chapter 37.txt

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coolexy
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304026
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chapter 37.txt
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2015-06-14 13:17:34
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stress coping
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stress and coping chapter 37
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stress and coping chapter 37
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  1. What is stress?
    It is an experience to which a person is exposed through a stimulus or stressor. Stressors are tension-producing stimuli operating within or on any system. It is also the appraisal, or perception, of a stressor. Appraisal is how people interpret the impact of the stressor on themselves or on what is happening and what they are able to do about it.
  2. How does the body adapt to stress?
    • Fight-or-flight response
    • • Neurophysiological responses:
    • – Medulla oblongata
    • – Reticular formation
    • – Pituitary gland
  3. How does Selye’s General Adaptation Syndrome (GAS) relate to the human stress response?
    • General Adaptation Syndrome (GAS)•: An immediate physiological response of the whole body to stress; involves several body systems, especially the autonomic nervous and endocrine systems, and includes immunological changes•
    • A three-stage reaction to stress:–
    • 1. Alarm reaction–
    • 2. Resistance stage–
    • 3. Exhaustion stage•

    • Psychological stress–
    • -Primary appraisal–
    • -Secondary appraisal–
    • -Coping•

    • Personal characteristics that influence response to a stressor:–
    • Level of personal control–
    • Presence of a social support system–
    • Feelings of competence•

    • Primary appraisal: evaluating an event for its personal meaning•
    • Secondary appraisal: focuses on possible coping strategies•
    • Coping: the person’s effort to manage psychological stress•
    • Ego-defense mechanisms: regulate emotional distress and give a person protection from anxiety and stress
  4. What are some factors that influence the response to stressors?
    • • Situational factors
    • – Arise from job changes, illness, caregiver stress
    • • Maturational factors
    • – Vary with life stages
    • • Sociocultural factors
    • – Environmental, social, and cultural stressors perceived by children, adolescents, and adults
  5. What are adaptive resources found in each dimension (physical, developmental, emotional,
    • intellectual, social, and spiritual) and what are examples of positive and negative outcomes of
    • stressors?
  6. Provide the definition and an example of each of the following ego-defense 4 mechanisms: compensation, conversion, denial, displacement, identification, regression?
    • Ego-defense mechanisms regulate emotional distress and thus give a person protection from anxiety and stress.
    • •Compensation is making up for a deficiency in one aspect of self- image by strongly emphasizing a feature considered an asset. (Example, A person who is a poor communicator relies on organizational skills.) •
    • Conversion is unconsciously repressing an anxiety-producing emotional conflict and transforming it into nonorganic symptoms (e.g., difficulty sleeping, loss of appetite). •
    • Denial is avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain. (Example, A person refuses to discuss or acknowledge a personal loss.) •
    • Displacement is transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute. (Example, A person transfers anger over an interpersonal conflict to a malfunctioning computer.) •
    • Identification is patterning behavior after that of another person and assuming that person's qualities, characteristics, and actions. •
    • Dissociation is experiencing a subjective sense of numbing and a reduced awareness of one's surroundings. •
    • Regression is coping with a stressor through actions and behaviors associated with an earlier developmental period.
  7. What are two types of stress identified by Selye?
    • • Chronic
    • – Chronic stress occurs in stable conditions and results from stressful roles.
    • • Acute
    • – Time-limited events that threaten a person for a relatively brief period provoke acute stress.
  8. Describe examples of developmental crises and situational crises.
    • • Developmental
    • – Developmental crises occur as a person moves through the stages of life.
    • • Situational
    • – External sources such as a job change, motor vehicle crash, death, or severe illness provoke
    • situational crises.
  9. How does each of the following impact the human stress response: situational factors, maturational factors, sociocultural factors?
  10. How can the nurse reduce stress for family members by involving them in caregiving?
    To develop appropriate and safe nursing care when caring for families or communities, ensure that you understand the meaning that the stress has for that group.
  11. What are the subjective and objective indicators of stress?
    • Subjective: Gather information about the health status of the patient from his or her perspective and begin the process of developing a trusting relationship with him or her. Use the interview to determine the patient's view of the stress, coping resources, any possible maladaptive coping, and adherence to prescribed medical recommendations such as medication or diet.
    • Objective: Observe grooming and hygiene, gait, characteristics of the handshake, actions while sitting, quality of speech, eye contact, and the attitude of the patient during the interview.
  12. What nursing diagnosis may be considered for a client or family members experiencing stress?
    • • Anxiety
    • • Caregiver role strain
    • • Ineffective coping
    • • Fear
    • • Risk for post-trauma syndrome
    • • Insomnia
    • • Situational low self-esteem
    • • Stress overload
  13. What are stress management nursing interventions for each of the following client needs: health promotion, acute care, restorative care?
    • • Health promotion
    • – Regular exercise
    • – Support systems
    • – Time management
    • – Guided imagery and visualization
    • – Progressive muscle relaxation
    • – Assertiveness training
    • – Journal writing
    • – Stress management in the workplace
    • • Crisis: When stress overwhelms a person’s usual coping mechanisms and demands mobilization of all available resources, the situation becomes a crisis.

    • • Acute care
    • – Crisis intervention: a specific type of brief psychotherapy with prescribed steps. It is more directive than traditional psychotherapy or counseling, and any member of the health care team who has been trained in its techniques can use it.

    • Restorative and continuing care: A person under stress recovers when the stress is removed or coping strategies are successful; however, a person who has experienced a crisis has changed, and the effects often last for years or for the rest of the person's life.

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