms such as HA, nausea, dizziness, insomnia, Trembling, Pounding heart, Hyperventilation, dread |
| Repression | exclusion of unpleasant or unwanted experiences, emotions or ideas from conscious awareness |
| Sublimation | substituting constructive & socially acceptable activity from strong impulses - not acceptable in their original form - impulses are sexual or aggressive in nature |
| Regression | ego returns to an earlier more comfortable, although less mature way of behaving |
| Displacement | transfer of emotions associated w/particular person, object or situation to another person object or situation that is non-threatening |
| Projection | unconsciously rejecting emotionally unacceptable feelings & attributing to another person, object or situation through projection |
| Blaming or Scapegoating is used as which coping mechanism | projection |
| Compensation | make up for deficits in one area by excelling an another to raise/maintain self-esteem |
| Reaction-formation (overcompensation) | unacceptable feelings or behaviors are kept out of awareness by developing the opposite behavior or emotion |
| Denial | escaping unpleasant realities by ignoring their existence |
| Identification | unconscious mechanism used to protect individual against anxiety & loss by imitation of mannerisms or behaviors of a person or group |
| Anxiety assessment | Unmet needs and expectation (individual often unaware), Level of anxiety, Relief behaviors, Circumstances |
| Mild to Moderate Anxiety goals include | Prevent further escalation of anxiety, Reduction of anxiety, Facilitate effective problem solving |
| Severe/Panic level of anxiety goals | Center on physical safety – protection from aggressive drives & physical neglect, Lower level of anxiety is crucial, Interventions are different, Simple, clear words |
| Situational | death, divorce, hospitalization |
| Maturational | pregnancy, adolescence |
| Pathophysiological | Secondary anxiety – anxiety due to physical disease |
Created by:
Ladystorm