Stress and Coping Chapter 22 Potter and Perry
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| Fight or Flight Response | Response to stress-Prepares a person for action by increasing heart rate;diverting blood from the intestines to the brain and straited muscles; and increasing BP,Heart rate,Respiratory rate,and blood glucose levels.(getting you ready to take that stress a
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| General Adaption Syndrome-(GAS)- | A Three stage reaction to stress-The gas reflects how the body responds to stressors through the alarm reaction,THE RESISTANCE STAGE,AND THE EXHAUSTION STAGE.The GAS is triggered either by physical event or indirectly by a psychological event.
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| The GAS | Is an immediate physiological response of the body to stress.
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| HYPOTHALAMUS | another part of the brain secretes ENDORPHINS.
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| ENDORPHINS | are hormones that act on the mind like morphine and opiates and produce a sense of well being and reduce pain.
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| How to release Endorphins | -EXERCISE,LAUGHING,
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| ALARM REACTION | Rising hormone levels result in increased blood volume,blood glucose levels,epinephrine, and norepinephrine amounts,heart rate,blood flow to the muscles,oxygen intake.(Also the pupils of the eyes dilate to produce a greater visual field.
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| The change in body system prepares a person for | FIGHT OR FLIGHT-LAST ONE MINUTE TO MANY HOURS.
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| F THE STRESSORS BECOME A THREAT TO LIFE OR LASTS A LONG TIME | THE PERSON PROGRESSES TO THE 2nd STAGE.
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| 2nd STAGE-RESISTANCE STAGE | The body stabilizes and responds in an opposite manner to the alarm reaction hormone levels,heart rate,BP,and cardiac output return to normal,and the body repairs any damage that occured.However if the stressors remain the person enters the 3rd stage
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| 3rg STAGE | EXHAUSTION STAGE-CANT TAKE ANYMORE-ALL ENERGY DRAINED-IF THE STRESS CONTINUES,ILLNESS AND DEATH RESULT
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| Stress makes people ill as a result of? | 1.INCREASED Levels of powerful hormones that change our bodies processes.2.COPING choices that are unhealthy such as not getting enough rest,diet,tobacco,alcohol and caffine.3.NEGLECT of warning signs of illness or prescribed meds.or treatments.(E
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| Exercise improves circulation and triggers the release of? | endorphins :)
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| PRIMARY APPRAISAL | (personal meaning)-Happens quickly and automatically in a persons mind.Seeing something as harm,loss,threat,challenge.
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| SECONDARY APPRAISAL | Focuses on possible coping strategies.(effectiveness of coping strategies depends on the persons needs.For this reason no single coping strategy works for everyone)
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| TYPES OF STRESS | Distress(damaging stress) and eustress(stress that protects health)
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| STRESS INCLUDES | Work stress,family,chronic stress,acute stress,daily hassles,trauma,and crisis.
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| CRISIS | Occurs when a persons emotional equalibrium is upset and custom problem-solving techniques cant be used to meet the daily problems of living.
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| TWO TYPES OF CRISIS | 1.Developmental Crisis(role changes) 2.Situational Crisis-when life events upsets the persons equilibrium
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| NURSING KNOWLEDGE-PRIMARY,SECONDARY,and TERTIARY PREVENTION. | 1.Primary-promotes pt. wellness by stress prevention and reduction of risk.2.Secondary-occurs after symptoms appear3.Tertiary-begins when the pt. system becomes more stable.
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| potenial stressors and coping mechanisms | vary across the life span)
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| Situational Factors | Job changs,Relocation,job interview.a.Chronic illness results in situational stress.Common diseases such as obesity,hypertention,diabetes,depression,asthma,and coronary artery disease,provoke stress
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| Maturational Factors | Stressors vary with life stage-Preadolescents experience stress related to self esteem issues,changing family structure due to divorce or death of a parent,or hospitalization
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| Sociocultural Factors- | Any age group,but especially stressful for young people.(Ex.prolonged poverty,physical handicap,and chronic illness.)
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| Cultural variations produce stress,particularly if the persons values in aspect of? | gender roles,family relationships and religious beliefs.)
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| Posttraumatic Stress Disorder(PTSD) | People who have experienced accidents,violents events such as rape,domestic abuse,war,and natural disasters.(People with PTSD sometimes have FLASHBACKS-a recollection so strong that the person thinks he is experiencing the trama again.)
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| This is a normal response to trauma but if it last 3 months? | the nurse makes a diagnosis of PTSD
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| CRITICAL THINKING-Synthesis | When examining your role with a pt. with stress,consider your pt. perception of the stress and examine your own frame of reference as a nurse.Interacting with a pt.with stress requires you to have confidence in yourself and integrity in dealing with a pt.
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| KNOWLEDGE | Physiological changes occur in pt. experiencing the alarm reaction,resistance stage and exhaustion stage of the General Adaption Syndrome(GAS).
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| EXPERIENCE | Your experience teaches you to understand the pt.unique perspective
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| ATTITUDES | Patients respects your advice and council from your belief in their ability to move past the stressful event or illness.
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| STANDARDS | Make accurate assessment of a pt. stress,coping mechanism,and support system before intervening.
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| NURSING PROCESS-ASSESSMENT | of a patients stress level and coping resources require that you first establish a trusting nurse-patient relationship.
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| Subjective Findings | Statements made by the patient,pt. view or stress,coping resourses
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| Objective Findings | things that we see,VS,behavior,appearance,groomingspeech,how they sit,eye contact
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| PATIENT EXPECTATION | What does pt. expect from you.(sometimes when nothing will change or improve the situation than Denial is ok.
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| NURSING DIAGNOSIS | Focus on Coping With Stress
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| Examples of Stress Related Nursing Diagnosis | Anxiety,Caregiver Role Strain,Compromised family coping,Ineffective Coping,Innefective Community Coping,Fear,Chronic Pain,Post-Trauma Syndrome,Relocation Stress Syndrome,Situational Loss Self-esteem,Disturbed Sleep PATTERN,Impaired Social Interaction.
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| Ineffective Coping | Inability to cope and Inability to ask for help.Ex.Denial,Self mutilation
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| PLANNING- Goals and Outcomes | Desirable Goals for the person experiencing stress are 1.Coping,2.Family Coping,3.Caregiver emotional help 4.Psychosocial Adjustment;life change
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| Nursing Interventions are designed within the framework of? | Primary,Secondary and Tertiary Prevention
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| Continuity Of Care | There will be times when nursing alone does not meet the pt. needs.Aneffective plan requires you to collaberate with occupational therapist,dietitians or pastoral care professional.
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| IMPLEMENTATION-HEALTH PROMOTION | Interventions for stress has a 3 prong approach 1.Decrease stress producing situations,Increase resistance to stress,Learn skills that reduce physiological responce to stress.
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| AS A NURSE YOU EDUCATE PATIENTS AND FAMILIES ABOUT | THE IMPORTANCE OF HEALTH PROMOTION.
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| Health Promotions | Regular Exercise,Guided Imagery,Support Sysyem,Cognitive Therapy-teaches pt.how certain thinking patterns cause symptoms of stress or depression,Assertive Training-teaches people to communicate effectively regarding their needs and desires.,and Stress Man
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| ACUTE CARE-Crisis Intervention | When stress overwhelms a persons usual coping mechanism and demands mobilization of all available resources,the stress becomes a crisis.
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| A crisis creates a turning point in a persons life because | it changes the direction of a persons life in some way.
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| The event usually occurs? | from 1-2 weeks before the person seeks help,but sometimes it has occured within the the past 24 hours.
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| Generally a crisis resolves in some way within? | approximately 6 weeks
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| CRISIS INTERVENTION | Aims to return the person to a precrisis level of functioning and to promote growth.
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| Restorative And Continuing Care | A person under stress recovers when the stress disappears or coping strategies succeed.However a person who has experienced a crisis has changed,and the effects sometimes last for years or for the rest of the persons life.
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| Evaluation-Patient Care | Review the behaviorally stated,measurable goals,and evaluate whether or not the patient has met the criteria as stated in the outcome.GOAL MET,NOT MET,PARTIALLY MET.
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| While Assessing a patient gor the effects of GAS Syndrome,be aware that? | Blood glucose levels increase during the alarm reaction stage.
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| While teachong a person with hypertention about how stress causes illness,you explain that: | Stress causes a person to forget to take medication and thereby cause illness.
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| Another nurse is talking to you about stress she feels on the job.You reconize that: | Nurses frequently experience stress with the rapid changes in health care technology and organizational restructuring.
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| When Assessing a child for the effects of stress,you observe that: | Stressors and coping methods are different for children than older people
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