Chapter 37: Stress And Coping Flashcards
(162 cards)
0
Q
________ Regression ego defense mechanism is coping with a stressor through actions and behaviors associated with an earlier developmental period.
What ego defense mechanism is this?
A
Regression ego defense mechanism
1
Q
If stress is present, ______ appraisal focuses on possible coping strategies. Balancing factors contribute to restoring _______.
A
Secondary
Equilibrium
2
Q
Nurses need to recognize the signs and symptoms of stress and understand _______ techniques to aid personal coping and design interventions for their patients and families.
A
stress management
3
Q
Patients ______ your advice and counsel and gain confidence from your belief in their ability to move past the stressful event or illness. Patients overwhelmed by life events are often unable, at least initially, to act on their own behalf and require either _______.
A
respect
direct intervention or guidance
4
Q
______ is a physical, emotional, or psychological demand that often leads to growth or overwhelms a person and leads to illness.
A
stress
5
Q
In ______ stressors include the loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition.
A
Old age
6
Q
The medulla oblongata, located in the lower portion of the brainstem, controls what three physiological changes? Impulses traveling to and from the medulla oblongata increase or decrease these vital functions.
A
heart rate,
blood pressure,
respirations.
7
Q
Potential stressors that affect any age-group but are especially stressful for young people include _______ and ________ .
A
Prolonged poverty and Physical handicap
9
Q
Nursing ____ frequently results from intense caregiving and manifests as emotional exhaustion, loss of a sense of personal identity, and feelings of failure.
A
Burnout
10
Q
The fight-or-flight response to stress, which is arousal of the __________ nervous system, prepares a person for action.
A
Sympathetic
11
Q
________ is transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute. (Example: A person transfers anger over an interpersonal conflict to a malfunctioning computer.)
What ego defense mechanism is this?
A
Displacement ego defense mechanism
13
Q
The _______ is a small gland immediately beneath the hypothalamus.
A
pituitary gland
14
Q
The _______ and _________ of the psychological threat and the ________ of other stressors that occur at the same time affect the person’s response to the threat.
A
Intensity
Duration
Number
15
Q
Evaluating an event for its personal meaning is _______.
A
Primary appraisal
16
Q
Coping mechanisms include psychological ______ behaviors. Such behaviors are often ______-oriented, involving the use of direct problem-solving techniques to cope with _____ threats.
A
Adaptive
Task
17
Q
_______ includes work, family, chronic, and acute stress; daily hassles; trauma; and crisis.
A
Stress
18
Q
_______ begins when a person experiences, witnesses, or is confronted with a traumatic event and responds with intense fear or helplessness.
A
Posttraumatic stress disorder (PTSD)
19
Q
A _____ implies that a person is facing a turning point in life. This means that previous ways of _____ are not effective and the person must change.
A
crisis
Coping
20
Q
The vital questions for a person in ______ are, “What does this mean to you; how is it going to affect your life?” What causes extreme stress for one person is _____ always stressful to another.
A
Crisis
Not
21
Q
__________ is based on the concepts of stress and reaction to it. This views the person, family, or community as constantly changing in response to the environment and stressors and helps explain individual, family, and community responses to stressors.
A
The Neuman Systems Model
22
Q
However, when physiological, psychological, sociocultural, devel- opmental, or spiritual resources are unable to buffer stress, the normal line of defense is broken, and _____ often results.
A
Disease
23
Q
_________ is making up for a deficiency in one aspect of self-image by strongly emphasizing a feature considered an asset. (Example: A person who is a poor communicator relies on organizational skills.)
What ego defense mechanism is this?
A
Compensation Ego Defense Mechanisms
24
Q
Recognize the need for collaboration and consultation; inform the patient about potential resources; and make arrangements for interventions such as ______, ______, or _______.
A
consultations
group sessions
therapy
25
Q
________ stress arises from personal or family job changes or relocation. Stressful job changes include promotions, transfers, downsizing, restructuring, changes in supervisors, and additional responsibilities.
A
Situational
26
The general adaptation syndrome is a three stage reaction to stress, describes how the body responds to stressors through the ________reaction, the _______ stage, and the ________ stage.
Alarm
Resistance
Exhaustion
26
________ is based on the belief that a person significantly reduces stress with imagination. It is a relaxed state in which a person actively uses imagination in a way that allows visualization of a soothing, peaceful setting. Typically the image created or suggested uses many sensory words to engage the mind and offer ______ and ______.
Guided imagery
| distraction and relaxation
28
Begin your assessment with an ______ question such as, “What is happening in your life that caused you to come today?” or “What happened in your life that is different?” This requires some focusing by the patient. Next assess the patient’s _______ of the event, available situational _______, and what he or she usually does when there is a problem that he or she cannot ______. Determine if a person is suicidal or homicidal by asking ________. For example, ask, “Are you thinking of killing yourself or someone else?”
```
open-ended
perception
supports
solve
directly
```
29
Stressors vary with life stage. _______ identify stressors related to their physical appearance, their families, their friends, and school.
Children
30
Be ______ in the belief that you and your patients can effectively manage stress. Patients who feel overwhelmed and perceive events as being beyond their capacity to cope rely on you as an _______.
confident
| Expert
31
Assessment of a patient’s stress level and coping resources requires that you first establish a ______ nurse-patient relationship because you are asking a patient to share personal and ________ information.
trusting
| sensitive
31
Often the patient has _______ expressing exactly what is most bothersome about the situation until there is an opportunity to discuss it with someone who has time to listen.
difficulty
31
Take time to understand a patient’s ________ of the precipitating event and the ways in which stress is _______ his or her life.
Meaning
| Affecting
32
People experience _____ as a consequence of daily life events and experiences. It stimulates thinking processes and helps people stay alert to their environment. It results in personal growth and facilitates development.
Stress
33
* What is bothering you most right now?
* What do you think about when you’re lying awake?
What stage is this in the nursing process?
Assessment of the patients Perception of Stressor
34
_______ is how people interpret the impact of the stressor on themselves or on what is happening and what they are able to do about it.
Appraisal
35
Nursing diagnoses for people experiencing stress generally focus on ______. Specifically major defining characteristics of ineffective coping include verbalization of an inability to cope and an inability to ask for help. To identify defining characteristics, ask the patient what is of ______ at the time of the interview. It is important to allow him or her sufficient ____ to answer.
coping
most concern
time
36
________ for persons experiencing stress frequently include effective coping, family coping, caregiver emotional health, and psychosocial adjustment: life change.
Desirable outcomes
37
___________ assist the patient in readapting and can include relaxation training and time-management training. The nurse and the patient assess the level and source of the existing stress and determine the appropriate points for intervention to reduce it.
What level is this nursing intervention?
Tertiary Level nursing Interventions
37
_______ identify multiple nursing diagnoses from the assessment database and show how they are related. In addition, this shows the relationship among the nursing diagnoses chronic low self-esteem, ineffective coping, anxiety, and caregiver role strain.
Concept maps
38
Stress in a ______ is sometimes from a critically ill family member, the sudden loss of a job, a move, or becoming homeless.
Family
40
Just as the nursing _________ of the patient’s stress and coping depends on the patient’s perception of the problem and coping resources, the interventions focus on a ______ with the patient and support system, usually the family.
assessment
| partnership
41
When assessing a patient’s level of stress and coping resources, create a _______ physical environment for the interaction. Assume the same ______ as the patient, arranging the interview environment so you can maintain or avoid eye contact ________. You do this by placing chairs at a _____ angle or ______ to reduce the intensity of the interaction.
```
Nonthreatening
Height
Comfortably
90 degree
Side by side
```
42
______ with occupational therapists, dietitians, pastoral care professionals, and health care professionals from other clinical specialties, depending on the patient’s stressful situation.
Collaborate
43
Three primary modes of intervention for stress are?
1. decrease stress-producing situations,
2. increase resistance to stress
3. learn skills that reduce physiological response to stress.
44
A regular _______ improves muscle tone and posture, controls weight, reduces tension, and promotes relaxation.
exercise program
45
Other potential threats to _______ include nutritional deficits; insomnia; self-care deficits; and poor judgment and impulsiveness that possibly lead to unsafe decisions about sex, drugs, money, or damage to personal relationships that the person might later regret.
safety
46
Obtain __________ findings related to stress and coping through observation of the appearance and non-verbal behavior of a patient. Observe grooming and hygiene, gait, characteristics of the handshake, actions while sitting, quality of speech, eye contact, and the attitude of the patient during the interview.
Objective
47
A _______ of family, friends, and colleagues who listen, offer advice, and provide emotional support benefits a patient experiencing stress.
support system
48
Give utmost attention to determining the patient’s ______ of the situation and his or her ability to cope with the stress.
perception
49
In many cases setting _____ helps individuals identify tasks that are not necessary or can be delegated to someone else.
priorities
50
You also help the person become ______ of present feelings such as anger, grief, or guilt to help him or her reduce feelings of tension. In addition, you help the patient explore coping mechanisms, perhaps identifying new __________. Finally you help the person increase __________ if he or she has been isolated and overly self-focused.
Aware
methods of coping
social contacts
51
In the presence of anxiety- provoking thoughts and events, a common physiological symptom is _______. Diminish ______ tension through a systematic approach to releasing tension in major muscle groups. Typically an individual achieves a relaxed state through deep chest breathing. Once the patient is breathing deeply, direct him or her to alternately tighten and relax muscles in specific groupings.
muscle tension
| physiological
52
________ includes skills for helping individuals communicate effectively regarding their needs and desires.
Assertiveness
53
For many people keeping a private, personal journal provides a therapeutic outlet for _______. Suggest that patients keep journals, especially during difficult situations. In a private journal patients are able to express a full range of emotion and vent their _______ feelings without hurting anyone else’s feelings and without concern for how they appear to others.
stress
| honest
54
The patient’s clinical condition and perception of stress determine which nursing diagnosis has the greatest ________. As in all areas of nursing, safety of the patient and others in his or her environment is the _______ priority
priority
| first
55
________ experience stress related to self-esteem issues, changing family structure as a result of divorce or death of a parent, or hospitalizations.
Preadolescents
56
Some individuals or families emerge from a crisis state functioning more _____, whereas others find themselves weakened, and still others are completely _______.
effectively
| dysfunctional
57
When stress overwhelms a person’s usual coping mechanisms and demands mobilization of all available resources, it becomes a ______.
crisis
58
The ________, a small cluster of neurons in the brainstem and spinal cord, continuously monitors the physiological status of the body through connections with _______ and ________ tracts.
reticular formation
| Sensory and motor
60
___________ is experiencing a subjective sense of numbing and a reduced awareness of one’s surroundings.
What ego defense mechanism is this?
Dissociation ego defense mechanism
61
________ techniques include developing lists of prioritized tasks. For example, help patients list tasks that require immediate attention, those that are important and can be delayed, and those that are routine and can be accomplished when time becomes available.
Time management
61
If desired outcomes have been met, the patient reports feeling better now than 6 months ago.
evaluation
62
A person under stress _________ when the stress is removed or coping strategies are successful.
Recovers
63
A patient recovering from acute stress often spontaneously reports feeling better when the stressor is _____. The recovery from chronic stress occurs more gradually as the patient emerges from the strain. In ______ situations reassess the patient for the presence of new or recurring stress-related symptoms.
gone
| Both
64
When using a _________ approach, you help the patient make the mental connection between the stressful event and his or her reaction to it. This is crucial because he or she is sometimes unable to see the whole situation ______.
Crisis Intervention
| Clearly
65
If contact with a patient ends before you have achieved the resolution of goals, it is important to refer him or her to appropriate resources so progress is ______ or _______.
not delayed or interrupted
66
Observe patient ______ and talk with the patient and family if appropriate. Ask the patient about ______, ________, and ______. Ask about coping strategies that the patient uses and determine their effectiveness.
behaviors
| sleep patterns, appetite, and ability to concentrate
66
When a person recovers from a stressful situation, the time is right for introducing ______ skills to reduce the number and intensity of stressful situations in the future.
stress management
67
If he or she reports continued acute stress, assess for ______ by asking about whether or not there have been any recent accidents at home, in the car, or at work. Ask about ______ to determine if the patient is using unsafe, maladaptive strategies. If the patient reports continued _______, ask about his or her perception of the stressor and coping behaviors used. Discuss the stressor with the patient to determine if it needs to be redefined.
safety
coping strategies
chronic stress
69
If you or your patients experience _______, it helps to make changes in behavior to cope with workplace stress.
burnout
70
However, a person who has experienced a crisis has changed, and the effects often last for years or for the rest of the person’s life. The final stage of adapting to a crisis is _________ of the long-term implications of the crisis. If a person has successfully coped with a crisis and its consequences, he or she becomes more
acknowledgment
| mature and healthy
71
_________ and _______ stressors place people who are vulnerable at higher risk for prolonged stress.
Situational
| social
72
Maintain ________ communication with patients regarding their coping. Patients under _______, or trauma, often experience feelings of powerlessness, vulnerability, and loss of control. The nurse addresses these feelings by actively involving patients and families in the processes of problem identification (assessment), prioritizing, goal setting, and evaluation. Involving patients in these processes gives them an opportunity to direct their _______ in a positive way and moves them toward taking greater responsibility for health maintenance and promotion.
ongoing
severe stress
energy
73
A ______ creates a turning point in a person’s life because it changes the direction of his or her life in some way. The precipitating event usually occurs approximately 1 to 2 weeks before the individual seeks help, but sometimes it has occurred within the past 24 hours.
crisis
74
Generally a person resolves the crisis in some way within approximately 6 weeks. ________ aims to return the person to a pre-crisis level of functioning and promote growth.
Crisis intervention
75
An important step in preventing _____ is identifying the limits and scope of responsibilities at work. Recognizing the areas over which you have control and can change and those for which you do not have responsibility is a vital insight.
burnout
76
Making a clear separation between work and home life is also crucial. Strengthening friendships outside of the workplace, arranging for temporary social isolation for personal “recharging” of emotional energy, and spending off-duty hours in interesting activities all help reduce ______.
burnout
77
Stressors such as rapid changes in health care technology, diversity in the workforce, organizational restructuring, and changing work systems place stress on employees. _______ occurs as a result of chronic stress.
Burnout
78
The ability to resolve conflict with others through ________ is important for reducing stress. Teaching in a group setting increases the benefits of the experience.
assertiveness training
79
In addition, this also reduces the risk of cardiovascular disease and improves cardiopulmonary functioning.
Regular Exercise
80
The ______ of your nursing practice cannot meet all of the patient’s needs. Patients experiencing stress from medical conditions or psychiatric disorders present needs that make it ________ for you to consult with advanced practice mental health nurses, psychiatrists, psychologists, or psychiatric social workers.
scope
| necessary
81
If ________ or ________ is not an issue, examine other potential threats to the safety of vulnerable people who are under the care of the patient. Provide for their temporary care or supervision if necessary.
suicide or homicide
82
Determine the degree of work, school, home, and family disruption in the person’s life. When you have completed immediate ______ and ensured ________, begin the problem-solving process.
assessment
| safety
83
Use of a _______ requires critical thinking skills to organize patient data and assists in planning for patient-centered care.
concept map
84
At the interventions of prevention you direct nursing activities to identifying individuals and populations who are possibly at risk for stress.
What level is this nursing intervention?
Primary level of nursing interventions
85
Nursing interventions at this level include actions directed at symptoms such as protecting the patient from self-harm.
What level is this nursing intervention?
Nursing interventions at the secondary level
86
_________ is patterning behavior after that of another person and assuming that person’s qualities, characteristics, and actions.
What ego defense mechanism is this?
Identification ego defense mechanism
87
To determine defining characteristics for a ________ nursing diagnosis observe for nonverbal signs of anxiety, fear, anger, irritability, and tension in a patient who is experiencing ineffective coping. Other defining characteristics include the presence of life stress, an inability to meet role expectations and basic needs, alteration in societal participation, self-destructive behavior, change in usual communication patterns, high rate of accidents, excessive food intake, drinking, smoking, and sleep disturbances.
Maladaptive coping
88
Before the interview begins or at the end of the interview, depending on the anxiety level of the patient, obtain _______ to assess for physiological signs of stress such as elevated blood pressure, heart rate, or respiratory rate. Make certain to incorporate _____ components of interpreting the patient’s nonverbal communication behaviors.
basic vital signs
| cultural
89
Gather information about the health status of the patient from his or her _______ and begin the process of developing a trusting relationship with him or her. Use the _________ to determine the patient’s view of the stress, coping resources, any possible maladaptive coping, and adherence to prescribed medical recommendations such as medication or diet.
perspective
| interview
90
If the patient is using ______ as a coping mechanism, be alert to whether he or she is overlooking necessary information. As in all interactions with the patient, respect the confidentiality and sensitivity of the information shared.
denial
91
An example of stress in a _______ is a natural disaster such as a major flood or the sudden, unexpected death of a beloved teacher or teenager.
Community
92
To develop appropriate and safe nursing care when caring for families or communities, ensure that you understand the meaning that the stress has for that _____.
group
93
* Do you have high blood pressure?
* Have you noticed an increase or decrease in weight?
* Are you taking your prescribed medications?
* Have you increased any medications?
What stage is this in the nursing process?
Assessment of Adherence to Healthy Practices
94
* Do you live alone or with others?
* Who helps you?
* Have you started drinking or smoking?
* Has your caffeine intake increased?
What stage is this in the nursing process?
Assessment to see if Maladaptive Coping is being Used
95
________ are tension-producing stimuli operating within or on any system.
Stressors
96
There is another factor related to stress perception and that is the the _______, or perception, of a stressor.
appraisal
96
When stress _______ existing coping mechanisms, patients lose emotional balance, and a ______ results. If symptoms of stress persist beyond the duration of the stressor, a person has experienced a ______.
overwhelms
crisis
trauma
96
Neurophysiological responses to stress function through _______. The process senses an abnormal state such as lowered body temperature and makes an adaptive response such as initiating shivering to generate body heat.
negative feedback
96
What three structures control the response of the body to a stressor?
medulla oblongata
the reticular formation
pituitary gland
97
________ refers to the consequences of the stressor and the person’s appraisal of it.
Stress
98
How people ______ to stress depends on how they view and evaluate the impact of the stressor, its effect on their situation and support at the time of the stress, and their usual coping mechanisms.
react
100
Sympathetic or parasympathetic nervous system impulses traveling from the medulla oblongata to the heart control regulation of the ________. The heart rate increases in response to impulses from _______ fibers and decreases with impulses from _______ fibers.
heartbeat
sympathetic
parasympathetic
102
Certain cells within the reticular formation cause a sleeping person to regain ________ or increase the level when a need arises.
consciousness
104
What produces hormones necessary for adaptation to stress such as adrenocorticotropic hormone, which in turn produces cortisol?
Pituitary gland
105
In addition, the pituitary gland regulates the secretion of ______, ______, and ________ hormones.
Thyroid
Gonadal
Parathyroid
106
_______ is controlled by a feedback mechanism continuously monitors hormone levels in the blood and regulates hormone secretion. When hormone levels drop, the gland receives a message to ________ hormone secretion. When they rise, it ________ hormone production.
Pituitary glad
increase
decreases
107
According to Neuman’s theory, the goal of ______ prevention is to promote patient wellness by stress prevention and reduction of risk factors.
Primary
108
The ________ is triggered either directly by a physical event or indirectly by a psychological event. It involves several body systems, especially the autonomic nervous and endocrine systems, and responds immediately to stress.
GAS
109
The ______ occurs when the body is no longer able to resist the effects of the stressor and has depleted the energy necessary to maintain adaptation. The physiological response has intensified; but with a compromised _______ level, the person’s adaptation to the stressor _________.
exhaustion stage
Energy
diminishes
110
During the _____ rising hormone levels result in increased blood volume, blood glucose levels, epinephrine and norepinephrine amounts, heart rate, blood flow to muscles, oxygen intake, and mental alertness. In addition, the pupils of the eyes dilate to produce a greater visual field. If the stressor poses an extreme threat to life or remains for a long time, the person progresses to the next stage. What is the next stage?
Alarm reaction
| Resistance
111
Whether or not the person _______ the stressor influences its effect. It is often more difficult to _____ with an unex- pected stressor.
anticipated
| cope
112
Personal characteristics that influence the ______ to a stressor include the level of personal control, presence of a social support system, and feelings of competence.
response
113
Appraisal of an event or circumstance is an ongoing _________ process. If primary appraisal results in the person identifying the event or circumstance as a harm, loss, threat, or challenge, the person experiences ______.
Perceptual
| Stress
114
According to ______, feedback cues lead to reappraisals of the original perception. Therefore coping behaviors constantly change as individuals _______ new information.
crisis theory
| Perceive
115
Crisis Intervention is a brief psychotherapy with ______ steps. It is more directive than psychotherapy or counseling. Any member of the health care team who has been trained in its techniques can use it. The basic approach is problem solving, and it focuses only on the problem presented by the crisis.
prescribed
116
However, if the GAS stress response is chronically activated, a state of _________ occurs. This chronic arousal with the presence of powerful hor- mones causes excessive wear and tear on the person and is called __________. An increased allostatic load leads to ________ illness .
Allostasis
Allostatic load
Chronic
117
_______ is the person’s effort to manage psychological stress. Effectiveness of strategies depends on the individual’s needs. A person’s _____ and _____ background influence these needs.
Coping
Age
Cultural
118
No single _____ strategy works for everyone or for every stressor. The same _______ may cope differently from one time to another.
coping
| person
119
In stressful situations most people use a combination of problem- and emotion-focused coping strategies. In other words, when under stress a person obtains information, takes action to ______ the situation, and _______ emotions tied to the stress.
change
| regulates
120
In some cases people avoid thinking about the situation or change the way they think about it without changing the actual _______ itself.
situation
121
The type of stress, people’s goals, their beliefs about themselves and the world, and personal resources determine how people _____ with stress. _____ include intelligence, money, social skills, supportive family and friends, physical attractiveness, health and energy, and ways of thinking such as _______.
cope
Resources
optimism
122
_______ mechanisms regulate emotional distress and thus give a person protection from anxiety and stress.
Ego-defense
123
_______help a person cope with stress indirectly and offer psychological protection from a stressful event. Everyone uses them unconsciously to protect against feelings of ________ and ________.
Ego-defense mechanisms
Worthlessness
Anxiety
124
Occasionally a defense mechanism becomes ______ and no longer helps the person adapt to a stressor.
distorted
125
Frequently _______ stressors activate ego-defense mechanisms. These usually do not result in psychiatric disorders.
short-term
126
A new _______ stage such as marriage, birth of a child, or retirement requires new coping styles. Developmental crises occur as a person moves through the stages of life.
Developmental
127
A persistent _______ can cause long- term physiological problems such as chronic hypertension, depres- sion, sleep deprivation, chronic fatigue syndrome, and autoimmune disorders.
allopathic load
128
Some examples of traumatic events that lead to _____ include motor vehicle crashes, natural disasters, violent personal assault, and military combat.
PTSD
129
One person looks at a stimulus and sees it as a ________, leading to mastery and growth. Another sees the same stimulus as a ________, leading to stagnation and loss.
Challenge
| Threat
129
_______ is avoiding emotional conflicts by refusing to consciously acknowl- edge anything that causes intolerable emotional pain. (Example: A person refuses to discuss or acknowledge a personal loss.)
What ego defense mechanism is this?
Denial ego defense mechanism
130
The individual with family responsibilities and a full-time job outside the home can experience ________. It occurs in stable conditions and from stressful roles. Living with a long-term ______ produces chronic stress. Conversely, time-limited events that threaten a person for a relatively brief period provoke _______.
chronic stress
illness
acute stress
131
Name the three types of crises?
1. Maturational or developmental crisis
2. Situational crisis
3. Disasters of Adventitious crisis
132
Recurrent daily hassles such as commuting to work, maintaining a house, dealing with difficult people, and managing money further com- plicate ______ or ______ stress.
chronic or acute
134
_____ associated with PTSD is sometimes manifested by nightmares and emotional detachment.
Anxiety
135
All systems experience multiple stressors, each of which potentially disturbs the person’s, family’s, or community’s _______. Every person develops a set of responses to stress that constitute the “______ line of defense” .
balance
| Baseline or normal
136
The perception of the event, situational supports, and coping mechanisms all influence return of ______ or _______. A person either _______ or _______ as a result of a crisis, depending on how he or she manages the crisis.
equilibrium or homeostasis
| advances or regresses
137
Examples of _____ include intrapersonal stressors such as an illness or injury, interpersonal stressors such as an argument or misunderstanding between two people, or extrapersonal stressors such as financial concerns.
Stress
138
_________ emphasizes the importance of accuracy in assessment and interventions that promote optimal wellness using primary, secondary, and tertiary prevention strategies.
The Neuman Systems Model
139
During the _______ the body stabilizes and responds in a manner opposite to that of the first stage. Hormone levels, heart rate, blood pressure, and cardiac output return to normal; and the body repairs any damage that has occurred.
resistance stage
140
As ______ search for their identity with peer groups and separate from their families, they experience stress. In addition, they face stressful questions about using mind-altering substances, sex, jobs, school, and career choices.
adolescents
141
According to Neuman’s theory, _______prevention occurs after symptoms appear. The nurse determines the meaning of the illness and stress to the patient and the patient’s needs and resources for meeting them.
Secondary
142
Allow time for him or her to express ________ for coping with stress. For example, in the case of a woman who has just been told that a breast mass was identified on a routine mammogram, it is important to know what the patient wants and needs most from the nurse. Although some women in this situation identify their need for information about biopsy or mastectomy as their personal priority, others need guidance and support in discussing how to share the news with family members.
Priorities
143
Gaining an understanding of patient expectations does not mean excluding certain types of care that are important simply because a patient _____ identify them as needs.
does not
144
______ is an essential attitude through which you respect the patient’s perception of the stressor. Make the effort to have the patient ______ his or her unique viewpoint and situation.
Integrity
| explain
145
In some cases, when there is nothing that will change or improve the situation, allowing the patient to use _______ as a coping mechanism is helpful.
denial
146
Adjusting to ________ leads to situational stress.
chronic illness
147
________ become vulnerable when they lose parents and caregivers through divorce, imprisonment, or death or when parents have mental illness or substance abuse disorders.
Children
148
Common diseases such as obesity, hypertension, diabetes, depression, asthma, and coronary artery disease provoke ______.
Stress
149
People use the term ______ in many ways. It is an experience to which a person is exposed through a stimulus or stressor.
Stress
150
Living under conditions of continuing violence, disintegrated neighborhoods, or homelessness affects people of any age, especially _______ people. A person’s _______ also influences stress and coping.
young
| culture
151
_______ associated with treatment and illness triggers stress in patients of all ages.
Uncertainty
152
Stress for ______ centers around major changes in life circumstances. These include the many milestones of beginning a family and a career, losing parents, seeing children leave home, and accepting physical aging.
adults
153
MAKE A SLIDE ABOUT ADVENTITIOUS AND SITUATIONAL CRISES
Forgot them
154
Paying for treatment and limited access to providers also create _____.
stress
155
Although being a family caregiver for someone with a chronic illness such as ________ is associated with stress, the actions of competent health care providers often ______ the stress for caregivers.
Alzheimer’s disease
| minimize
157
When the body encounters a physical demand such as an injury, the _________ initiates the GAS.
Pituitary gland
158
According to Neuman’s theory, _______ prevention begins when the patient’s system becomes more stable and recovers. At this level of prevention the nurse supports rehabilitation pro- cesses involved in healing and moving the patient back to wellness and the primary level of disease prevention.
tertiary
159
Some people with ______ experience flashbacks, or recurrent and intrusive recollections of the event. Responses may also include self-destructive behaviors such as suicide attempts and substance abuse.
PTSD
161
__________ is unconsciously repressing an anxiety-producing emotional conflict and transforming it into nonorganic symptoms (e.g., difficulty sleeping, loss of appetite).
What ego defense mechanism is this?
Conversion Ego defense mechanism
162
```
• Anxiety
• Caregiver role strain
• Ineffective coping
• Fear
• Risk for post-trauma syndrome
• Insomnia
• Situational low self-esteem
• Stress overload
These are examples of nursing diagnoses R/T _________.
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Stress
163
• Attached to leg with adhesive and secured with elastic bandage, attached to pulley and weight. Boot is available
• Assess alignment, skin breakdown,
• Maintain pulley system, weights hang free
_____ – for hip, femur, knee, back.
Buck’s traction
