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the initial reaction of the body to stress, which alerts the body's defenses
Alarm reaction
an emotional state consisting of a subjective feeling of animosity or strong displeasure
Anger
a state of mental uneasiness, apprehension, or dread producing an increased level of arousal caused by an impending or anticipated threat to self or significant relationships
Anxiety
a complex syndrome of behaviors that can be likened to the exhaustion stage of general adaptation syndrome; an overwhelming feeling that can lead to physical and emotional depletion, a negative attitude and self-concept, and feelings of helplessness and hopelessness
Burnout
a role that has traditionally inclided those activities that assist the client physically and psychologically
Caregiver Burnout
dealing with change
Coping
an innate or acquired way of responding to a changing environment or specific problem or situation
Coping Mechanism
or Coping strategy
second part of alarm reaction in which the changes the body experienced during the shock phase are reversed
Countershock phase
therapy focused on solving immediate problems involving individuals, groups, or families in crisis
Crisis Counseling
a short-term helping process of assisting clients to work through a crisis to its resolution and restore their precrisis level of functioning
Crisis Intervention
feelings of sadness and dejection, often accompanied by physcologic change such as decreased functional activity
Depression
(Freud) mental mechanisms that develop as the personality attempts to defend itself, establish compromises among conflicting impulses, and allay inner tensions
Ego Defense Mechanisms
an emotional response to an actual, present danger
Fear
a general arousal response of the body to a stressor characterized by certain physiologic events and dominated by sympathetic nervous system
General Adaptation Syndrome (GAS)
the reaction of one organ or body part to stress
Local Adaptation Syndrome (LAS)
first part of the alarm reaction in which the stressor may be perceived consciously or unconsciously by the person
Shock Phase
the third stage in the adaptation syndromes that occurs when the adaptation that the body made during the second stage cannot be maintained
Stage of Exhaustion
the second stage in the adaptation syndromes when the body's adaptation takes place
Stage of Resistance
stress is defined as a stimulus, life event, or set of circumstances that arouses physiologic and/or psychologic reactions that may increase the individual's vunerability to illness
Stimulus-based stress model
an event or set of circumstances causing a dirupted response; the disruption caused by a noxious stimulus or stressor
stress
any factor that produces stress or alters the body's equilubrium
stressor
a theory that encompasses a set of cognitive, affective, and adaptive (coping) responses that arise out of person-environment transactions; the person and the environment are inseparable and affect each other
Transactional stress theory
Concepts of stress
stimulus-based models
response-based models
transaction-based models
Stimulus-based models
-stress defined as a stimulus, a life event, or a set of circumstances that arousesĀ  physiologic/psychlogic reaction
- This stress may increase vunerability to illness
- both positive and negative events considered stressful
Resoponse based Models
- Stress may be considerd a response
- a nonspecific response of body to any kind of demand made upon it
Transaction-based model
- set of cognitive, affective, and adaptive (coping) responses that arse out of person-environment transactions
- person and environment are inseparable - each afects and affected by the other
- stress refers to any event in which environmental and/or internal demands tax adaptive resources of indivdual, social system, or tissue system
Indicators for stress
-physiologic
-psycologic
-cognitive
Physiologic Indicators of stress
-pupils dialate
-sweat production increases
-HR and CO increase
-sodium and water retained
-rate and depth of respiration increase
-urinary output decreases
-mouth may be dry
-peristalsis of the intestines decrease for serious threats
-mental alertness
-blood sugar increases
Psychologic Indicators of Stress
-anxiety
-fear
-anger
-depression
-unconscious ego defense mechanisms
Cognitive Indicators of Stress
-problem solving
-structuring
-self control or self discipline
-suppression
-Fantasy
Four levels of anxiety
-mild
-moderate
-severe
-panic
Indicators of mild anxiety
-increased questioning
-mild restlessness
-sleeplessness
-feelings of increased arousal and alertness
-use of learning to adapt
Indicators of moderate anxiety
-voice tremors and pitch changes
-tremors
-facial twitches
-shakiness
-increased muscle tension
-narrowed focus of attention
-ability to focus but selectively inattentive
-slightly impaired learning
-slight increased RR and HR
-mild gasric symptoms
Indicators of severe anxiety
-communication tat is difficult to understand
-increased motor activity
-inability to relax
-fearful facial expression
-inability to focus or concentrate
-easily distracted
-severly impaired learning
-tachycardia
-hyperventilation
-headache
-dizziness
-nausea
Indicators of Panic
-communication not understandable
-increased motor activity
-agitation
-unpredictable responses
-trembling
-poor motor coordination
-perception distorted or exaggerated
-inability to learn or function
-dyspnea, palpitations, choking
-chest pain/pressure
-feeling of impending doom
-paresthesia sweating
Defense mechanisms
-compensation
-denial
-displacement
-indentification
-intellectualization
-introjection
-minimization
-projection
-rationalization
-reaction formation
-regression
-repression
-sublimation
-substitution
-undoing
Coping
-dealing with change (either successfully or unsuccessfully)
-coping strategy is natural or learned way of responding to changing environment or specific problem or situation
Types of coping
Problem focused
-efforts to improve situation by making changes or taking action
emotion focused coping
-thoughts and actions that relieve emotional distress
-doesn't improve situation but person feels better
both types usually occur together
Coping strategies
Long term
-can be constructive and realistic
Short term
-reducse stress temporarily but ineffective to deal with reality
-may be destrcutive or detrimental
Adaptive
-can be effective
-result of effective coping
Maladaptive
-results in unnecessary distress
-results from ineffective coping
Assessing stress and coping patterns Nursing History
-client perceived stressors or stressful
-manifestations of stress
-past and present coping strategies
-developing transitions
Assessing stress and coping patterns
Assessment interview
-scale to rate specific stressors
-duration of stressful situation
-usual strategy for handling stressful situations
-effectiveness of these strategies
Assessing stress and coping patterns
Physical examination
-verbal
-motor
-cognitive
-other physical manifestations of stress
Nursing diagnosises related to stress
-anxiety
-caregiver role strain
-compromised family coping
-decision conflict (specify)
-defensive coping
-disabled family coping
-fear
-impaired adjustment
-ineffective coping
-ineffective denial
-post trauma syndrome
-relocation stress syndrome
Interventions to miinimize and manage stress
-physical exercise
-optimal nutrition
-adequate rest and sleep
-time management
Interventions
Physical exercise
-promotes physical and emotional health
-30 minutes/day recommended
Optimal nutritional
-essential for health
-increases resistance to stress
-avoid excesses of caffeine, salt, sugar, fat
-avoid vitamin deficiencies
Interventions
Sleep
-restore's body's energy level
-may need to use relaxation techniques
Time Management
-must address what is important and achievable
-reexamination "should do", "ought to do", "must do"
Reducing client stress
Other methods include
-listen attentively
-provide atmosphere of warmth and trust
-convey sense of caring and empathy
-include client in plan of care
-promote feeling of safety and security
-minimize additional stressors
-help with recognition of stressors and coping mechanisms
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