Stress and Coping

• • Spiritually, stress can challenge one’s beliefs and values
• • Three stages of GAS and LAS:
  • Alarm reaction: Fight or flight, shock phase, medulla secretes epinephrine and norepinephrine
  • Resistance: After initial shock, body’s adaptation takes place
  • Exhaustion: Adaptation made during the second stage cannot be maintained, prolonged or chronic stress
• Models of Stress:

  • Stimulus-based Models:
  • Stress is defined as a stimulus, a life event, or a set of circumstances that arouses physiologic and psychologic reactions that may increase the individual’s vulnerability to illness
  • Response-Based Models:
  • Stress may also be considered as a response, described by Selye as “the nonspecific response of the body to any kind of demand made upon it”
  • General Adaptation Syndrome (GAS) or stress syndrome is a chain or pattern of physiologic events
  • Local Adaptation Syndrome (LAS) allows the body to react locally
• Indicators of Stress:

  • Physiologic Indicators result from activation of the sympathetic and neuroendocrine systems of the body
  • Psychologic Indicators include anxiety, fear, anger, depression, and ego defense mechanisms
  • Cognitive Indicators involve problem-solving, structuring, and self-control (discipline)
• • Emotion-focused coping includes thoughts and actions that relieve emotional distress
• Nursing Management:

  • Assessing includes Nursing History and Physical History
  • Diagnosing includes NANDA 2014 International diagnoses like Anxiety, Caregiver Role Strain, Compromised Family Coping, and Defensive Coping
  • Planning/ Goals aim to decrease or resolve stress, increase ability to cope, and improve role performance
  • Implementing involves encouraging health promotion strategies like exercise, nutrition, sleep, and time management
• condition in which an individual experiences changes in the normal balanced state

  stress
• any event or stimulus that causes an individual to experience stress

  stressor
• Refers to responses when an individual faces stressors

  coping mechanisms
• Source of stress: originate within an individual, for example, infection or feelings of depression

  Internal stressor
• Source of stressor: outside the individual, for exam- ple, a move to another city, a death in the family, or pres- sure from peers

  External stressor
• Developmental stressor

  Source of stress: occur at predictable times throughout an individual’s life
• Source of stress: unpredictable and may occur at any time during life

  situational stressor
• Effect of stress that threatens an individual’s physiological homeostasis

  Physical
• Effect of stress that influence an individual’s perceptual and problem-solving abilities

  intellectual
• T/F: Stress can affect a person spiritually by challenging their beliefs and values

  T
• T/F: stress can affect a person socially by producing negative or non constructive feelings about the self.

  F, emotionally
• Stimulus-based model


  model of stress where stress is defined as a stimulus, a life event, or a set of circumstances that arouses physiologic and psychologic reactions that may increase the individual’s vulnerability to illness
• Model of stress where Stress may also be considered as a response.

  Response-based model
• Chain or pattern of physiologic events

  General Adaptation Syndrome (GAS) or stress syndrome
• Besides adapting globally, the body can also react locally; that is, one organ or a part of the body reacts alone

  Local Adaptation Syndrome (LAS)
• Give the three stages of GAS:

  • Alarm Reaction
  • Resistance
  • Exhaustion
• Alarm reactiom


  stage of gas wherein there is the “fight or flight”
• Phase during the alarm reaction where medulla secretes epinephrine and norepinephrine

  shock phase
• phase during alarm reaction where changes produced in the body during the shock phase are reversed

  Countershock phase
• stage of gas after initial shock, and when the body’s adaptation takes place the body begins to repair itself

  resistance
• stage during gas where the adaptation that the body made during the second stage cannot be maintained

  exhaustion
• T/F: The physical effects of prolonged stress   can weaken the immune system   and increase risk for heart disease,   including mental health disorders,   hypertension, diabetes, and other   chronic health problems.


  T
• Model where Stress “refers to any event in which environmental demands, internal demands, or both tax or exceed the adaptive resources of an individual, social system, or tissue system”

  transaction-based model
• cognitive appraisal: Evaluation of an event for possible threat or danger

  primary
• cognitive appraisal: Evaluation of the resources that the person has to address any perceived threat

  secondary
• Give the types of anxiety:

  • mild
  • moderate
  • severe
  • panic
• state of mental uneasiness, apprehension, dread, or foreboding or a feel- ing of helplessness related to an impending or anticipated unidentified threat to self or significant relationships

  anxiety
• level of anxiety that produces a slight arousal that enhances perception, learning, and productive abilities

  mild anxiety
• level of anxiety that Attention is focused more on a particular aspect of a situation than on peripheral activities

  moderate anxiety
• level of anxiety that consumes most of the individual’s energies and requires intervention

  severe anxiety
• level of anxiety wherein:

  • The perception is distorted.
  • Loss rational thoughts

  Panic
• an emotion or feeling of apprehension aroused by impending or seeming danger, pain, or another per- ceived threat

  fear
• T/F: The source of anxiety is identifiable; the source of fear is not.

  F
• emotional state consisting of a subjective feeling of animosity or strong displeasure

  anger