Stress and Coping

Client has cancer that is unresponsive to treatment, and is experiencing significant weight loss and fatigue. When asked how they are feeling, they say "Great! I'm going to beat this cancer." Which defense mechanism is being used?

Denial

Which part of the body activates the stress response?

Hypothalamus

Client is recently divorced with 2 young children. Client reports difficulty sleeping, feeling hopeless, and being estranged from family. The nurse should monitor for what potential manifestation of chronic stress?

Suicide

Client is distressed and says "my ex is suing for full custody. I'm so worried and don't know what to do." What questions should the nurse ask to evaluate coping skills?

What strategies have you used in the past to deal with stress?

If the body is unable to effectively resist or adapt to the stressor, or if resources become exhausted, prolonged exposure to stress may result in illness or disease

exhaustion

The body remains on alert while hormonal and other bodily functions return to normal.

resistance

The parasympathetic nervous system (PNS) attempts to return physiological functions to normal levels

resistance

Nurse is caring for a new mother, who is tense, refuses to hold her baby, and says "I have no idea how to handle having a baby. I wish this pregnancy had never happened." What statement should the nurse make?

"Becoming a parent is a new experience for you. Let's talk about your concerns."

Client is upset and reports that their stress is "too much to handle." Client is unemployed, a single parent to young children, and has periodic asthma attacks. Which stress-related condition is the client experiencing?

Allostatic load

Client reports being distressed and unable to sleep following a neighborhood fire several days ago. Client has hypertension, tachycardia, and is diaphoretic. The nurse should identify that the client is experiencing which type of stress?

Acute stress

Client has experienced workplace violence when an armed person held workers at gunpoint before police intervened. Client now reports being anxious and fears the gunman might return. What type of crisis is being experienced?

Adventitious

A perceived stressor arouses the central nervous system (CNS)

alarm

A client has migraine headaches and reports that they are getting worse. What question(s) should the nurse ask to determine if the headaches are a stress-related disorder?

Ask about intensity, how often they occur, what type of support is available, and any coping strategies used

Client is in crisis following the breakup of a long-term relationship, and tells the nurse "I might as well just die. My life is over." Which actions should be taken first by the nurse?

Conduct a suicidal risk evaluation

Client has partner hospitalized with COVID-19. Client is experiencing manifestations related to the alarm stage of GAS. Which manifestations should be monitored?

Hypertension, dilated pupils, increased state of arousal

Which is a physiological response experienced during the exhaustion stage of GAS? a. Initiation of neuroendocrine activity b. Increased mental alertness c. Vasoconstriction d. Development of an autoimmune disorder

Development of an autoimmune disorder (B/c the immune system will be suppressed for so long that it becomes permanently weakened)

Older adult client reports being stressed about their health b/c of problems with short memory, slower reaction times, and urinary frequency. Client is experiencing what type of stressor?

Developmental stressors

Hormones released from the adrenal cortex create a state of readiness (fight-or-flight response).

alarm

Client is a new mother who tells the nurse they are stressed about being a new parent, but they are thrilled by the birth of their child. What type of stress is being experienced?

Eustress (positive stress)

Client has been diagnosed w/ Hodgkin's disease and will be getting radiation and chemotherapy. What statement by the client indicates a positive coping mechanism to be used during these treatments? a. I won't leave the house bald b. Losing my hair won't bother me c. I will be one of the few who doesn't lose my hair d. I have selected a wig, even though I will miss my own hair

I have selected a wig, even though I will miss my own hair

A client was sexually assaulted 6 months ago and has been diagnosed with PTSD. Which manifestations should the nurse expect?

Intrusive memories of the event, flashbacks of the event, exaggerated startle response when reminded of the event

Client reports abdominal cramping and bloating with diarrhea and states, "I am completely stress out from working at home. " The client is experiencing manifestations of what stress-related condition?

Irritable bowel syndrome

College student is admitted for acute alcohol intoxication. Client reports feeling overwhelmed and expresses an inability to cope with stressors at school. What should the nurse say?

Let's talk about the coping methods that have worked for you in the past

Nurse is providing discharge teaching to a client with type 2 diabetes. Which instructions should they include?

Practice mindful breathing, start each day with a to-do list, develop habits to mitigate stress

What is an example of effective coping strategy by a partner of a client who has dementia?

Practicing deep breathing while sitting outside

Client has been charged with violence against their spouse. The client is angry, pacing, and yells "I wouldn't lose my temper if my spouse would just leave me alone. It's their fault." The client is displaying what defense mechanism?

Projection

A 72-year old female is recovering from abdominal surgery, which was stressful and prolonged. Her blood sugars are elevated, even though she has not been diagnosed w/ diabetes. To what do you attribute this elevation in blood sugar? a. Result of antidiuretic hormone b. Must have had diabetes prior to surgery c. Has become a diabetic from the surgery d. Result of the "fight-or-flight" reaction

Result of the "fight-or-flight" reaction

Client reports that they are stressing over an upcoming surgical procedure. What describes the characteristics of stress?

Stress is a condition in which the body responds to physical, emotional, or environmental changes affecting one's state of equilibrium

Rising hormone levels result in increased blood pressure and heart rate, blood glucose levels, oxygen intake, pupil dilation, and mental alertness

alarm

Identify the following items as contributors to acute or chronic stress: a. Being involved in a motor vehicle accident b. Living in poverty c. Living in a dysfunctional family d. Being a victim of a crime

acute chronic chronic acute

Identify the following items as contributors to acute or chronic stress: a. Experiencing the loss of a loved one b. Living with a prolonged illness c. Exposure to racism

acute chronic chronic