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is a disturbance in a person's normal balanced state.
- is a stimulus that the person percieves as a challengeor threat.
- it disturbs the persons' equalibriumby initiating a physical or emotional response
when stress occurs, t produces voluntary and involuntary copoing responses aimed at restoring equlibriuem(balance or homeostasis)
the changes that take place as a result of stress and copoing.
ongoing effort to maintain external and internal equilibrium
- are the thinking processs and behaviors a person uses to manage stressors
- Can be Adaptive and Maladaptive
- consists of making healthy choices that reduce the negative effects of stress.
- ex. exercising to relieve ension, engagin in a favorite hobby.
Maladaptive (inefective) coping
does not promote adaptation. Unhealthful coping choices include overeating,working too much, substance abuse.
3 approaches to coping
- Altering the stressor: actions to remove or change the stressor
- Adapting to the stressor: not always possible to remove or change a stressor. IT is changing of one 's thoughts or behaviors related to the stressor
- Avoiding the stressor: sometimes, it is healthful to avoid a stressor
3 stages of General Adaptation Syndrom GAS
- 1. Alarm Stage - "Fight or Flight": has two phases
- Shock phase: begins when the cerebral cortex first perceives a stressor and sends out messages to activate the endcrine and sympathetic nervous systems. Last less than 24 hrs and maby a 1 2 min.
- Countershock phase: all the changes produced in the shock phase are reversed.
- 2. Resistance Stage - Coping with the Stressor: the body attempts to stabilize by using physiological and psychological coping mechanisms, and the body systems (e.g., heart, lungs, and immune response) return to normal.
- 3. Exhaustion or Recovery stage - Final effort to adapt: if stress continues and adaptivce mechamisms become ineffective or a re used up, a person enters the final stage, exhaustion. Or recover - if adaptation is successful.
Results of Adaptation failure
- Cardiovascular system: contineus secretion of epinephrine may cause angina, myocardial infarction, cardiomagaly.
- Immune system: attack self
- Gastrointestinal system: constipation or diarrhea, hear burn, erosion of gastro intestinoal tract
- Musculoskeletal System: constant readiness for fight or flight produces muscle tension and pain in various body systems. Tension headache, jaw joint pain
- Respiratory system: Epinephrine and circulating hormones dialte the bronchila tubes and increase the reate of respiration. Alkalosis, dizziness, tingling hands and feet and axiety.
- Somatophorm disorders: presence of physical symtoms with no known organic cause.
- Hypochondriasis: person is preoccupied with the idea that he is or will become serously ill. Axiety about his health can trigger the physical sensations.
- Pain disorder: emotional pain that manifest phisicaly.
- Malingering: conscious effort to escape unpleasent situations.
- Crisis: when event is a person's life drastically changes the person's routine. The perons' usual coping methods are inefective.
- Post traumatic stress disorder: victim experiences anxiety and flashbacks that my last for monts or years.
Activities that can assists with stress management
- Nutrition: help to maintain integrity of the immune system. will help in maintainig physical hemostasis and resist stress
- exersize: imrpove phisical hemostatsis by improving muscle tone and controlling weight. Also promotes relaxation and reducing tension. During exercise, the brain release endogeneous opioids which create a feeling of well-being. Exer for 30 min 5 days a week.
- Sleep and rest: restores energy levels
- Leasure Activities: any activities that provides joy and satisfaction.
- Time management:
- Avoding maladaptive behaviors: such as consuming excess coffeine, abusing alcohol, smoking, avoiding social intaractions.
- Releave anxiety
- Anger management
- Stress managemetn
Nursing interventions to assist patients in he midst of a crisis situation
- Step 1. Assess the situation
- ● What is the nature of the patient’s condition and the severity of the crisis?
- Step 2. Ensure safety.
- ● Call for help if you or the patient is in physical danger.
- ● Do not leave the patient unless you think you are in imminent danger.
- ● First ensure your own safety; then provide for the patient’s safety.
- Step 3. Defuse the situation.
- ● Keep in mind that a person in crisis may not be in control of his actions.
- ● Try to calm the person verbally.
- ● Maintain an outward appearance of being calm yourself.
- ● Attempt physical restraint only as a last resort and only when there is enough help to do it safely for staff and patient.
- Step 4. Decrease the person’s anxiety.
- ● Reassure the patient that he is in a safe place and that you are concerned and want to help.
- ● Explain gently but firmly that you need his help and cooperation.
- ● Help the patient to vent feelings of fear, guilt, and anger.
- ● Use physical contact very cautiously. The patient in turmoil may interpret touch as aggression or sexual innuendo.
- Step 5. Determine the problem.
- ● Find out what the patient believes to be the cause of the crisis.
- ● Remain calm and do not pressure the patient to give reasons. Any tension on your part will create further panic in the patient.
- Step 6. Decide on the type of help needed.
- ● You may be able to calm the patient enough for him to understand what just happened, or you may not. Evaluate your ability to calm the patient on your assessment of his coping skills and resources.
- ● Put in place the help needed to restore the person to a minimal level of functioning. This may require long-term treatment. In that case, make the referrals.
- Step 7. Return the person to pre-crisis level of functioning. This may involve crisis counseling and/or home crisis visits.
- ● The goal of crisis counseling is to provide immediate relief, solve the most urgent problems, and give long-term counseling if needed. Crisis centers often rely on telephone counseling (“hotlines”).
- ● If telephone counseling is not adequate, or if observations of the home environment are needed, home visits may be made.