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NURS 112 - TEST 4 - Unite E.2 > CH 33 - COPING > Flashcards

CH 33 - COPING Flashcards

1
Q

Stress describes

A

changes in an individual’s state of balance in response to stressors,

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2
Q

Any stressor, whether it is perceived as “good” or “bad,” produces

A

similar biological response in the body.

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3
Q

Stress can be situational

A

(adjusting to a chronic disease or a stressful job change)

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4
Q

Role conflict:

A

This develops when a person must assume opposing roles with incompatible expectations.

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5
Q

Sick role:

A

Expectations of others and society regarding how one should behave when sick (caring for self while sick and continuing to provide childcare to grandchildren).

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6
Q

Role ambiguity:

A

Uncertainty about what is expected when assuming a role; creates confusion.

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7
Q

Role strain:

A

The frustration and anxiety that occurs when a person feels inadequate for assuming a role (caring for a parent with dementia).

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8
Q

Role overload:

A

More responsibility and roles than are manageable; very common (assuming the role of student, employee, and parent).

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9
Q

List at least four factors that influence an individual’s ability to cope.

A

● Number of stressors
● Duration of the stressors
● Intensity of the stressors
● Individual’s past experiences
● Current support system
● Available resources

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10
Q

A nurse is caring for a client whose partner passed away 4 months ago. The client has a recent diagnosis of diabetes mellitus. The client is tearful and states, “How could you possibly understand what I am going through?” Which of the following esponses should the nurse make?
A. “It takes time to get over the loss of a loved one.” (USE ALT + ENTER - MOVE TEXT TO NEW LINE IN SAME CELL)
B. “You are right. I cannot really understand. Perhaps you’d like to tell me more about what you’re feeling.”
C. “Why don’t you try something to take your mind off your troubles, like watching a funny movie.”
D. “I might not share your exact situation, but I do know what people go through when they deal with a loss.”

A

A. Telling the client it will take more time to heal belittles the client’s feelings and gives false reassurance.
B. CORRECT: By stating there is a lack of understanding, the nurse is using the therapeutic communication technique of validation, whereby a person shows sensitivity to the meaning behind a behavior. The nurse is also creating a supportive and nonjudgmental environment, and inviting the client to express frustrations.
C. Telling the client to try a distraction dismisses the client’s feelings and gives common advice instead of expert advice.
D. Saying the nurse knows what clients feel is presumptive and inappropriate.

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11
Q

Coping describes how an individual deals with

A

problems (illness and stress)

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12
Q

Factors Involved in coping and adaptation include

A

family dynamics
adherence to treatment regimens
role an individual can play in important relationships

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13
Q

Stress describes

A

changes in an individual’s state of balance in response to stressors

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14
Q

stressors

A

internal / external forces - disrupt state of balance

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15
Q

any stressor can be perceived as:

A

good or bad

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16
Q

whether a stressor is perceived as “good” or “bad,”it produces

A

a similar biological response in the body

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17
Q

Stress can be (2)

A

situational (adjusting to a chronic disease or a stressful job change)
developmental (varying with life stage)

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18
Q

Adult stressors can include

A

losing parents, having a baby, and getting married

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19
Q

Stress can be caused by sociocultural factors, including (pls)

A

substance use, lack of education, and prolonged poverty

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20
Q

Stress impairs and weakens

A

immune system

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21
Q

stress is a causal factor in

A

numerous health conditions

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22
Q

presence of stressors delays a client’s

A

return to health in the same way that the presence of a foreign body or infection delays the healing of a wound

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23
Q

Coping describes

A

how an individual deals with problems and issues

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24
Q

Coping is

A

behavioral and cognitive efforts of an individual to manage stress

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25
Q

Factors influencing an individual’s ability to cope include

A

number, duration, and intensity of stressors; the individual’s past experiences; the current support system; and available resources

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26
Q

Coping strategies are unique to an individual and can

A

vary greatly with each stressor

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27
Q

Ego defense mechanisms

A

assist a person during a stressful situation or crisis by regulating emotional distress

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28
Q

Adaptation

A

Coping behavior that describes how an individual handles demands imposed by the environment

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29
Q

General adaptation syndrome (GAS)

A

Also known as “stress syndrome.”

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30
Q

Hans Selye developed a theory of adaptation that describes the stress reaction in three stages.

A

General adaptation syndrome (GAS)

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31
Q

General adaptation syndrome (GAS) - 3 stages

A

alarm; resistance; exhaustion

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32
Q

Alarm stage:

A

Body functions heightened to respond to stressors, also called fight-or-flight response.

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33
Q

what happens to the body in the alarm stage

A

Hormones (epinephrine, norepinephrine, cortisone) are released, which cause elevated blood pressure and heart rate, heightened mental alertness, increased secretion of epinephrine and norepinephrine, and increased blood flow to muscles

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34
Q

Resistance stage:

A

Body functions normalize while responding to the stressor

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35
Q

what happens to the body in the resistance stage

A

The body attempts to cope with the stressor and return to homeostasis.
Stabilization of blood pressure, heart rate, and hormones will occur

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36
Q

Exhaustion stage:

A

Body functions are no longer able to maintain a response to the stressor and the client cannot adapt.

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37
Q

what is the end result of the exhaustion stage

A

The end of this stage results in recovery or death

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38
Q

Adherence

A

commitment and ability of the client and family to follow a given treatment regimen

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39
Q

Commitment to the regimen increases

A

adherence

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40
Q

Complicated regimen interferes with

A

adherence

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41
Q

Involvement of the client and significant support people in the planning stage increases

A

adherence

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42
Q

Adverse effects of medications diminish

A

adherence

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43
Q

Negative coping mechanisms (denial) can cause

A

nonadherence

44
Q

positive coping mechanisms can increase

A

adherence

45
Q

Available resources increase

A

adherence

46
Q

TO ASSESS / COLLECT DATA ON CLIENT STRESSORS ASK QUESTIONS RELATED TO

A

Current stress, perception of stressors, ability to cope
Support systems
Adherence to healthy behaviors and/or treatment regimen
Sleep patterns
Altered elimination patterns, changes in appetite, weight loss / gain

47
Q

TO ASSESS / COLLECT DATA ON CLIENT STRESSORS OBSERVE WHAT

A

client’s appearance and eye contact, verbal, motor, and cognitive status during the assessment’ Observe for irritability, anxiety, and tension

48
Q

health promotion strategies

A

regular exercise, optimal nutrition, adequate sleep and rest

49
Q

relaxation techniques

A

breathing exercises, massage, imagery, yoga, meditation

50
Q

Control the environment to

A

reduce the number of external stressors

51
Q

Examples of environmental controls to reduce stressors

A

noise
breaks in the continuity of care

52
Q

training to manage stress

A

journal writing, assertiveness training, stress management in the workplace, mindfulness-based stress reduction

53
Q

optimal time to teach a client about stress-management skills

A

after coping with crisis successfully

54
Q

Use effective communication techniques to foster

A

expression of feelings

55
Q

Nursing interventions ot help client cope

A

empathetic in communication -encourage client to verbalize feelings
Identify client’s / family’s strengths / abilities
Encourage client’s autonomy w/ decision‑making
Discuss client’s / family’s abilities to deal w/ current situation
Encourage client - describe coping skills used effectively in past
Identify available community resources - refer client for counseling if needed

56
Q

Nursing interventions to help adherence

A

Put instructions in writing
Allow client to give input into treatment regimen
Simplify treatment regimens as much as possible
Follow up w/ client - address any questions / problems

57
Q

Family is defined by

A

the client

58
Q

family consists of

A

individual structures and roles
typically two or more people whose relationships create a bond - influence their mutual development, support, goals, resources

59
Q

five realms of processes involved in family function during a family assessment (hi cid)

A

interactive, developmental, coping, integrity, health

60
Q

Family dynamics are constantly evolving due to

A

processes of family life and developmental stages of the family members

61
Q

FASTEST‑GROWING POPULATION

A

Those older than 65 years, leading to caregiver issues

62
Q

Current Trends of families and populations

A

fastest growing population is >65
declining ecomonic status of families
family violence
acute/chronic illness - disrupt family unit
homelessness

63
Q

DECLINING ECONOMIC STATUS OF FAMILIES why?

A

increased unemployment

64
Q

Family violence is what kind of cycle

A

endless cycle

65
Q

acute / chronic illness can do what to family unit

A

disrupt family unit

66
Q

HOMELESSNESS

A

Lack of stable environment, financial issues, inadequate access to health care

67
Q

fastest‑growing homeless population

A

families w/ children

68
Q

The homeless population is increasing due to

A

lack of affordable housing

69
Q

structure dicates the families ability to

A

cope

70
Q

what two types of family structures

A

regid and open

71
Q

rigid structure

A

dictatorial and strict

72
Q

open structure

A

few or no boundaries, consistent behavior, or consequences

73
Q

the two types of familiy strucutres can provide what types of outcomes

A

either can provide both positive or negative outcomea

74
Q

function describes the course a family uses to

A

reach its goals, including members’ communication skills, problem‑solving abilities, and available resources

75
Q

Assess all clients within the context

A

of family

76
Q

Assess a family by looking at its

A

structure and function

77
Q

Assessment of a family can focus on

A

family as a context, a client, or a system

78
Q

A role is

A

function a person adopts within their life. Seldom is it limited to one role, but rather is multidimensional and is often relative to the role of others

79
Q

(6) examples of roles

A

grandparent, parent, dependent child, employee/employer, committee member, community activist

80
Q

Illness causes role stress by

A

creating a situation in which roles can change simply due to the effect and progression of the illness

81
Q

Nurses must be aware of a client’s roles in life, as well as

A

how the situation of illness might change these roles, either temporarily or permanently

82
Q

Types of role problems (5)

A

role conflict
sick role
role ambiguity
role strain
role overload

83
Q

Role conflict

A

develops when person must assume opposing roles w/ incompatible expectations.

84
Q

Role conflicts can be what two types

A

interpersonal and inter-role

85
Q

Role conflicts interpersonal EX:

A

(when parents expect adolescents to participate in sports and perform household tasks)

86
Q

Role conflicts can be inter-role EX:

A

inter‑role (when a mother wants to stay at home with her infant, but family finances require her to work).

87
Q

Sick role:

A

Expectations of others and society regarding how one should behave when sick (caring for self while sick and continuing to provide childcare to grandchildren)

88
Q

Role ambiguity:

A

Uncertainty about what is expected when assuming a role; creates confusion

89
Q

Role strain:

A

The frustration and anxiety that occurs when a person feels inadequate for assuming a role (caring for a parent with dementia). Caregiver burden results from the accumulated stress of caring for someone else over time.

90
Q

Role overload:

A

More responsibility and roles than are manageable; very common (assuming the role of student, employee, and parent).

91
Q

SITUATIONAL ROLE CHANGES caused by

A

situations other than physical growth and development (marriage, job changes, divorce)

92
Q

SITUATIONAL ROLE CHANGES can disrupt

A

one or more of the client’s roles in life (with illness or hospitalization)

93
Q

TEMPORARY ROLE CHANGES:

A

client will resume the role when illness resolves.

94
Q

PERMANENT ROLE CHANGES

A

Illness has altered the level of the client’s health to a point that previous roles are no longer available.

95
Q

five realms of family life

A

(interactive processes, developmental processes, coping processes, integrity processes, health processes

96
Q

potential stressors - 2 Ex’s.

A

social isolation, physical demands

97
Q

List at least four factors that influence an individual’s ability to cope

A

Number of stressors
Duration of Stressort
Intensity of stressor
Individuals past expierience
Current support system
Available resources

98
Q

List three interventions the nurse can take to assist the client in coping with a stressful event or situation

A

Be empathetic in communication, and encourage the client to verbalize feelings.
Identify the client’s and family’s strengths and abilities.
Discuss the client’s and family’s abilities to deal with the current situation.
Encourage the client to describe coping skills used effectively in the past.
Identify available community resources, and refer the client for counseling if needed

99
Q

A nurse is caring for a client whose partner passed away 4 months ago. The client has a recent diagnosis of diabetes mellitus. The client is tearful and states, “How could you possibly understand what I am going through?” Which of the following esponses should the nurse make?
A. “It takes time to get over the loss of a loved one.”
B. “You are right. I cannot really understand. Perhaps you’d like to tell me more about what you’re feeling.”
C. “Why don’t you try something to take your mind off your troubles, like watching a funny movie.”
D. “I might not share your exact situation, but I do know what people go through when they deal with a loss.”

A

A. Telling the client it will take more time to heal belittles the client’s feelings and gives false reassurance.
B. CORRECT: By stating there is a lack of understanding, the nurse is using the therapeutic communication technique
of validation, whereby a person shows sensitivity to the meaning behind a behavior. The nurse is also creating a supportive and nonjudgmental environment, and inviting the client to express frustrations.
C. Telling the client to try a distraction dismisses the client’s feelings and gives common advice instead of expert advice.
D. Saying the nurse knows what clients feel is presumptive and inappropriate.

100
Q

A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives, the nurse takes the client’s vital signs and notes an elevation in blood pressure and heart rate. The nurse should recognize this response as which part of the general adaptation syndrome (GAS)?
A. Exhaustion stage
B. Resistance stage
C. Alarm stage
D. Recovery stage

A

A. Although the exhaustion stage is a component of GAS, body functions are no longer able to respond to the stressor in this stage.
B. Although the resistance stage is a component of GAS, body functions normalize in an attempt to cope with the stressor in this stage.
C. CORRECT: In the alarm stage of GAS, body functions (blood pressure and heart rate) are heightened in order to respond to stressors.
D. Although not technically a component of GAS, recovery stage is an alternative to the exhaustion stage, but it would not account for an elevation in blood pressure and heart rate.

101
Q

A nurse is caring for a client who has left‑sided hemiplegia resulting from a cerebrovascular accident. The client works as a carpenter and is now experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the client’s role problem?
A. Role conflict
B. Role overload
C. Role ambiguity
D. Role strain

A

A. CORRECT: The client is experiencing role conflict because their career is extremely physical, and they can no longer perform the job duties. However, the client is the primary wage earner in the family.
B. Although the client can feel overloaded and overwhelmed, role overload occurs when the client is trying to juggle too many roles.
C. The client is not experiencing role ambiguity because their job duties and physical limitations are quite clear.
D. The client is not experiencing role strain. That occurs when one feels inadequate for assuming a role.

102
Q

A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan should the nurse initiate at this time? (Select all that apply.)
A. Suggest coping skills for the client to use in this situation.
B. Allow the client to provide input in the treatment plan.
C. Assist the client with time management, and address the client’s priorities.
D. Provide extensive instructions on the client’s treatment regimen.
E. Encourage the client in the expression of feelings and concerns.

A

A. Although it can seem helpful to suggest specific coping skills for the client, it is best to allow the client to discuss coping skills that have worked in the past.
B. CORRECT: Allowing the client to contribute to the treatment plan allows for greater adherence to the plan.
C. CORRECT: Helping the client to prioritize is an intervention that can reduce levels of stress for the client because many times time management is extremely difficult in times of stress.
D. Although it is necessary to provide complete information on treatment plans, simplifying treatment regimens as much as possible allows for greater adherence to the treatment plan.
E. CORRECT: By using effective communication techniques, encouraging the client to verbalize feelings is an intervention for stress, coping, and adherence that allows the client to reduce stress, validate emotions, and start planning for valid concerns.

103
Q

A nurse is caring for a family who is experiencing a crisis. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis?
A. Prescribing tasks unilaterally
B. Delegating care to one member
C. Speaking to the primary client privately
D. Convening a family meeting

A

A. Prescribing tasks is too rigid for acceptance by a family with an open structure.
B. Delegating care is too rigid for acceptance by a family with an open structure.
C. Speaking to the primary client privately excludes the family.
D. CORRECT: An open structure is loose, and convening a family meeting would give all family members input and an opportunity to express their feelings.

104
Q

Role conflicts can be.

A

interpersonal (when parents expect adolescents to participate in sports and perform household tasks) or inter‑role (when a mother wants to stay at home with her infant, but family finances require her to work)

105
Q

stressors, the

A

internal and external forces that disrupt that state of balance

106
Q

Caregiver burden results from the

A

accumulated stress of caring for someone else over time.

NURS 112 - TEST 4 - Unite E.2 (7 decks)

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