Nurs 377 Health & Illness Concepts 1 Exam 1

innate immunity

(also referred to as natural or native) is the immunity present at birth; it provides nonspecific response not considered antigen specific.

What are two sources of stress?

* Physiological * Psychological/Emotional

What are the three types of stress?

*Acute *Episodic *Chronic

What are some examples of Pharmacological Therapies

*Anxiolytics *Hypnotics *Antidepressants *Psychotherapeutics *Muscle relaxants *Antimigraine agents *Selective serotonin reuptake inhibitors (SSRIs) (older adults)

What are some coping responses?

*Cognitive assessment *Primary Appraisal Initial assessment of stressor to determine if stressor is a threat *Secondary Appraisal Evaluation of resources to Overcome the stressor Eliminate the stressor Reduce the stressor *Engagement

Counseling consists of individual or group therapy and it includes multiple techniques. What are these techniques?

*Cognitive behavioral therapy *Meditation *Relaxation techniques and massage *Time management *Health education

What are the definition for Coping?

*Cognitive means and behavioral actions to manage internal or external situations perceived as difficult and/or beyond the individual's current resources. *Being action oriented toward a goal of changing a situation.

What are the individual risk factors of stress?

*Impaired cognition *Chronic health conditions including mental health issues *Multiple significant life changes *Socioeconomic status (e.g., poor, homeless) *Caregiver *Individual in a foreign country--especially with language/cultural barrier

What are the individual risk factors for Maladaptive Coping?

*Impaired cognition *Limited resources *Age *Changes in health status *Chronic health conditions.

What are the general risk factors for Maladaptive Coping?

*Inability to accurately assess the stressor *Denial or avoidance *Actual pr perceived lack of control *Actual or perceived lack of support *No experience or poor past experiences in managing stressful situations.

What does the use of Coping Measurement Instruments do?

*Instruments enhance objectivity to the assessment. *Provides ability to monitor over time. *Multiple instruments are available, some for specific populations or situations.

What are the consequences of Anxiety?

*Mild to moderate anxiety May have a positive impact (depending on the person or the situation); If the impact is not positive, increased anxiety levels can result. *Severe anxiety to panic Can lead to injury to self or others (in some cases, suicide, primarily due to impulsivity.)

What are the risk factors for anxiety?

*Most prevalent subgroup of mental illness; affects people of all ages and backgrounds. *Lifetime prevalence is higher among females *Age prevalence peaks in middle adulthood (30s-50s). *Non-Hispanic whites have a higher incidence than Hispanics and non-hispanic blacks *Lower SES is linked to a higher rate of anxiety in youth. *Familial patterns appear in certain anxiety disorders.

What do you look at upon examination of coping?

*Observation of behavior *Mental health assessment

What do you look at when looking at the history of coping?

*Perception of threat *Past coping patterns *Medical history *Social history

What are the types of coping strategies?

*Problem-focused *Emotion-focused *Meaning-focused

Who is part of the interdisciplinary team for the collaborative care of Anxiety?

*Provider *Nurse *Social Work *Occupational Therapist *Physical Therapist *Chaplain

What is some methods of primary prevention of stress.

*Stress management and reduction techniques *Counseling *Maintenance of positive relationships Family, friends, social networks, and others *Maintenance of optimal health Wellness programs Health education

What do you know about Diagnostic tests for Anxiety?

*There is no specific tests to confirm anxiety. *Some diagnostic tests may be useful to detect conditions that contribute to anxiety *Anxiety screening tools such as Beck Anxiety Inventory (BAI) and the Spence Children's Anxiety Scale (SCAC).

Clinical Management: Primary prevention (anxiety)

*Well visits across the lifespan *Fostering healthy family function *Early recognition and referral for anxiety based symptoms

Match the Key Terms 1) Cognitive Appraisal 2) General Adaptation Syndrome 3) Coping 4) Equilibrium a) Describes the body's short-term and long-term reactions to stress. b) Condition in which all competing elements are in balance. c) Individual's perception regarding how stressful an event is or will be. d) Cognitive and behavioral efforts to manage stress.

1) Cognitive Appraisal--c) Individual's perception regarding how stressful an event is or will be. 2) General Adaptation Syndrome--a) Describes the body's short-term and long-term reactions to stress. 3) Coping--d) Cognitive and behavioral efforts to manage stress 4) Equilibrium--b) Condition in which all competing elements are in balance

Pathogen

A microorganism that causes disease

What is the definition of Anxiety?

A subjectively distressful experience activated by the perception of threat, which has both a potential psychological and physiological etiology and expression.

What is the definition of Stress?

An Internal or external event or demand of life experienced by the individual that is perceived and appraised for some and meaning on a continuum to determine whether resources and abilities for management are available, exceeded, or exhausted

Macro level stress experience

An environmental event such as a natural disaster or a large-scale terroristic attack.

Emerging infection

An infectious disease that has recently increased in incidence or that threatens to increase in the immediate future

What are some disorders that manifest with Anxiety?

Cancer Chronic Obstructive Pulmonary Disease (COPD) Dysrhythmias Encephalitis Heart failure Hyperthyroidism Hypoglycemia Pheochromocytoma Pneumonia Vestibular dysfunction Vitamin B12 deficiency

What does cortisol do to the body?

Cortisol mobilizes cellular metabolism, particularly glucose and protein metabolism. In elevated levels, cortisol also has a role in the immune response, including immunosuppressive and anti inflammatory effects.

Standard precautions

Designed for care of all patients in hospitals and health care facilities. Applies to: *blood *All bodily fluids, secretions, and excretions *Non-intact skin *Mucous membranes

Transmission-based precautions

Designed for specific diseases. These include Airborne precautions, droplet precautions, and contact precautions.

What is the goal of assessment of the stressor?

Determine the individual appraisal stage and coping strategies.

Micro level stress

Focuses on the way a stressor affects an individual, specifically on the internal localized context (cell, organs, or body systems).

What does Chronic stress lead to?

Heightened responses

Disseminated infection

Infection that has spread to areas of the body beyond the initial site of infection.

Localized infection

Infection that is limited to a small area

Health care-associated infections (HAIs)

Infections that are acquired as a result of exposure to microorganisms in a health care setting.

Systemic infections

Infections that have spread extensively throughout the body, often via the blood.

Activation of the adrenal cortex during stress response

Leads to the secretion of cortisol, a glucocorticoid.

Reaction of norepinephrine

Norepinephrine is released throughout the brain, triggering neural pathways for sensory information and stimulating arousal, vigilance, anxiety and labile emotions.

Resistance

Occurs when pathogenic organisms change in ways that decrease the ability of a drug (or family of drugs) to treat disease.

Collaborative interventions (anxiety)

Pharmacotherapy (depending on etiology) ß-adrenergic receptor antagonists Benzodiazepines Nonbenzodiazepine antianxiety agents Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors (SNRIs), Tricyclic antidepressants (TCAs), Monoamine oxidase (MAO) inhibitors Psychotherapy Psychoeducation Cognitive behavioral Therapy (CBT) Prolonged exposure therapy Cognitive processing therapy Mindfulness-based cognitive therapy Eye movement desensitization and reprocessing (EMDR) Complementary and alternative medicine

More serious threat stressor

Stress response is initiated by the nervous and endocrine systems, particularly the hypothalamus, sympathetic nervous systen(SNS) , the pituitary glad, and the adrenal gland.

Response of the sympathetic nervous system

The hypothalamus secretes corticotropin-releasing factor (CRF), which activates the SNS, the anterior pituitary, and the posterior pituitary. Activation of the SNS causes the release of catecholamines (noreoinephrine, epinephrine, and dopamine).

What does the exhaustion of resources lead to?

This leads to a loss of homeostasis. This has negative physical, psychological, and/or social manifestations.

Normal physiological process

When faced with a potential or actual stressor, the individual first appraises the situation.. can cause an anticipatory response beginning in the limbic system

Immunity is defined as:

a physiological process that provides an individual with protection or defense from disease. It is a characteristic that allows one to be resistant to a particular disease or condition; the term is derived from the Latin word immunis, meaning exempt.

active acquired immunity

develops after the introduction of a foreign antigen resulting in the formation of antibodies or sensitized T lymphocytes. For example, active immunity may be obtained artificially through the immune response to an immunization, or it may be obtained naturally through the immune response to exposure to infectious pathogens such as varicella-zoster virus.

Aquired immunity

immunity protection that is gained after birth either actively or passively.

Passive acquired immunity

occurs by the introduction of preformed antibodies—either from an artificial route, such as a transfusion of immunoglobulin (Ig), or from a natural route, such as from a mother to her fetus through placental blood transference or through colostrum transfer during breast-feeding.

Antigen

substance that elicits an immune response.