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ATI Module
Stress and Coping (Exam 2)
| Question | Answer |
|---|---|
| acute stress | The most common type of stress. It is usually brief and triggers the fight-or-flight response. |
| acute stress disorder (ASD) | An intense and dysfunctional reaction to a traumatic event that lasts less than a month. |
| chronic stress | Occurs when stress is heightened, constant, and prolonged. Continuous activation of the nervous system can cause or exacerbate health problems. |
| coping strategies | The strategies that an individual adopts to deal with a stressor, which is highly influenced by psychological, sociological, and cultural factors. |
| Adaptive coping strategies include | maintaining a healthy diet and nutrition, exercise, time management techniques, building personal resilience, rest and relaxation, mindfulness activities, complementary and alternative therapies, and journaling. |
| crisis | A crisis is a threatening situation triggered by a precipitating event whereby an individual experiences a strong behavioral, emotional, or psychiatric response. Crises arise from various sources. |
| cultural stressors | Stress that individuals may experience by living within a society in which they are or are perceived as different from those belonging to the dominate culture and/or receiving care that ignores their cultural beliefs. |
| ego defense mechanism | Defense mechanisms are psychological strategies that help individuals separate from and put distance between themselves and unpleasant events, feelings, or thoughts. |
| Common ego defense mechanisms include | denial, rationalization, projection, repression, regression, and compartmentalization. |
| episodic acute stress | Characterized by frequent bouts of acute stress, usually associated with taking on too much responsibility. |
| fight-or-flight response | A rapid physiological reaction to a perceived threat, mediated by activation of the sympathetic nervous system and the adrenal medulla. |
| This activation triggers the release of the | catecholamines epinephrine and norepinephrine, producing increased heart rate, blood pressure, blood glucose, and heightened alertness to prepare the body for immediate action. |
| general adaptation syndrome (GAS) | The body's attempt to maintain equilibrium and homeostasis. Consists of three stages: alarm, resistance, and exhaustion. |
| health promotion | The process of enabling clients to increase control over and improvement of all aspects of their general health. |
| posttraumatic stress disorder (PTSD) | A prolonged and heightened stress reaction to a traumatic event that lasts more than a month. |
| resilience | The body’s ability to sustain physical and mental health despite challenges. Individual responses to stress differ largely due to how people interpret events in relation to their wellbeing. |
| Seven-Stage Model of Crisis Intervention | An action plan for nurses to help a client identify precipitating events leading up to a crisis, utilize skills, resources, and available support systems to effectively deal with the crises |
| stress | The mental, emotional, or physical response and adaptation to real or perceived changes and challenges. Stress response: Initiated by the nervous and endocrine systems when a stressor is perceived as a serious threat. |
| stress-related disorders | Stress-related disorders include acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and other mental health related conditions. |
| Transactional Theory of Stress and Coping (TTSC | Describes stress as a dynamic process and a transaction between a person and their environment. How an individual appraises a stressor determines how they will respond to the stressor. |
| A stress reaction occurs | when perceived demands (stressors) exceed an individual’s existing resources to meet them. |
| a particular stressor is positive or pleasant | eustress |
| a particular stressor is negative or unhealthy | distress |
| person experiences a potential or actual stressor, the body appraises the situation | the body appraises the situation, and the limbic system activates an anticipatory response. The amygdala, hippocampus, and prefrontal cortex work together to process emotional responses to stress. |
| allostasis | the idea that the body adjusts to meet new challenges |
| The sympathetic–adrenal–medullary (SAM) system | helps the body quickly respond to stress by releasing norepinephrine, epinephrine, and dopamine |
| The hypothalamic–pituitary–adrenal (HPA) axis | releases neurotransmitters that work to regulate the body’s physical responses to stress. |
| The hypothalamic–pituitary–adrenal (HPA) axis release neurotransmitters that prompt the release of | corticotropin-releasing hormone (CRH), which triggers the pituitary gland to release adrenocorticotropic hormone (ACTH), which then prompts the adrenal glands to make cortisol. |
| Chronic cortisol elevation | suppresses immunity and promotes inflammatory dysregulation |
| prolonged exposure to cortisol causes | glucocorticoid resistance, in which immune cells become less sensitive to cortisol, leading to chronic inflammation. High cortisol levels also reduce the number and function of immune cells. |
| the GAS is a three-stage response involving | alarm, resistance, and exhaustion. |
| A fundamental concept underlying GAS is that the | body attempts to return to a steady state of internal, physical, and chemical balance (homeostasis) to maintain optimal functioning. |
| Alarm stage: | the CNS is activated, and catecholamines from the adrenal medulla and hormones from the adrenal cortex mobilize the body for fight-or-flight. If exposure to the stressor is prolonged or severe, the person progresses to the resistance stage. |
| Resistance stage: | body works to counteract the stress and attempts to return toward homeostasis, although full restoration is not achieved while the stressor persists. The parasympathetic nervous system moderates the initial fight-or-flight activation. |
| Exhaustion stage: | If the stressor continues beyond the body’s ability to adapt, the body enters the exhaustion stage. Physiological defenses become depleted, and the body can no longer sustain the adaptation. |
| allostatic load | over time can lead to long-term health risks such as hypertension, depression, autoimmune disorders, and other stress-related conditions. |
| Appraisal of the stressor is influenced by | including cognitive, physiological, affective, psychological, and neurological skills, abilities, and resources. |
| individual experiences two stages of appraisal | primary and secondary—before responding to stress. |
| During primary appraisal | an individual evaluates a situation to determine whether the stressor poses a threat. |
| During Secondary appraisal | assesses whether they can cope with the situation by examining the balance of situational demands, such as risk, uncertainty, and difficulty with the available resources for addressing the threat, including social support, expertise, and past successes. |
| TTSC is considered a transactional model, because | it suggests that appraisals impact responses, which in turn result in changes in the situation or the individual, and these changes then influence ongoing reappraisals |
| Stress is categorized into several categories, including | acute stress, episodic acute stress, chronic stress, traumatic stress, environmental stress, psychological stress, and physiological stress. |
| Traumatic stress happens as a result of | events such as natural disasters, accidents, or violence that can exceed an individual’s ability to cope |
| Environmental stress comes from | difficult surroundings, such as loud noise, pollution, crowded spaces, housing instability, food insecurity, or neighborhood violence. |
| psychological stressor is an | event, situation, comment, condition, or interaction that an individual interprets as negative or threatening |
| Physiological stress is generally associated with | injury or illness, such as exposure to extreme temperatures, trauma, injury, illness, or pain. |
| common major life events that can trigger stress include | work-related issues, financial pressures, bereavement, family problems, illness, fear of criminal victimization, excessive noise and overcrowding, and fear of the unknown. |
| Developmental Crises | Life Transitions: puberty, retirement, Menopause, Starting a family |
| Situational Crisies | External Events: Loss of a loved one, Trauma, Natural Disaster, Domestic violence, physical illness, Employment loss |
| Existential Crises | Internal Factors: Personal Meaning, Identity, Individual Purpose |
| Psychiatric Emergencies | Acute mental Health Episodes: Suicide attempt, severe depression, psychosis, |
| Crisis intervention is not process-oriented, but rather action and situation-focused. The goal is to | help the client identify precipitating events leading up to the crisis; utilize skills, resources, and available support systems to effectively deal with the crisis; and formulate a plan of care for current and future critical events |
| Seven-Stage Model of Crisis Intervention: Step 1 | Conduct a thorough biopsychosocial crisis assessment. Assess for suicidal and homicidal risk, drug and alcohol abuse, need for medical attention, and ineffective coping strategies. Assess resilience, protective factors, and support systems. |
| Seven-Stage Model of Crisis Intervention: Step 2 | Establish rapport and a therapeutic environment by conveying respect and acceptance. Display neutrality and a nonjudgmental attitude. |
| Seven-Stage Model of Crisis Intervention: Step 3 | Assess the dimensions of the problem or crisis. Identify client issues and challenges, including what precipitated the crisis, to glean insight into the presenting problem. |
| Seven-Stage Model of Crisis Intervention: Step 4 | Encourage the client to explore and express feelings and emotions. Use active listening, reflection, and paraphrasing, and respond with encouraging statements. |
| Seven-Stage Model of Crisis Intervention: Step 5 | Explore past positive coping strategies and alternatives. View the client as resourceful and resilient, and as possessing an array of potential resources and alternatives. |
| Seven-Stage Model of Crisis Intervention: Step 6 | Implement the action plan. Identify supportive individuals and contact referral sources. |
| Seven-Stage Model of Crisis Intervention: Step 7 | Establish a follow-up plan after the initial intervention to determine the client’s status and ensure that the crisis has been resolved. |
| stress in nursing: related to work Organization | Working extra hours, poor conditions, limited opportunities for advancement |
| stress in nursing: Psychosocial | Expectation to deliver consistent, optical care. Receiving unaligned work instructions lack of support interpersonal conflicts Aggression from clients and families Lack of recognition |
| stress in nursing: Related to individual characteristics | responsibility for health & life Exposure to suffering & death Fear of job loss Lack of motivation need to improve professional skills |
| Healthy Nurse, Healthy Nation™ (HNHN), which is a | social movement designed to enhance national health by strengthening the well-being of America’s nurses. |
| Healthy Nurse, Healthy Nation™ (HNHN) five key domains: | quality of life, safety, physical activity, sleep, and nutrition |
| Healthy Nurse, Healthy Nation™ (HNHN)The program features a comprehensive web platform that | encourages participation, fosters healthy competition, delivers valuable content and resources, collects data, and facilitates connections among nurses, employers, and organizations. |
| the nurse should recognize that practicing -------------- helps nurses recognize early signs of stress, such as fatigue, irritability, or emotional overload, before these symptoms escalate. | self awareness |
| By noticing these early indicators, nurses can take -----------such as maintaining healthy routines, ensuring adequate rest, and incorporating daily physical activity. | proactive steps |
| the nurse should understand that using-----------, such as planning ahead, seeking emotional or practical support, and applying task-focused approaches, helps nurses feel more in control during demanding shifts. | positive coping strategies |
| Leininger’s (1988) Transcultural Nursing Theory, also known as Culture Care Theory, involves | knowing, understanding, and appreciating different cultures, beliefs, and values that influence nursing care. |
| Trauma-informed care is an approach | that recognizes how past stress or trauma can shape a person’s physical, emotional, and behavioral responses in health care settings |
| Precision nursing (PN) is an approach that | shifts the focus of how nurses deliver care. PN aims to improve health outcomes by personalizing care through an understanding of how genetics, the environment, and the client’s body interact. |
| Perceived Stress Scale (PSS) developed by Cohen and colleagues in 1983 is a cornerstone assessment tool that | measures how unpredictable, uncontrollable, and overwhelming individuals perceive their lives to be. assesses respondents' feelings of their circumstances exceed their coping abilities, using questions about thoughts and feelings over the past month. |
| nurses use several therapeutic communication techniques to build trusting relationships, including | active listening, asking open-ended questions, seeking clarification, and offering observations |
| Coping refers to | the conscious and intentional thoughts and actions employed to handle stressful situations, both internally and externally. |
| Coping is typically categorized into two types: | reactive coping, which is the response that occurs after encountering a stressor, and proactive coping, which involves actions taken to prevent or mitigate future stress. |
| A problem-focused approach | involves dealing with the situation itself by trying to change it into something more palatable |
| emotion-focused approach requires | altering our association with the situation to reduce the stress it may cause |
| A healthy diet can help offset the impact of stress by | strengthening the immune system, lowering blood pressure, and supporting overall good health. |
| One of the best stress-reducing strategies is to | exercise and increase physical activity |
| Mindfulness Practice | Perform meditation for at least 10 min at three times per week. |
| Complementary and alternative therapies refer to treatments such as | aromatherapy, herbal medicine, acupuncture, massage, biofeedback, and meditation. |
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