Pathophysiology: Chapter 7 Stress and Adaptation
T/F A positive feedback mechanism contributes to the restoration of homeostasis.
F
_________ is the purposeful maintenance of a stable internal environment.
Homeostasis
____________ therapy involves soft tissue manipulation to promote muscle relaxation.
Massage
T/F Negative feedback mechanisms are more common than positive feedback mechanisms.
T
T/F Stress is normally associated with increased levels of cortisol.
T
T/F The ability to adapt to stress can be linked to sex.
T
T/F Under normal circumstances, the neural responses and the hormones that are released during the stress response are not around long enough to cause damage to vital tissues.
T
A client's primary care provider has recommended biofeedback in an effort to address chronic stress and reduce the potential for complications. What will be the goal of this intervention? Teaching the client to consciously control their own physiologic (body) functioning Using exercise to control the client's endocrine function Helping the client to accommodate continued nervous stimulation Relieving tension using tactile stimulation
a
Although stress exposure initiates integrated responses by multiple systems, the functional changes are first manifested in which body system? Neuroendocrine Pulmonary Gastrointestinal Cardiovascular
a
The first stage of Selye's general adaptation syndrome is ____________.
alarm
Following a stressful event, which manifestation of stress would the nurse recognize as the nonspecific "fight-or-flight" response? Decreased short-term memory Increased cardiopulmonary rates Increased gastrointestinal motility Pupillary constriction
b
The client is hospitalized for 4 days with an acute myocardial infarction. After a coronary artery stent is placed, the client is discharged to home in stable condition. This would be an example of which pattern of stress? Chronic intermittent Acute time limited Chronic sustained Posttraumatic stress disorder (PTSD)
b
The locus caeruleus (LC) is an area in the brain stem that produces which hormone? Aldosterone Norepinephrine (NE) Antidiuretic hormone (ADH) Cortisol
b
The locus caeruleus (LC) is an area in the brain stem that produces which hormone? Cortisol Norepinephrine (NE) Antidiuretic hormone (ADH) Aldosterone
b
The nurse is caring for an ex-soldier who has been diagnosed with posttraumatic stress disorder (PTSD). The nurse should prioritize which action? Encouraging the client to talk about his trauma Assessing the client for depression and risk for suicide Assessing the client's neurologic status frequently Teaching the client to modify his stress response
b
The nurse is reviewing a client's history and recognizes that she has remained healthy despite being challenged by a high level of stressors. This is known as: Negative feedback mechanism Hardiness Fight-or-flight response General adaptation syndrome
b
The psychologist is counseling a client who is overwhelmed by losing his job and the recent death of a parent. Which strategy would be effective for stress reduction? Encouraging the client to listen to music on the radio Teaching the client to systematically contract and relax major muscle groups Encouraging the client to decrease interaction with others Encouraging the client to eat and drink whatever he wants
b
The client has just been told that he has a debilitating illness. Which signs and symptoms would the nurse recognize as being related to stress? Select all that apply. Pupils constrict Increased respiratory rate Increased activity of the gastrointestinal tract Mouth becomes dry Decreased heart rate
b d
A client diagnosed with posttraumatic stress disorder (PTSD) tells the nurse about having "flashbacks" during waking hours or nightmares in which the past traumatic event is relived, often in vivid and frightening detail. What term for this experience will the nurse document in the client's record? Hyperarousal Arousal Intrusion Avoidance
c
A client is experiencing an increase in cortisol secretion. It would be most important for the nurse to assess the client for: increased levels of epinephrine in the blood. increased immune reactions. increased blood glucose. decreased vascular tone.
c
A client is experiencing stress as a nurse prepares to insert a peripheral intravenous catheter into his forearm. The client's locus caeruleus (LC) is consequently producing which hormone? Antidiuretic hormone (ADH) Corticotropin-releasing factor (CRF) Norepinephrine (NE) Adrenocorticotropic hormone (ACTH)
c
A client presents to the emergency department following a major traffic accident. Though outwardly there are no apparent physical injuries found, the client is experiencing chest pain and heightened alertness, which the health care worker attributes to the first stage of general adaptation syndrome (GAS). The health care worker concludes the client is experiencing manifestations related to the release of: aldosterone, which interferes with sodium absorption. thyroid-stimulating hormone. epinephrine. too little cortisol.
c
A client who is a performer expends a tremendous amount of energy while on stage, but his body is not harmed by the added stress. Protection against the harmful effects of stress is primarily a result of: immune system compensation. cultural factors. physiologic reserve. anatomic characteristics.
c
A previously healthy 42-year-old client was recently diagnosed with hypertension. Which client activity will the nurse document as the best evidence the client is having a positive response to the stress of chronic illness? Spending more time at work Ceasing to exercise Decreasing dietary sodium and fat intake Exhibiting a carefree attitude about life
c
After exposure to poison ivy, the client has hives on his trunk and extremities. In an effort to decrease his immune response the practitioner places him on which medication? Antidiuretic hormone Aldosterone Glucocorticoid Insulin
c
The client has expressed a desire to explore stress-reducing strategies for chronic migraines. The provider explains one technique that involves electronic monitoring of physiologic responses to stress with immediate feedback. This is known as which of the following? Progressive muscle relaxation Imagery Biofeedback Music therapy
c
The client is receiving chronic glucocorticoid therapy for chronic obstructive pulmonary disease (COPD). Which lab result would the provider expect to see? Increased albumin Increased hemoglobin Increased blood glucose Increased white blood count (WBC)
c
Which client is experiencing the effects of a positive feedback mechanism? A client who is producing white blood cells (WBC) in response to sepsis. A postoperative client who is shivering in response to low environmental temperature. A pregnant client whose oxytocin levels are rising during the second stage of labor. A client whose fluid volume is increasing because of the release of antidiuretic hormone (ADH) from the posterior pituitary gland
c
The means used to achieve a new balance between a stressor and the ability to deal with it is known as a/an __________ mechanism.
coping
A child has been experiencing hypoglycemic episodes. The child's parent asks: "How does the body know when to secrete insulin and when to stop secreting it?" How should the nurse respond? "Once the child starts getting confused, the brain will send a message to the pancreas to stop producing insulin." "It is just a big guessing game; first we give sugar like orange juice, and then we withhold the carbohydrates if the blood glucose level is too high." "The pituitary gland in the brain is the 'master gland,' and it controls and regulates all the hormones." "If the blood glucose level falls, the body will inhibit insulin secretion and release glucagon to stimulate the release glucose from the liver."
d
A client who has been experiencing tremendous stress has developed pneumonia, which he ultimately attributes to the stressors he has been facing. This phenomenon may result from: pituitary dysfunction. atrophy of the hypothalamus. hypertrophy of the thymus. catecholamine release.
d
As a nurse prepares to change a client's dressing, the client states that she is afraid that it will be painful. Noting that the client's heart rate and respiratory rate have increased, the nurse adjusts the plan of care to reflect care for a client in which phase of Selye's general adaptation syndrome? Exacerbation Exhaustion Resistance Alarm
d
The client experienced a traumatic event in the past that has caused chronic nightmares in which the event is relived. The client may have increased levels of which of the following? Aldosterone Thyroid stimulating hormone (TSH) Cytokines Norepinephrine
d
Which client will have the most efficient adaptation? A client who is vomiting blood from ruptured esophageal varices A client who has a ruptured abdominal aortic aneurysm A client in a motor vehicle accident who hemorrhages into his abdomen A client who has been noticing small amounts of blood in his stool over the past week
d
The ability of body systems to increase their function, given the need to adapt, is known as the _______ reserve.
physiologic