1.3--Stress and Coping according to hec.pptx

nursing ppt on topic steas and coping hec slybuss

1. Stress and coping Tolerance

2. Key Terms Stress: Regarded as a normal part of life and can have both positive and negative effect on a person’s functional capacity. Eustress: positive stress that can be associated with adaptation and is necessary for growth and development. Distress: Negative stress that is potentially harmful and may exhaust adaptive capacity.

3. Cont … Stressor: alarming stimuli that arouse the body from the resting state into a state of readiness to combat or deal with the stressor. Types of Stressor: Physiologic Stressor: Physical stimuli that initiate the stress response. It may be detected during the physical examination as well as during the interview. Examples: disease process, fatigue, aging, sleep deprivation.

4. Cont … Psychological Stressors: stimuli originating from the person’s thought process in relation to personal safety and security, personal control over events, and social integration. Environmental Stressors: a person’s unfamiliar surrounding or setting. Examples: Changes in daily routine, lack of privacy, sensory deprivation or overload. Sociocultural Stressors: Encompass stressful events related to family relations, career, financial concerns and religion.

5. Stress Response: An adaptive mechanism that restores a person’s balance and equilibrium. Coping: is a process used to manage events that are perceived and interpreted as stressful. OR what one does about a problem in order to bring about relief, and equilibrium. Adaptation: is the process of development of resistance to changes in environment. Coping Strategies: Specific techniques used to deal with a stressor and its consequences to relieve the intensity of the stressors..

6. Effective Coping Effective coping is manifested by high levels of adaptation to stress or the development of stress tolerance. It may have the following results as: Distress is maintained within manageable limits. Hope and encouragement are generated. A sense of personal worth is maintained. Relationship with significant others are maintained or destroyed. Prospects for favorable situations and physical recovery are enhanced.

7. Stressor Intensity An intense stressor may be perceived as insurmountable / overwhelming and may precipitate crisis. Past experiences with stressors----the stressors may be viewed as less threatening. Personality---certain people are more stress resistant especially those who view change as a challenge and believe that they can influence events

8. Crisis occurs when the person feels overwhelmed by stressors and unable to resolve the problem. It is an acute, self-limiting state that usually resolved within a period of 4 to 6 weeks.

9. Stages of Stress Alarm Reaction (AR) —body alerts in response to stress. Stage of Resistance (SR) —adaptation and competition with stressors to limit them. attempts are made to maintain usual structures, often by applying coping strategies to reduce tension and to recognize one’s thoughts. Being challenged at this stage may result in anger because it interferes with coping attempts. Stage of Exhaustion (SE) —If the adaptation does not overcome the stressors the adaptation will fail and the effects may spread to the entire body.

10. A) ALARM STAGE As you begin to experience a stressful event or perceive something to be stressful, psychological changes occur in your body. This experience or perception disrupts your body’s normal balance and immediately your body begins to respond to the stressor(s) as effectively as possible. 11

11. EXAMPLES Cardiac - increased heart rate Respiratory - increased respiration Skin - decreased temperature Hormonal - increased stimulation of adrenal genes which produce an adrenal rush. 12

12. B) RESISTANCE STAGE During this stage your body tries to cope or adapt to the stressors by beginning a process of repairing any damage the stressor has caused. Your friends, family or co-workers may notice changes in you before you do so. It is important to examine their feedback to make sure you do not reach overload. 13

13. EXAMPLES Behavior indicators include: lack of enthusiasm for family, school, work or life in general, withdrawal, change in eating habits, insomnia, hypersomnia, anger, fatigue. Cognitive Indicators include: poor problem solving, confusion, nightmares. 14

14. RESISTANCE STAGE (CON…) MORE EXAMPLES Emotional indicators include: tearfulness fear anxiety guilt agitation depression overwhelmed. 15

15. C) EXHAUSTION STAGE During this stage the stressor is not being managed effectively and the body and mind are not able to repair the damage. 16

16. EXAMPLES Digestive disorders, withdrawal, headaches, tension, insomnia, loss of temper. 17

17. Nursing Assessment A Physiological Response: Stressors activate the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, resulting in physiological alterations that may be observed during physical assessment .

18. Assessment Cont.… Cardiovascular System: When the SNS is activated during stress, norepinephrine is released, producing the following: Increased heart rate Cutaneous vasoconstriction Increased myocardial consumption Increased systolic blood pressure Cardiac dysrhythmias, Chest pain sensations/ischemic pain and palpitations Headache

19. Assessment Cont … Respiratory System: Norepinephrine secretion during stress can lead to bronchodilation. Increased respiratory rate. Gastrointestinal System: SNS stimulation inhibits GIT motility. Stress is often associated with nausea, vomiting, increases peristaltic activity, and excessive secretion of HCl .

20. Assessment cont.… Musculoskeletal System: Increased muscular tone in response to stress. The person may appear tense May be tremors in hands. Integumentary System: Diaphoresis Skin lesions

21. Assessment cont.… Behavioral Response: Impaired thinking process Difficulty learning new skills Inability to interact with friends Cognitive Responses: Inability to concentrate and make decision Affective Responses: Anxiety, depression, fear and frustration Ambivalence and conflict.

22. Coping Mechanism/Strategy Coping mechanism is an innate or acquired way of responding to a changing environment or situation. Effective coping results in adaptation. Ineffective coping results in maladaptation. All coping strategies may not always be appropriate. Coping strategies vary among individuals. Coping mechanism may be short term or long term

23. Stress Management A nurse can relieve and manage a client’s stress through: Therapeutic touch Massage—effleurage (stroking) and petrissage(kneading) Relaxation exercise Guided imagery

24. Nursing Diagnosis Ineffective coping mechanism Fear (related to perceived effects of…..) Hopelessness (r/t separation from significant others) Altered self-concept (r\t change in role) Rape trauma syndrome Spiritual distress Potential for violence: self directed or directed at others Powerlessness (r/t long term abusive relationship) Anxiety r/t perceived threat to health status Ineffective individual coping r/t problem-solving skills deficit