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holistic man

1.3, 1.4, & 1.5 HOLISTIC MAN

QuestionAnswer
general adaptation syndrome: aka; def; how many stages; name the 3 stages; GAS; physical response to stress; 3; alarm, resistance, exhaustion;
general adaptation syndrome: alarm stage- what is stimulation; what happens; SNS; shock and countershock;
general adaptation syndrome: resistance- this is an adaptation to what; does it expend energy; this is dpendent on what; stressor; yes; magnitude of stressor and coping resource;
general adaptation syndrome: exhaustion- this occurs because ____ cannot be maintained; what is depleted; what is needed; what is adaptive energy; adaption; resources; outside sources of adaptive energy; rest or death
is stress always negative no
stressor classifications: are they internal or external; is it acute or chronic; all; all
General Adaptation Syndrome (GAS): begins with what; what is the stimulus; the stimulus is recognized by what; this recognition by the brain is called what; the brain initiates what; this fight and flight is ___ response; stimulus; stress; the brain; stress reception; the physiological fight/flight/fright system; stress response;
General Adaptation Syndrome (GAS): what is the desired outcome of stress; adaptation is achieved through what; what are goals of adaptation; maladaptive coping responses are often percursors to what; adaptation; coping; physical and psychological health; disease;
physical response to stress: CNS integration activates what in brain; this axis activates what; hypothalamic-pituitary-adrenal axis; autonomic system;
body organs affected by prolonged stress: what happens to GI tract; what happens to the adrenal glands; what happens to lymphatic structures; the rugae in stomach deepen; they enlarge with prolonged stress; thymus, spleen, lymph nodes atrophy;
alarms: Shock- this is a ___ reaction; ANS reaction is AKA; what is released with ANS reaction; how long does it last; ANS; fight or flight; epinephrine and cortisone; a few minutes to an hour
ALARM: def countershock; reverse or shock
s/s sns stimulation: what happens to BP; what happens to HR; what happens to RR; what happens to GI motility; what happens to pupils; what happens GI; increases; increases; increases; decreases; dilates; nasea, fatigue, anorexia, wt loss
resistance: this mediates what; the body attempts to cope with what; what happens with the physical s/s; internal and external environments; stressor and localize it the smallest area; they return to normal
exhaustion: when does it develop; are there physical s/s; when stressor is overwhelming, ongoing or coping mechanisms are inadequate/dysfunctional; yes they return
Stress stages: def homeostasis; what are the stages of stress in order; in what stage is stress perceived; all systems are reactive to everyday stressors in a balanced and healthful manner; alarm, resistance, exhaustion; alarm;
alarm: what happens to homeostasis; it slightly drops as the mind body temporarily lose balance;
resistance: what is mobilized to combat stress; what system comes into play; adaption of resources; the endocrine system;Q
exhaustion: what is depleted; when the energy and adaptation stores and replenished what happens; adaption and energy stores; body returns to homeostasis;
stages of stress: what are 2 things that can happen after exhaustion; why would death happen; when does recovery happen; death or recovery; chronic exhaustion is soo bad; stress that is managed ok;
stress response: epinephrine release: what happens to HR; what happens to heart contraction; what happens to bronchials; what happens to blood; what happens to metabolism; tachycardia; increases; dilates; blood clotting; increases;
stress response: noepinephrine release- where in body is blood not shunted to; what happens to renin; kidneys; it increase
stress response: release of cortisone- what happens to protein; it is cotabolism
stress response: in what stage does shock phase occur; what 3 things are released in shock phase; the release of these 3 things cause what phase alarm; epi, norepi, cortisone; contershock phase
what effects bodies stress response the intensity, the amount of stress that occurs in one time
stress response: what happens after stress occurs; the perception of the stress response occurs where; where in the brain causes the SNS response; the pituitary releases what; our response to stress; in the cerebral cortex; hypothalamus; ADH, ACTH
what is internal conditioning; age,heredity, pre-existing physical conditions, previous experiences, nutrition
stress response: release of ADH causes what; release of aCTH retains what; release of ACTH eliminates what; aliguria; Na, Cl, H2O; K
stress response: SNS- it is responsible for changes where; in VS;
vsriables affecting stress response: what in stress affects response; what other variables; intensity, duration, number and type; perception, conditioning factors
impact of ICU: stress- what deficit do these pt often experience; nutritional deficits removes ___ resistance to things; there is a loss of what; what are environmental stresses in ICU; there is isolation from whom; nutritional; bodies; control; lights, noise, equipment, 24/7 activity; support ppl
impact of ICU: why is there sleep issues; sensory perception deprivation why; sensory overload why; pt not getting good rem sleep bc of constant waking of pt; day-night issues, isolation or comfort touch; overload of light, noise, equipment lights and alarms, pain, procedures
impact of ICU: nutritional deficits- there is a hyper____ states; what other state is there hypermetabolic states; catabolic and malnourished
impact of ICU: sleep- this process facilitates ___ growth; sleep also repairs ___; def NREM; def REM; what sleep cycle is 75% of the sleep time; what is 25% of sleep time; cell; damaged aging tissue; non rapid eye movement; rapid eye movement; NREM; REM
impact of ICU: sleep- what happens in nrem; what happens in rem sleep; metabolic, cardiac resp rate decreases, bp decreases, bone marrow activity increases, protein synthesis occurs; sns accelerates and increases COand HR RR, perfusion to grey matter doubles, info is stored,
sleep cycle: each cycle is completed in an interval of __ min; the cycle should occur how many times in a 24 hour period; 70-100; 4-6 cycles;
Delirium: what age is at risk; who else is at risk; what environmental factors puts one at risk; what physical factors increase risk; what meds increase risk increase in age; cognitive impairments, sensory deficits, substance abuse; sleep deprivation, anxiety, sensory overload, immpbilization; severe infection, hemodynamic instability, decreased 02, increased co2, electrolyte imbalance; benzos
ex of nezodiazapine meds Ativan, xanax
altered family processes: why does this happen when pt is sick; what are cultural factors; change in role, responsibility, multiple stressors, family loss of control, anxiety over pt condition, cultural factors, spiritual crisis; meaning of sickness and health, caregiver responsibility, pain, death and dying, grief
what are behavioral reactions to stress anxious, aggressive irritable, depressed, withdrawal, decreased motivation, forgetful, suspicion, somatization, changes in eating/sleeping patterns
def somatization the production of recurrent and multiple medical s/s with no discernible organic cause
nursing interventions to reduce fear and enhance family coping: acknowledge ___; note s/s of prolonged ___ stage; source of emotional discomfort; alarm;
nursing interventions to reduce fear and enhance family coping: how nurse can reduce stress- give info how; increase fam sense of __; don't personalize ____ reactions; involve ___ in care; reduce ___ overload; refer what simple explanations; control; negative; family; sensory; support systems - spiritual care, SW, community supports
nursing interventions to reduce fear and enhance family coping: fear is a response to what; and identifiable threat,
physiologic stress response: adrenal hormones- adrenal cortex produces what; where are adrenal glands located; name 3 corticosteroids; corticosteroids; triangles on top of the kidneys; glucocorticoids, mineralcorticoids, androgens;
physiologic stress response: adrenal hormones- what is a glucocorticoid; cortisol regulates ___; what can cortisol increase; cortisol retains ___ and gets rid of ___; it increases or decreases formation of gastric acids cortisol; metabolism; BG: Na, K; increases
physiologic stress response: adrenal hormones- what is a mineral corticoid; helps body save what; aldosterone regulates what balance; aldosterone; salt; sodium-k+ balance;
physiologic stress response: adrenal hormones- what are androgens; androgens are responsible for what; testosterone and estrogen; growth and development and sexual function in females;
physiologic stress response: adrenal hormones- the adrenal medulla is responsible for what response; the adrenal medulla produces _____; epi and norepi and aka; fight or flight; epi and norepi; catecholamines
adrenal anatomy: where is cortex located; where is medulla located; outside portion; inside portion;
cushings syndrome: this is an excess of ____; cortisol;
cushings syndrome: causes- what long term drug use can cause this; what adenomas cause an increase in ACTH; what tumors cause this; steroid; pituitary; adrenal
cushings syndrome: s/s are r/t what; exaggerated cortisol actions;
cushings syndrome: dx- what would cortisol levels be; what other labs are assessed; what other test is done; high in serum and urine; serum electrolytes, glucose; dexamethasone suppression test
Addison's disease is r/t ____ destruction or dysfunction adrenal
cushings syndrome: CMs- what is deposited in body; where is fat deposited; what happens to bp; what happens to salt; what happens to BG: what happens to muscles; what happens to skin; there is delayed ___; what happens to bones; what are emotional changes fat; truncal obesity, moon face, buffalo hump; increases; it is retained; increases; weakness and wasting; thins and striae occur; healing; osteoporosis; depression to psychosis
cushings syndrome: there is abnormal ___ metabolism; there is an excess of what hormone; since there is a decrease in fibroblasts this = ___ loss; what response is inhibited; carb, protein, glucose; aldosterone; collagen loss; immune;
cushings syndrome: Nursing Dx; tx depends of what fluid vol excess, risk for infection, disturbed body image, risk for injury, impaired tissue integrity, acute confusion; what cause
Addison's disease: this is a deficiency in what; what is the primary cause; other causes; adrenal hemorrhage is caused by what; what is a secondary cause; cortisol; adrenal dysfunction; autoimmune disease, adrenal hemorrhage; trauma, sepsis, anticoagulants; pituitary fails to produce ACTH, withdrawal of steroid therapy abruptly;
Addison's disease: s/s are r/t what hormone levels; how is it dx; increase in ACTH, decrease in aldosterone and cortisol; decreased cortisol levels, increased ACTH levels, ACTH stim test, lytes, glucose
Addison's disease: CMs- decreased aldosterone levels- what happens to salt; what happens to fluid volume; hyponatremia causes what s/s; hypovolemia causes what s/s; decreased levels; hypovolemia; dizziness, confusion, irritability; hypotension, shock, syncope
why does hypovolemic shock kill you b/c organs cannot be perfused
Addison's disease: CMs- cortisol deficiency- what happens to BG; what happens to stress response; weak or strong; GI issues; hypoglycemic, decreases stress response; weak; anorexia, n/v, diarrhea
Addison's disease: CMs- ACTH excess- causes ___pigmentation hyperpigmentation
Addison's crisis: is it life threatening; this is acute ___ insufficiency; what triggers it; yes; adrenal; surgery, trauma, systemic infection or abrupt withdrawal long term steroid use;
Addison's crisis: s/s- what happens to temp; where is severe pain; GI; what happens to heart; what are dysrhythmias r/t; what happens to bp; hypotension leads to what; high fever; abd, back and legs; severe Vomiting and diarrhea; dysrhythmias; possible increase in k+; hypotension; shock-coma-death;
Addison's crisis: tx- what needs to be replaced; what fluid should be used; why is D5.9 used; why does pt need dextrose; what meds are given; what precipitating stressors be treated to prevent occurance fluid; D5.9NS; pt needs dextrose Na and fluid; bc they do not have ability to create sugar in the liver; glucocorticoids- hydrocortisone, fludrocortisone; infection and underlying cause
Addison's crisis/disease: nursing DX- fluid volume deficit, risk for ineffective self health management, acute pain, diarrhea, anxiety, knowledge deficits
what are the three stages of GAS alarm reaction, stage of resistance, stage of exhaution
stress response: what part of the body evals the emotional response to stress; cerebral cortex;
hypthalamus and stress: Cstress activates ___ system; the limbic system in turn activates what; it is the central connection between the ____ and ___ systems in responding to stress; limbic system; the hypothalamus; nervous and endocrine system
hypthalamus and stress: the hypothalamus stimulates the release of ___ inf the pituitary ACTH;
endocrine system and stress: the SNS stimulates the adrenal medulla to release what; epi and norepi prep the body for what stress reposnse; ACTH stimulates ___ to release ___; epi and norepi; fight or flight; the adrenal coretx to synthesize and secrete cortisol and aldosterone;
cortisol: what is it; what do they do; a corticosteroid; increase BG, inhibit inflam response;
stress and the immune system: chronic stress induces what; immunosuppression;
addison's disease: is hypo function of ___; is there too much or too little ACTH secretion; what are the 3 classes of adrenal corticosteriods; the adrenal cortex; too little; glucocorticoids, mineralcorticoids and androgens;
addison's disease: are the 3 classes of corticosteroids increased of reduced in this disease; ACTH deficiency is caused by what suppression and disease; what is the most common cause; in the autoimmune response what is destroyed; reduced; pituitary; an autoimmune response; adrenal tissue;
addison's disease: what destroys the adrenal tissue; what resp disease can cause this; pt antibodies; TB;
addison's disease: CMs are not noticeable until __% of the adrenal cortex is destroyed; so is the disease advanced or in early stages usually when it is Dx; are CMs slow or fast onset; what are the common slow onset s/s; 90%; advanced; slow; fatigue, wt loss, anorexia;
addison's disease: what happens to the skin; where on body is skin hyperpigmented; where is hyperpigmentation most noticable on body; what causes hyperpigmentation it is hyperpigmented; on sun exposed areas of the body, creases, joints, pressure areas; in creases of hands; incrased secretion of B liptropin
addison's disease: increased secretion of B lipotropin stimulates what; what happens to BP; is sodium high or low; is K+ high or low; what happens GI; melanocyte production; orth HTN;low; high; N&V&D
addison's disease: what is a serious complications; what happens to bg; acute adrenal insufficiency/addisonians crisis; it decreases;
addisonian crisis: what is there a sudden decrease of; what triggters this; ex of stressers; sudden withdrawn of what medication therapy can cause this; adrenocrotical hormones; stress; trauma, hemmorhage, surgery; corticosteroid hormone replacement therapy;
addisonian crisis: s/s are similar to addisonians crisis but more__; where does pain occur; what happens to circulatory system; circ. collapse does not respond to what type of Tx; what does severe hypotension lead to; severe; abdomen, lower back and legs; it collapses; norm fluid replacement and vasopressors; shock and circulatory collapse
addison's disease: dx- what is acth stimulation test; if pt is having s/s of this but cortisol levels do rise with ACTH stim testing what is issue when this test is done and acth is stimulated the cortisol levels do not rise like they should and pt dx with addisonians disease; usually pituitary issue
addison's disease: lab findings- what is sodium; what is k+; what is chloride; what is BG; what does H&H show; what does BUN show; what does urine levels of free cortisol reveal; low; high; low; low; anemia; it is higher; they are low;
addison's disease: Dx- what does ECG reveal; why does ECG show tented T waves; why are Cts and MRIs used peaked/tented T wave; due to increased k+; to find tumor
addison's disease: what is treatement; what is the med used for replacement therapy; during situations of anticipated stress what may physician increase to prevent the crisis; replacement therapy; hydrocortisone; glucocorticoid ;
addison's disease: tx- what is main tx for crisis; what fluids are given in the crisis; hydrocortisone therapy and shock management; 0.9% and 5% dextrose;
addison's disease: nursing interventions- why should pt be protected from noise, light, and environmental temp extremes; teach what they cannot cope with these stressers b/c of the inability to produce corticosteroids; the importance to maintain corticosteroid therapy
addison's disease: what conditions would increase the need for more meds; pt will need lifelong what trauma, infection, surgery and emotional crisis'; med therapy
addison's disease: why is the dosage of meds given at certain times of the day; we need to teach ___ management; when in doubt it is better to error on the side of over or under replacement; s/s of corticosteroid excess is what; to reflect the circadium rhythm of hormone secretion; stress; over; cushings syndrome;
addison's disease: waht meds increase the need for more corticosteroids; pt needs to learn how to take what vital sign; in emergency what should pt have at how if unable to take oral dose of corticosteroids; dilantin, antacids; BP; IM hydrocortisol;
Created by: jmkettel