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30 Cards in this Set
- Front
- Back
Stressors
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- Are disruptive forces operating within or on any system
- When stress overwhelms a person’s existing coping mechanisms, disequilibrium occurs, and a crisis results - If symptoms of stress persist beyond the duration of the stressor, a person has experienced a trauma |
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Appraisal
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Is how people interpret the impact of the stressor on themselves, of what is happening, and what they are able to do about it
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Fight-or-flight response to stress
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- Arousal of the sympathetic nervous system
- Increases heart rate - Diverting blood from intestines to the brain and striated muscles - Increasing blood pressure, respiratory rate, and blood glucose levels - Neurophysiological Responses function through negative feedback - Senses an abnormal state such as lowered body temperature, and makes an adaptive response, such as initiating shivering to generate body heat - 3 structures, the medulla oblongata, the reticular formation, and the pituitary gland, control the body’s response to a stressor |
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Medulla Oblongata
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- Controls the heart rate, blood pressure and respiration
- Heart rate increases in response to impulses from sympathetic fibers and decreases with impulses from parasympathetic fibers |
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Reticular Formation
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Continuously monitors the physiological status of the body through connections with sensory and motor tracts
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Pituitary Gland
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- Produces hormones necessary for adaptation to stress, such as adrenocorticotropic hormone (ACTH) which produces cortisol
- Regulates the secretion of thyroid, gonadal, and parathyroid hormones |
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General Adaptation Syndrome (GAS)
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- 3 stage reaction to stress
- Body responds to stressors: - Alarm reaction - Resistance stage - Exhaustion stage - Gas is triggered either directly by a physical event or indirectly by a psychological event - Gas involves the autonomic nervous system and the endocrine system - Communicates with the - Hypothalamus which secretes endorphins - Endorphins are hormones that act on the mind like morphine and opiates, produce a sense of well-being and reduce pain |
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Alarm Reaction
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- Rising hormone levels result in increased blood volume
- Blood glucose levels - Epinephrine and norepinephrine amounts - Heart rate - Blood flow to muscles - Oxygen intake - Mental alertness - Pupils of the eyes dilate to produce a greater visual - Can last from 1 minute to many hours |
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Resistance Stage
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- Body stabilizes and responds in an opposite manner to the alarm reaction
- Hormone levels, heart rate, blood pressure, and cardiac output return to normal, and the body repairs any damage that has occurred |
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Exhaustion Stage
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- Occurs when the body is no longer able to resist the effects of the stressor and when the body has depleted
- Body cannot defend itself against the impact of the event, physiologically regulation diminishes, if stress continues death results |
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Stress makes people ill as a result of:
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- Increased levels of powerful hormones that change our bodily processes
- Coping choices that are unhealthy, such as not getting enough rest or a proper diet or use of tobacco, alcohol, other substances, or caffeine - Neglect of warning signs of illness or failure to adhere to prescribed medicines or treatments |
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Reaction to Psychological Stress:
Primary Appraisal |
- Evaluating an event for its personal meaning
- Appraisal of an event or circumstance is an ongoing perceptual process |
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Reaction to Psychological Stress:
Secondary Appraisal |
If stress is present secondary appraisal focuses on possible coping strategies
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Coping
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- Is the person’s effort to manage psychological stress
- Effectiveness of coping strategies depends on the individual’s needs - Combination of problem-focused coping and emotion-focused coping strategies - Coping behaviors constantly change as individuals perceive new information |
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Ego-Defense Mechanisms
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- Purpose of which is to regulate emotional distress and thus give a person protection from anxiety and stress
- Help a person cope with stress indirectly - Offer psychological protection from a stressful event |
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Distress
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Damaging stress
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Eustress
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Stress that protects health
Is motivating energy, such as happiness, hopefulness, and purposeful movement |
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Developmental Crises and Situational Crises
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- Developmental stage is a marriage, birth of child, retirement
- Situational crisis can be provoked by an external source like a job change, vehicle accident, death, or severe illness - “What does this mean to you; how is it going to affect your life?” |
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Neuman Systems Model
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- Nursing theory views nursing as being responsible for developing interventions to prevent or reduce stressors on the client or to make them more bearable for the client
- Every person develops a set of responses to stress that constitute the “Normal line of defense” - Stresses the importance of accuracy in assessment and interventions that promote optimal wellness using primary, secondary, and tertiary prevention strategies |
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Primary Prevention
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Goal of primary prevention is to promote client wellness by stress prevention and reduction of risk factors
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Secondary Prevention
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Secondary prevention occurs after symptoms appear
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Tertiary Prevention
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Tertiary prevention begins when the client system becomes more stable and recovers
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Situational Factors
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- Job changes, relocation
- Adjusting to chronic illness leads to situational stress |
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Maturational Factors
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Self-esteem issues, changing family structure due to divorce or death of a parent
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Sociocultural Factors
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Environmental and social stressors lead to developmental problems
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Goals and Outcome
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- Primary level of prevention
- You direct nursing activities to identifying individuals and populations who are possibly at risk for stress - Secondary level Interventions - Include actions directed at symptoms, such as protecting from self-harm - Tertiary Level Interventions - Have the purpose of assisting the client in readapting and will possibly include relaxation training and time management training |
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Setting Priorities
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- “What is happening in your life that you needed to come today?”
- Assess the client’s perception of the event, available situational supports, and what the person usually does when there is a problem the client cannot solve - Determine if the person is suicidal - “Are you thinking of killing yourself or someone else?” |
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Health Promotion
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Three primary modes of intervention for stress are to decrease stress-producing situations, increase resistance to stress, and learn skills that reduce physiological response to stress
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Burnout
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Occurs as a result of chronic stress
Is a syndrome of emotional exhaustion, depersonalization of others, and perceptions of reduced personal accomplishment, resulting from intense involvement with people in a care-giving environment |
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Crisis Intervention
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- Is a specific type of brief psychotherapy with prescribed steps
- 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 - Crisis intervention aims to return the person to a precrisis level of functioning and to promote growth |