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What is stress?

A change in the environment that is perceived as a challenge, threat, or danger; can have both positive and negative effects.

What are stressors?An event, stimulus, or factor which disturbs body’s equilibrium. May be either internal or external.

Describe adaptation.

The change that takes place as a result of the response to a stressor. An ongoing process as a person strives to maintain balance in his or her internal and external environments.

What is homeostasis?

Physiologic mechanisms within the body respond to internal changes to maintain relative constancy in the internal environment

Describe the effects of physical & emotional stress.

PHYSICAL- Any disruption of physiologic homeostasis = illnessEMOTIONAL- Reduced self concept/esteem = altered relationships, spiritual distress, perceptual & lowered problem solving abilities

What are the primary homeostatic control mechanisms?

The autonomic nervous system and the endocrine system primarily control homeostatic mechanisms.

Describe the Local Adaptation Syndrome response to stress.

A localized response of the body to stress. Involves a specific body part (tissue, organ) instead of the whole body. May be traumatic or pathologic & is a primary homeostatic short-term adaptive response.

What part of the ANS controls the body under normal conditions and

at rest and what does it do?

Parasympathetic system regulates heart rate, stimulates secretion of digestive juices & digestive tract, smooth muscle & stimulates insulin secretion & improves digestion.

How does the Sympathetic—Function affect the body's

response to stress?

Stimulates heart rate and force Dilates skeletal muscle blood vessels Dilates blood vessels to the brain Stimulates release of glycogen storesIncreases rate, strengthens contractions, increases cardiac output Increases muscle strength Increases mental alertness Increases blood glucose levels

Pituitary Secretes what hormones:

Adrenocorticotropic hormone (ACTH)Thyroid-stimulating hormone (TSH)Stimulates the adrenal cortex Stimulates the thyroid

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Adrenals Medulla produces

epinephrine and norepinephrine Cortex secretes mineralocorticoids, glucocorticoids, and androgensPrepares the person for emergencies; supports the sympathetic system Mineralocorticoid aldosterone regulates fluid and electrolytes Glucocorticoids raise glucose levels (for energy) and increase resistance to physical stress

Thyroid Secretesthyroid hormone and calcitoninRegulates metabolic rate and growth

Cardiovascular

Serves as transport system and pumpProvides oxygen and nutrients and removes carbon dioxide and wastes from cells

Renal

Filters, excretes, and reabsorbs metabolic products and waterMaintains fluid, electrolyte, and acid–base balance

Respiratory Intake and output of oxygen and

carbon dioxideNecessary for metabolism; helps maintain acid–base balance

Gastrointestinal

Takes in food and fluids Eliminates waste productsEnergy sources; maintains fluids and electrolytes

What is the Reflex Pain Response?

The response of the central nervous system to pain. Rapid & automatic, serving as a protective mechanism to prevent injury. Depends on a functioning neurologic reflex arc and involves both sensory and motor neurons.

Describe the inflammatory Response.

The inflammatory response is a local response to injury or infection. It serves to localize and prevent the spread of infection and promote wound healing. When you cut your finger, for example, you often develop the symptoms of the inflammatory response—pain, swelling, heat, redness, and changes in function

List several Physical Illnesses Associated With Stress

Graves' disease (hyperthyroidism)Rheumatoid arthritisUlcerative colitisPsoriasisMyasthenia gravisCardiovascular disordersHypertensionCoronary artery diseaseRespiratory disordersAsthmaGastrointestinal disordersEsophageal refluxConstipationDiarrheaUlcerative colitis

List the three phases in the inflammatory response

1st phase - Vasoconstriction followed by the release of histamines & incresed capillary permeability. WBC's move to the area. Blood flow returns to normal2cd - Exudate formation 3rd - Damaged cells are repaired or replaced

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What is the General Adaptation Syndrome (GAS)?

A biochemical model of stress developed by Hans Selye. Describes 3 stages the body under goes during stress. Affects have a gerneralized response to all body systems & include: the alarm reaction, resistance, & exhaustion.

Describe the Alarm Reaction of the GAS response.

Consists of 2 phases.1st phase - Fight-or-flight response is activated; hormone levels rise to prepare the body to react. Energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness increase. 2cnd phase - countershock, there is a reversal of body changes.

Describe the resistance phase of GAS.

Having perceived the threat and mobilized its resources, the body now attempts to adapt to the stressor. Vital signs, hormone levels, and energy production return to normal. If the stress can be managed or confined to a small area (LAS), the body regains homeostasis. If the damage to the body is too great (eg, with severe injury and bleeding or a major illness such as cancer or a heart attack), the adaptive mechanisms fail.

Describe th exhaustion phase of GAS.

Exhaustion results when the adaptive mechanisms are exhausted. Without defense against the stressor, the body may either rest and mobilize its defenses to return to normal or reach total exhaustion and die.The GAS is a physiologic response to stress, but it is important to remember that the response results from either physical or emotional stressors. The stages occur with either physical or psychological damage to the person. Obvious examples are seen in patients with severe

injury or an illness, but GAS is also a factor in mental illness, social isolation, and loss (or lack) of human relations.

What are the Psychological Homeostasis mechinisms?

psychological homeostasis involves the need of a person to feel love & belonging, to feel safe and secure, & to have self-esteem. When these needs are not met or a threat to need fulfillment occurs, homeostatic measures in the form of coping or defense mechanisms help return the person to emotional balance.

Physiologic Indicators of Stress

BackacheConstipation or diarrheaDilated pupilsDry mouthHeadacheIncreased urinationIncreased pulse, blood pressure, and respirationsNauseaSleep disturbancesStiff neckIncreased perspirationChest painWeight gain or lossDecreased sex drive

What is the most common human response to stress?

The most common human response is anxiety. Anxiety is a vague, uneasy feeling of discomfort or dread accompanied by an autonomic response; the source is often nonspecific or unknown to the individual. It is also a feeling of apprehension caused by anticipating a danger.

How does Panic effect a person?

Panic causes the person to lose control and experience dread and terror. The resulting disorganized state is characterized by increased physical activity, distorted perception of events, and loss of rational thought. The person is unable to learn, concentrates only on the present situation, and often experiences feelings of impending doom.

List common the coping mechanisms

Crying, laughing, sleeping, cursingPhysical activity, exerciseSmoking, drinkingLack of eye contact, withdrawalLimiting relationships to those with similar values and interests

What are defense mechanisms?

Unconscious reactions to stressors, called defense mechanisms, often occur. These mechanisms protect one's self-esteem and are useful in mild to moderate anxiety. When extreme, however, they distort reality and create problems with relationships. At that point, the mechanisms become maladaptive instead of adaptive.

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Effects of Stress on Basic Human Needs:Physiologic

Change in appetite, activity, or sleepChange in elimination patternsIncreased pulse, respirations, blood pressure

Effects of Stress on Basic Human Needs:

Safety/Security

Feels threatened or nervousUses ineffective coping mechanismsIs inattentive

Effects of Stress on Basic Human Needs: Love/Belonging

Is withdrawn and isolatedBlames others for own faultsDemonstrates aggressive behaviorsBecomes overly dependent on others

Effects of Stress on Basic Human Needs: Self-Esteem

Becomes a workaholicExhibits attention-seeking behaviors

Effects of Stress on Basic Human Needs: Self-Actualization

Refuses to accept realityCenters on own problemsDemonstrates lack of control

What are the two sets of adaptive tasks that occur in response to

General tasks (as in the case of any situational stress) involve

acute and chronic illness?

maintaining self-esteem and personal relationships and preparing for an uncertain future.

Illness-related tasks include such stressors as losing independence and control, handling pain and disability, and carrying out the prescribed medical regimen.

Crisis

A crisis is a disturbance caused by a precipitating event, such as a perceived loss, a threat of loss, or a challenge, that is perceived as a threat to self

Types of crisis

Maturational, situational, or adventitious. Maturational crises occur during developmental events that require role change, such as when a teenager moves into adulthood. Situational crises occur when a life event disrupts a person's psychological equilibrium, such as loss of a job or death of a loved family member. Adventitious crises are accidental and unexpected events, resulting in multiple losses and major environmental changes, such as fires, earthquakes, and floods that involve not only individuals but also entire communities

Factors Affecting Stress and Adaptation

Stress and adaptation are affected by the sources of stress, the types of stressors experienced, and personal factors.

List two common factors of the localized stress response that afect

nursing care.

The two most common responses that influence nursing care are the reflex pain response and the inflammatory response.

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Displacement You redirect your feelings to another target

An employee who is angry with a coworker kicks a chair.

Introjection

A person incorporates qualities or values of another person into his or her own ego structure. This mechanism is important in the formation of conscience during childhood.

An older sibling tells his preschool sister not to talk to

strangers, expressing his parents' values to his younger

sister.

Projection You think someone else has your thought or feeling.

"That professor hates me.""That student hates the prof."

Reaction formation

A person develops conscious attitudes and behavior patterns that are opposite to what he or she would really like to do.

A married woman is attracted to her husband's best friend but is

constantly rude to him.

Sublimation You redirect the feeling into a socially productive activity

"I'm going to write a poem about anger."

RegressionYou revert to an old, usually immature behavior to ventilate your feeling.

"Let's shoot spitballs at people!"

Reaction Formation

You turn the feeling into its opposite. A person develops conscious attitudes and behavior patterns that are opposite to what he or she would really like to do.

A married woman is attracted to her husband's best friend but is

constantly rude to him

Undoing

You try to reverse or undo your feeling by DOING something that indicates the opposite feeling. It may be an "apology" for the feeling you find unacceptable within yourself.

A husband who was physically abusive to his wife may bring her

an expensive present the next day.