Upgrade to remove ads
Only $35.99/year

NUR 215 Mod 9 - Stress and Coping

Terms in this set (80)

Stressor
Stimulus that person perceives as a threat
Coping
Reducing tension, strain, and pressure
Adaptations
Changes that take place as a result of coping
Homeostasis
External and internal equilibrium
Distress - Categories of Stress
-Can threaten health
e.g. Continual financial worries
Developmental - Categories of Stress
-Associated with life stages
e.g. College graduation
Eustress - Categories of Stress
-Good stress
e.g. Passionate kiss
Situational - Categories of Stress
-Random
-Unpredictable
e.g. hurricane, accident
Anticipatory - Categories of Stress
-The future
e.g. Upcoming exam
Time - Categories of Stress
-Unable to meet demands
e.g. Multiple demands, rushing
Physiological - Categories of Stress
-Affect body: structure/function
e.g. Diseases, mobility problems
Psychological - Categories of Stress
-Arise from life event
e.g. Work pressure, family arguments
Chemical - Physiological Stressors
-Medications
-Tobacco
Physical - Physiological Stressors
-Trauma
-Joint overuse
Nutritional - Physiological Stressors
-Diet
-Vitamin Deficiency
Biological - Physiological Stressors
-Viruses
-Bacteria
Genetic - Physiological Stressors
-Inborn errors
Lifestyle - Physiological Stressors
-Obesity
-Sedentary lifestyle
Adaptive - Styles of Coping Strategies
-Healthy choices
-Directly reduce negative effects of stress
e.g. Change in lifestyle, problem-solving
Maladaptive (ineffective) - Styles of Coping Strategies
-Unhealthy style, temporary fix
-Possible other harmful effects
-Does not promote adaptation
e.g. Substance abuse, overeating
Dealing with Stress: Coping Strategies
Three general approaches for coping, depending on situation:

1. Alter the stressor: Change jobs

2. Adapt to the stressor: Changing thoughts about nursing clinical

3. Avoid the stressor: Ending a relationship
Adaptation
-A possible/desired outcome of stress
-Involves adjusting to the stress/stressor
-Allows for
+Normal growth and development
+Effective responses to life's challenges
-Ability to adapt depends on
+Intensity of the stressor
+Effectiveness of coping skills
+Personal factors
Factors that Influence Adaptation
-Personal perception of stressor
+Is understanding of stressor realistic?
+How successful have previous adaptation attempts been?

-Overall health status
+The number of illnesses present and the chronicity of illnesses may affect the ability to adapt to new stressors

-Support system (e.g. friends, family providing emotional, financial, physical help)
+Strong support = better adaptation

-Hardiness
+Personal factors: Age, developmental level, life experiences
General Adaptation Syndrome (GAS)
-Selye's theoretical model of physiological responses to stress
-Nonspecific bodily responses shared by all people
-Response to distress as well as eustress
-Involves three stages
Alarm Stage of GAS
-Fight or flight
-Involves involuntary body responses
Endocrine System - Alarm Stage of GAS
-Increased release of hormones from
+Hypothalamus (CRH)
+Anterior pituitary (ACTH)
+Posterior pituitary (endorphins, ADH)
+Adrenal cortex (cortisol, aldosterone)
+Adrenal medulla/Sympathetic nervous system (epinephrine, norepinephrine)
Cardiovascular System - Alarm Stage of GAS
-Vasoconstriction
-Elevated blood pressure
-Elevated heart rate
Respiratory System - Alarm Stage of GAS
-Dilated bronchioles
Metabolic System - Alarm Stage of GAS
-Increased availability of glucose
Urinary System - Alarm Stage of GAS
-Sodium and water retention
Gastrointestinal System - Alarm Stage of GAS
-Decreased peristalsis
Musculoskeletal System - Alarm Stage of GAS
-Increased blood flow to muscles
Resistance Stage of Gas
-Goal: Maintenance of homeostasis
-Involves use of coping mechanisms
+Psychological
+Physical > Return of vital signs to normal
-Failure to adapt or contain stress leads to third phase
Exhaustion Stage of Gas
-If adaptive mechanisms become ineffective/nonexistant
-Decrease in blood pressure, elevated pulse, respiration
-Usually ends in disease or death
Recovery Stage of GAS
-Third stage, if adaptation is successful
Local Adaptation Syndrome - Physical Response to Stressors
-Response to stress involving specific body part, tissue, or organ
-Short-term attempt to restore homeostasis
-Localized
-Types
+Reflex pain response
+Inflammatory response: Pain, heat, swelling, redness
Inflammatory Process - Physical Response to Stressors
-Vascular response
-Cellular response: Phagocytes engulf bacteria and destroy them
-Exudate formation: Fluid and WBC from circulation
-Healing/Regeneration: Replacement of damaged cells with similar or identical cells
Vascular Response
-Injured cells release histamine
-Dying cells release kinin (cause vasodilation)
-Capillaries become more permeable causing edema
-Leukocytes (WBC) move into area
-Blood flow decreased to allow leukocytes to perform their function
Psychological Responses to Stress
-Include feelings, thoughts, and behaviors
+Anxiety and fear
+Ego defense mechanisms (e.g. denial, rationalization, projection)
+Anger
+Hostility
+Depression
Avoidance - Psychological Defense Mechanisms
Unconsciously staying away from events or situations that might open feelings of aggression or anxiety
Compensation - Psychological Defense Mechanisms
Making up for a perceived inadequacy by developing or emphasizing some other desirable trait
Conversion - Psychological Defense Mechanisms
-Emotional conflict is changed into physical symptoms that have no physical basis
-The symptoms often disappear after the threat is over
Denial - Psychological Defense Mechanisms
-Transforming reality by refusing to acknowledge thoughts, feelings, desires, or impulses
-This is unconscious; the person is not consciously lying
-Usually the first defense learned
Displacement - Psychological Defense Mechanisms
-"Kick the dog."
-Transferring emotions, ideas, or wishes from one original object or situation to a substitute inappropriate person or object that is perceived to be less powerful or threatening
-This mechanism is rarely adaptive
Dissociation - Psychological Defense Mechanisms
Painful events are separated or dissociated from the conscious mind
Identification - Psychological Defense Mechanisms
A person takes on the ideas, personality, or characteristics of another person, especially someone whom the person fears or respects
Intellectualization - Psychological Defense Mechanisms
Cognitive reasoning is used to block or avoid feelings about a painful incident
Minimization - Psychological Defense Mechanisms
Not acknowledging or accepting the significance of one's own behavior, making it less important
Projection - Psychological Defense Mechanisms
-Blaming others
-Attributing one's own personality traits, mistakes, emotions, motives, and thoughts to another
-"Finger pointing"
Rationalization - Psychological Defense Mechanisms
-Use of logical-sounding excuse to cover up or justify true ideas, actions, or feelings
-An attempt to preserve self-respect or approval or to conceal a motive for some action by giving a socially acceptable reason
-Similar to intellectualization, but uses faulty logic
Reaction Formation - Psychological Defense Mechanisms
-Similar to compensation, except the person develops the opposite trait
-The person is aware of her feelings but acts in ways opposite to what she is really feeling
Regression - Psychological Defense Mechanisms
Using behavior appropriate in an earlier stage of development to overcome feeling of insecurity in a present situation
Repression - Psychological Defense Mechanisms
-Unconscious "burying" or "forgetting" of painful thoughts, feelings, memories, ideas; pushing them from a conscious to an unconscious level
-It is a step deeper than denial
Restitution (Undoing) - Psychological Defense Mechanisms
Making amends for a behavior one thinks is unacceptable to reduce guilt
Sublimation - Psychological Defense Mechanisms
Unacceptable drives, traits, or behaviors (often sexual or aggressive) are unconsciously diverted to socially accepted traits
Stress-Induced Organic Responses - Consequences of Failed Adaptation
-Continual stress
-Repeated CNS stimulation
-Elevation of certain hormones
-Results in long-term changes in body systems
Cardiovascular System - Organic Responses Related to Failure of Adaptation
-Decreased cardiac output, oxygen depletion, and fatigue
-Vasoconstriction causes hypertension
-Electrolyte imbalance and edema
Endocrine System - Organic Responses Related to Failure of Adaptation
-Diabetes
-Hyper- or hypothyroidism
-Prenatal Effects
Immune System - Organic Responses Related to Failure of Adaptation
-Autoimmune illness
-Suppression of immunity
Gastrointestinal System - Organic Responses Related to Failure of Adaptation
-Bowel inflammation
-Constipation
-Diarrhea
-Gastric hyperacidity
Musculoskeletal System - Organic Responses Related to Failure of Adaptation
-Muscle tension and pain
-Tension headache and temporomandibular joint pain
Respiratory System - Organic Responses Related to Failure of Adaptation
-Increased respiratory rate
-Hyperventilation
-Exacerbation of existing asthma, hay fever, and allergies
Somatoform Disorders - Consequences of Failed Adaptation
-Hypochondriasis: Abnormal concern for health
-Somatization: Anxiety in physical form
-Somatoform pain disorder: Emotional converts to physical
-Malingering: Conscious effort to avoid stress
Stress-Induced Psychological Responses - Consequences of Failed Adaptation
-Crisis
-Burnout
-PTSD
Precrisis - Stages of Crisis
-No symptoms
-Denies stress
-Usual coping strategies
Impact - Stages of Crisis
Anxiety and confusion increase
Crisis - Stages of Crisis
Recognizes problem but denies it is out of control
Adaptive - Stages of Crisis
Redefines crisis in realistic way
Postcrisis - Stages of Crisis
May develop better coping skills or be hostile, depressed, maladaptive
Burnout
Person cannot cope with the physical and emotional demands of workplace
PTSD
-Severe form of anxiety
-Exposure to extreme psychological and violent trauma
-Can be physical or emotional abuse
Role Conflict
Person assumes opposing roles with incompatible expectations
Sick Role
How one should behave when sick according to society
Role Ambiguity
Uncertain about what is expected when assuming role
Role Strain
Person feels frustration and anxiety over inadequate feelings in role
Assessment
-Determine if client has realistic view of stressors
-Identify factors that increase stress
-Identify interventions to reduce stress
-Physiological signs: Pulse, BP, respirations
Analysis/Nursing Diagnosis
+Physical - Constipation
+Behavioral - Ineffective health management
+Cognitive - Impaired memory
+Emotional - Anxiety
+Interpersonal - Impaired parenting
+Spiritual - Hopelessness
Outcomes/Evaluation
-Reduce strength and duration of the stressor
-Relieve or remove the responses to stress
-Use effective coping mechanisms
Health Promotion Activities - Stress Reduction Interventions
-Promote adequate nutrition
-Help client establish a routine that includes regular exercise
-Teach client importance of getting 7 to 8 hours of sleep per day
-Encourage participation in leisure activities
-Help clients to manage time, balance, responsibilities, prioritize tasks
-Advise clients to avoid maladaptive behaviors: Excess alcohol, caffeine, sweets, smoking, illicit drugs
Stress Reduction Interventions
-Use of specific interventions to relieve anxiety
-Anger management
-Stress management techniques
+Meditation, biofeedback, Reiki, humor, etc.
-Change perception of self
-Change perception of stressor
-Identify and use support systems
-Reduce the stress of hospitalization
-Use spiritual support
-Employ crisis intervention
-Use proper referrals
Sets with similar terms