Stress and coping
A nurse is caring for a client who has delivered a healthy newborn. The client tells the nurse that while they are somewhat stressed about being a new parent, they are thrilled by the birth of their child. The nurse should identify that the client is experiencing which of the following types of stress?
Eustress
A nurse is caring for a client who has migraine headaches and reports that they are getting worse. Which of the following questions should the nurse ask the client to determine if the headaches are a stress-related disorder?
What is the intensity of your migraine headaches? How often do the migraine headaches occur? What type of support system? What coping strategies?
Chronic stress
disabling condition occurring when stress levels are heightened, constant, and prolonged believe they have little or no control over their situation or circumstances
Adventitious stressors
disaster events - generally rare and unexpected
Fight or flight
increased heart rate, blood pressure, and cardiac output; dilation of bronchial airways; pupil dilation; and an increase in blood glucose levels Send distress call to hypothalamus Hormones - epinephrine, norepinephrine
Cultural stressors
live in a society where they do not culturally fit or receive care that ignores cultural beliefs
Ex Adventitious factors
maturation events occurring throughout the lifespan
Acute stress
most common brief positive or negative immediate reaction and biological response to a perceived stressor and triggers fight or flight response
Developmental (maturational) stressors
occur as an individual moves through the stages of life
Transactional theory of stress and coping (TTSC)
stress is a dynamic process and a transaction between a person and their environment
Episodic acute stress
when someone experiences frequent bouts of acute stress too much responsibility, disorganized, rushed tension headaches, irritable
Ex Cultural factors
events resulting from natural disasters
Ex Socioeconomic factors
factors related to personal, family, or work related issues
Ex Developmental factors
factors related to poverty, low income, and homelessness
Autonomic nervous system
the part of the peripheral nervous system that helps maintain homeostasis in the body and generally works without conscious control controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms.
A client asks the nurse which part of the body activates the stress response. Which of the following responses should the nurse provide?
Hypothalamus
A nurse in a health clinic is interviewing a client who is upset and reports that their stress is too much to handle. The client is unemployed, a single guardian to young children, and has periodic asthma attacks. Which of the following stress-related conditions is the client experiencing?
Allostatic load
Physiological responses that occur during the 3 stages of the GAS
A perceived stressor arouses the CNS Hormones released from the adrenal cortex create a state of readiness (fight or flight response) Rising hormone levels result in increased blood pressure and heart rate, blood glucose levels, oxygen intake, pupil dilation, and mental alertness The PNS attempts to return physiological functions to normal levels The body remains on alert while hormonal and other bodily functions return to normal 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
A nurse is interviewing a client who recently experienced an act of workplace violence when an armed person held the workers at gunpoint before police intervened. The client now reports being anxious and fears the gunman might return. The nurse should identify the client is experiencing which of the following types of crisis?
Adventitious
Examples of acute stress
Being involved in a motor vehicle accident Experiencing the loss of a loved one Being a victim of a crime
Examples of chronic stress
Living in a dysfunctional family Living in poverty Exposure to racism Living with a prolonged illness
A nurse is planning care for a client who is recently divorced with two young children. The client reports difficulty sleeping, feeling hopeless, and being estranged from family. The nurse should plan to monitor the client for which of the following potential manifestations of chronic stress?
Suicide
Corticotropin-releasing factor
activates SNS to release norepinephrine, epinephrine, and dopamine
Ex Situational factors
beliefs and values that influence how an individual perceives and responds to stress
A nurse is caring for a client who has pancreatic cancer that is unresponsive to treatment. The client is experiencing significant weight loss and fatigue, but when the nurse asks how they are feeling, they respond with, "great! i'm going to beat this cancer." Which of the following defense mechanisms is the client using?
denial
a nurse is providing discharge teaching about health promotion to a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following instructions should the nurse include?
Practice mindful breathing Start each day with a to do list Develop habits to mitigate stress
General Adaptation Syndrome (GAS)
a three-stage physiological response that appears regardless of the stressor that is encountered Alarm Resistance Exhaustion
IBS
chronic gastrointestinal condition - symptoms of abdominal discomfort, cramping, bloating, diarrhea, and/or constipation
Ego defense mechanisms
compartmentalization denial projection rationalization regression repression
Situational stressors
created by personal, family, or work related issues diagnoses, finances
Acute Stress Disorder (ASD)
from an overwhelming event that causes an intense and dysfunctional reaction last less than an month
Socioeconomic stressors
not necessarily fixed or universal
