Fundamentals of Nursing: Stress and Adaptation Flashcards
a person attempts to overcome a perceived weakness by emphasizing a more desirable trait or overachieving in a more comfortable area
A student who has difficulty with academics may excel in sports
refusing to acknowledge the presence of a condition that is disturbing
despite finding a lump in her breast, a woman does not seek medical treatment
transfers (displaces) an emotional reaction from one object or person to another object or person
An employee who is angry with a coworker kicks a chair
subconsciously protecting oneself from the memories of a horrific or painful event by allowing the mind to forget the incident
an adult cannot recall childhood memories surrounding the traumatic death of a sibling
incorporation of values or qualities of an admired person or group into ones own ego structure. This mechanism is important in the formation of conscience during childhood
an older sibling tells his preschool sister not to talk to strangers, expressing his parents values to his younger sister
a person attributes impulses or thoughts to someone else
a person who denies any sexual feelings for a coworker accuses him of sexual harrassment
a person tries to give a logical or socially acceptable explanation for questionable behavior
a patient who forgot to keep a health care appointment says, "If patients didn't have to wait 3 months to get an appointment, they wouldn't forget them"
a person develops conscious attitudes and behavior patterns that are opposite to what he or she would really like to do
reaction formation example
a married woman is attracted to her husband's best friend but is constantly rude to him
a person returns to an earlier method of behaving
children often regress to soiling diapers or demanding a bottle when they are ill
a person voluntarily excludes an anxiety producing event from conscious awareness
A father may not remember shaking his crying baby.
a person substitutes a socially acceptable goal for one whose normal channel of expression is blocked
A person who is aggressive toward others may become a star football player.
a person uses an act or communication to negate a previous act or communication
A husband who was physically abusive to his wife may bring her an expensive present the next day.
What is stress?
a condition in which the human system responds to changes in its normal balanced state
what does stress result from?
anything that is perceived as a challenge, threat or danger
1. Chemical agents (drugs, poisons)
2. **Physical agents (heat, cold, trauma)**
3. Infectious agents (viruses, bacteria)
4. Nutritional imbalances
5. Hypoxia and immune disorders
catastrophic events, pressured situations, conflict, daily hassles, chronic strain, life changes
Two types of stressors are:
- The change that takes place as a result of the response to a
- Can be ongoing as a person strives to maintain balance in the internal and external environments
- Is necessary to tolerate changing situations, and to respond to physical and emotional stressors
Adaptation is necessary for:
- Normal growth and development
- AND the ability to tolerate changing situations, the ability to respond to physical and emotional stressors.
Ability to adapt depends on:
-intensity of the stressor
-effectiveness of coping skills
Physiological homeostasis is:
- A process where various physiologic mechanisms within the body respond to internal changes to maintain relative constancy in the internal environment
What body systems primarily control homeostatic mechanisms?
- The autonomic nervous system (ANS)
e.g. Parasympathetic and sympathetic
- The endocrine system
e.g. pituitary, adrenal, thyroid
What body systems control homeostatic mechanisms to a lesser degree?
Local adaptation syndrome (LAS) is:
- A localized response of the body to stress
- Involves only a specific body part (such as tissue or organ) instead of the whole body
- Stress may be traumatic or pathologic
- Primarily homeostatic, short-term adaptive response
What are the two most common responses that influence nursing care?
- Reflex Pain Response
- Inflammatory Response
Reflex pain response is:
- A response of the central nervous system to pain
- Protective and automatic
e.g. Automatically removing hand from hot stove
Inflammatory response is:
- A local response to injury or infection
- Person does not have control over this
-e.g. When you cut your finger there is pain, swelling, heat, redness, and changes in function
Inflammatory Response Phases
- Vascular response: Blood vessels constrict to narrow and control bleeding.
Injured cells release histamine then the vessels dilate to increase blood flow to the area.
- Cellular response: White blood cells migrate to the site of the injury
- Exudate Formation: Fluid and white blood cells move from the circulation to the site of the injury to form exudate
- Healing: Tissue regeneration or repair
The general adaptation syndrome (GAS) is:
- A biochemical model of stress developed to describe the body's
general response to stress.
- Consists of 3 stages (Alarm reaction, Stage of resistance, Stage of exhaustion)
Alarm Reaction Stage
- The first stage of the General Adaptation Syndrome in which the
body goes into
a temporary state of shock, then rebounds (counter shock), following initial exposure to a stressor
- Fight-or-flight response happens in this stage. Also called the shock phase.
- Characterized by increased energy, increased breathing, increased cardiac output, increased BP, increased mental alertness
Stage of Resistance (GAS)
- Body attempts to adapt to stressor
- Goal is to protect the body against the stressor and maintain homeostasis
- Vital signs, hormone levels, and energy production return to normal
- Body regains homeostasis or adaptive mechanisms fail
Stage of Exhaustion (GAS)
- Adaptive mechanisms can no longer provide defense
- Depletion of resources results in damage to the body (wear and tear) or systemic damage
- Body will either rest and mobilize its defenses to return to normal or reach total exhaustion and die
To maintain mental well-being, humans must also maintain ____________ _______________.
Coping or ___________ ____________ are used when a persons
psychological needs are not met.
e.g. Feeling loved, sense of belonging, having self-esteem
Adaptation to stress depends on a person's:
- Developmental level
- Past experiences
- Support system
- Coping mechanisms
- A relationship between psychological stressors and physiologic
e.g. Up all night studying for an exam you must pass. Next morning you can't swallow food, have a rapid heartbeat and diarrhea.
Physiologic indicators of prolonged stress include:
- Backache or stiff neck
- Chest pain
- Constipation or diarrhea
- Decreased sex drive
- Dilated pupils
- Dry mouth
- Increased urination
- Increased perspiration
- Increase pulse, BP, and respirations
- Sleep disturbances
- Weight gain or loss
The most common response to stress is?
- A vague, uneasy feeling of discomfort or dread. Also a feeling of apprehension of anticipated perceived danger.
- A feeling of dread in response to a known threat.
Mild anxiety is present in day-to-day living and is characterized by:
- Increased alertness and perceptual fields.
- Motivates learning and growth
- May interfere with sleep
- Facilitates problem solving
- Often manifested by restlessness and increased questioning
Moderate anxiety narrows perceptual fields and focuses on immediate concerns with inattention to other communications. Characterized by:
- Quivering voice
- Increased muscle tension
- "Butterflies in stomach"
- Slight increase in respiration and pulse
Severe anxiety creates a very narrow focus, causing all behavior to be geared toward getting relief. Characterized by:
- Impaired learning ability
- Easily distracted
- Extreme fear of a danger that is not real
- Difficulty communicating verbally
- Increased motor activity
- Fearful facial expression
Panic causes the person to lose control and experience dread and terror. Disorganized state characterized by:
- Increased physical activity
- Distorted perception of events
- Loss of rational thoughts
- Choking sensation
- Chest pain/pressure
- Along with severe anxiety manifestations
Anxiety is often managed without conscious thought by _________ ____________.
Coping Mechanisms are:
- Behaviors used to decrease stress and anxiety
- Many are learned based on a person's family, past experiences, and sociocultural influences and expectations.
- May be positive or negative in terms of how they affect health
Typical coping mechanisms include:
- Crying, laughing, sleeping, cursing
- Physical activity, exercise
- Smoking, drinking
- Lack of eye contact, withdrawal
- Limiting relationships to those with similar values and interests
What is the purpose of defense mechanisms?
- To protect a person's self-esteem and are useful in mild to moderate anxiety.
Effects of long-term stress include:
- Threat to physical and emotional health
- Increase risk for disease or injury
- Compromises recovery and return to normal function
- Associated with specific diseases (alcoholism, depression, eating disorders)
Family stressors include:
- Changes in family structure and roles
- Anger and feelings of helplessness and guilt
- Loss of control over normal routines
- Concern for future financial stability
Caring for a family member at home for long periods can cause prolonged stress called ____________ ____________.
Caregiver burden responses include:
- Chronic fatigue
- Sleep problems
- Increased incidence of stress-related illnesses such as heart disease and high blood pressure.
A crisis is:
- A disturbance caused by a precipitating event, such as a perceived loss, a threat of loss, or a challenge, that is perceived as a threat to self
Crisis exists when:
- An event dramatically changes routine or perception of self.
- Or a persons coping mechanisms are ineffective resulting in high levels of anxiety and the inability to function adequately.
Crisis interventions include:
- ENSURE SAFETY FIRST
- Assess situation
- Diffuse the situation
- Decrease the person's anxiety
- Determine the problem
- Decide the help that is needed
- Return the person to pre-crisis situation