Fundamentals of Nursing Chapters 23, 26, and 42
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Condition in which the person experiences changes in the normal balanced state
Define what a Stressor is
Any event or stimulus that causes an individual to experience stress
Define the coping responses of stress
- Coping strategies
- Coping response
- Coping mechanisms
What are the indicators of Mild Anxiety?
- Increased questioning
- Mild restlessness
- Feelings of increase arousal and alertness
- Use of learning to adapt
What are the indicators of Moderate Anxiety?
- Voice tremors and ptch changes
- Facial twitches
- Increased muscle tension
- Narrowed focus of attention
- Ability to focus, but selectively inattentive
- Slightly impaired learning
- Slight increased RR and HR
- Mild gastric symptoms
What are the indicators of Severe Anxiety?
- Communication that is difficult to understand
- Increased motor activity
- Inability to relax
- Fearful facial expression
- Inability to focus or concentrate
- Easily distracted
- Severely impaired learning
What are the indicators of Panic?
- Communication not understandable
- Increased motor activity
- 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
- May feel they are having a heart attack
Between stimulus and response, what do we have?
- A choice!
- We have to think about how we will handle things!
What are some indicators of stress?
What are some physiological indicators of stress?
- Pupils dilate
- Sweat production increases
- Heart rate and cardiac output increase
- Skin is pallid
- Sodium and water retention
- Rate and depth of respiration increase
- Urinary output decreases
- Mouth may be dry
- Peristalsis of the intestines decrease for serious threats
- Mental alertness improves
- Blood sugar increases
What are some psychological indicators of stress?
- Anxiety (mild, moderate, severe, and panic)
- Unconscious ego defense mechanisms
How many levels of anxiety are there?
- Four (4)
- - Mild
- - Moderate
- - Severe
- - Panic
What are the three models of stress?
- Stimulus-based models
- Response-based models
- Transaction-based models
Define the Stimulus-based Models
- Stress defined as a stimulus, a life event, or set of circumstances that arouses physiologic/psychologic reaction
- This stress may increase vulnerability to illness
- Both positive and negative events considered stressful
- EXAMPLE: Moving into your dream house is still stressful!
Define the Response-based Models
- Stress may be considereda response
- Selye (1956, 1976) defined as nonspecific response of body to any kind of demand made upon it
Define the Transaction-Based Models
- Based on work of Lazarus (1966)
- Set of cognitive, affective, and adaptive (coping) responses that arise out of person-environment transactions
- Person and environment are inseparable - each affects and affected by the other
- Stress refers to any event in which environmental and/or internal demands tax adaptive resources of individual, social system, or tissue system
What are some cognitive indicators of stress?
- Problem solving
- Self-control or self-discipline
- Fantasy or daydreaming
What are some of the defense mechanisms that can come up when an individual is under stress?
- Reaction formation
- Dealing with change (either successfully or unsuccessfully)
- Coping strategy is natural or learned way of responding to changing environment or specific problem or situation
What are the different types of coping?
- A combination of both
Define problem-focused coping
Efforts to improve situation by making changes or taking action
Define emotion-focused coping
- Thoughts and actions that relieve emotional distress
- Doesn't improve situation but person feels better
List the four types of coping strategies
- Long term
- Short term
Define the long term coping strategy
Can be constructive and realistic
Define the short term coping strategy
- Reduce stress temporarily but ineffective to deal with reality
- May be destructive or detrimental
Define an adaptive coping strategy
- Can be affective
- Result of effective coping
Define a maladaptive coping strategy
- Results in unnecessary distress
- Results from ineffective coping
Describe the type of NURSING HISTORY that can be taken for a patient who is dealing with stress
- Client-perceived stressors or stressful incidents
- Manifestations of stress
- Past and present coping strategies
- Developmental transitions
What would you like to do?
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