chapter 42
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| stress | results from changes in the environment that is perceived as a threat. can be positive or negative
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| stressor | anything perceived to be threatening
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| strsss affects__________ | physical, emotional, intellecutal, social, spiritual aspect of pt
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| physiologic homeostasis | goal is to keep the body is balance
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| adaptation | changes that occur due to respose to the stressor
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| stages of general adaptation syndrome | alarm reaction, resistance, exhaustion
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| alarm reaction stage of GAS | shock phase. may last 1 minute to several hours. fight or flight response occurs
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| fight or flight response | increase heart rate, increase blood pressure, increase peripheral vasoconstriciton, increase metabolism, increase water retention, increase mental alertness.
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| resistance stage of GAS | body stabilizes and regains homeostasis or adative mechanisms fail.
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| exhaustion stage of GAS | body either rests and mobilizes its defenses to return to normal or dies.
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| psychological homeostasis | these needs must be met: love& belonging, safety & security, self-esteem
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| emotional response to stress | depression, anger, anxiety
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| levels of anxiety | mild, moderate, severe, panic
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| positive level of anxiety | mild
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| anxiety | vague,uneasy feeling of discomfort or dread. source in non-specific
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| coping mechanisms used to decress stress | crying, laughing, sleeping, exercis, drinking, smoking, eating, lack of eye contact, withdrawal
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| task oriented reaction to stress | conscious decision to decrease stress
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| types of task oriented reaction to stress | attack behavior, withdrawl, compromise behavior
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| attack behavior | problem solving (positive)/ agression (negative)
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| withdrawal behavior | withdrawing from stress, "giving up"
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| compromise behavior | finding a positive reason for stress
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| defense mechaninsms used with stress | compenstaion, denial, displacement, projection, rationalization, regression,
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| effects of long term stress | increses risk for disease, affects physical status
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| family stressors | changes in family structure/roles, loss of control, concern for future financial stabilty
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| factors affecting stress and adaptation | source of stress, types of stress personal factors
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| sources of stress | developmental and situational
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| developmental stress | occurs as one progessess through stages of growth and development. maybe positive or negative
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| situational stress | does not occur in predictable patterns. maybe positive or negative
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| types of stressors | physiologic and psychosocial
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| physiologic stressor | infectious agents, nutritional deficiencies, immune disorders
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| psychosocial stressors | real and perceived threats
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| healthy ADL's to cope with stress | exercise, rest/sleep, proper nutrition, use of support systems, use of stress management techniques
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| stress management techniques | relaxation, meditation, anticipatory guidance, music therapy
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| how to evaluate interventions | pt verbalizes what causes stress, pt verbalizes decrease in stress
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| example of manifestations of long term stress | cardiovascular disease, cancer, GI diorders
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| coping mechanisms are used to________ | protect the ego
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| raationalization | justfiying when things do not go as expected
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| denial | when a pt does not view behavior/choices as affecting their health or a situation
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| crisis | when in crisis mode pt in unable to learn or to hear/understand all of what the nurse is saying. short,direct statements are made to the pt.
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