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NURS 112 - TEST 4 - Unite E.2 > EF - Stress and Coping > Flashcards

EF - Stress and Coping Flashcards

1
Q

SUMMARY

A

SUMMARY

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2
Q

Stress

A

mental, emotional / physical response / adaptation to real/perceived changes/challenges OR
psychological / emotional / physical response / adaptation to real / perceived changes / challenges

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3
Q

economists - stress -social / economic

A

Poverty / unemployment

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4
Q

psychologists - stress - individual life events

A

divorce / job loss

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5
Q

nature or stress is

A

ambiguous -  perceptions of stress often based personal life experiences

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6
Q

stress involves what or\gans / tissues

A

nearly every organ system / tissue human body

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7
Q

Stress affects entire

A

family

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8
Q

All individuals experience

A

stress as a normal part of daily life
health care professionals - may experience stress in own lives / clinical practice
Recognizing signs / symptoms own stress / implementing self-care / stress management techniques

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9
Q

responding to stress is a necessary physiological process for

A

regulation/homeostasis

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10
Q

situation is determined-stressful, nervous/endocrine systems

A

respond by initiating fight-or-flight response

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11
Q

stress reaction

A

when perceived demands (stressors) > individual resources - meet demands

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12
Q

When disrupted by stress

A

body works to maintain equilibrium GAS

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13
Q

stress can be both

A

positive and negative
depending - how individual perceives stress (appraisal)

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14
Q

stress is bodys response to

A

∆s affecting normal balanced state of equilibrium

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15
Q

Selye

A

(early pioneer study of stress) - identified stressor
 Any event / experience / environmental stimulus → causes stress in individual

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16
Q

stressors are inherently

A

neutral
 individual’s perceptions of / responses - determine stressor – positive / pleasant (eustress) / negative / unhealthy (distress)

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17
Q

“eustress”

A

positive / pleasant

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18
Q

Unhealthy / chronically prolonged stress levels

A

→ physical / emotional fatigue / ill health

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19
Q

concept of stress encompasses (2)

A

 effects of stressor
 person’s appraisal / interpretation of stressor

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20
Q

everyday stressors - effectively managed through

A

homeostatic / regulation processes
 ↓ impact on individual / maintain health

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21
Q

When person experiences potential / actual stressor

A

 situation appraised
 limbic system activates anticipatory response

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22
Q

anticipatory response

A

??

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23
Q

stressor perceived as minor

A

 physiological / psychological / behavioral processes compensate for it
 homeostasis maintained

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24
Q

v stressor perceived as more serious threat

A

??CLARIFY

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25
Q

hypothalamus secretes

A

corticotropin-releasing factor (CRF)

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26
Q

corticotropin-releasing factor (CRF) activates

A

SNS to release norepinephrine / epinephrine / dopamine
AKA fight or flight

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27
Q

fight-or-flight response

A

 ↑ in heart rate / blood pressure / cardiac output
 dilation of bronchial airways / pupil dilation
 ↑ in blood glucose levels
body prepared for action

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28
Q

CRF also signals

A

anterior / posterior pituitary glands
release adrenocorticotropic hormone (ACTH) from adrenal cortex

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29
Q

ACTH stimulates

A

adrenal glands - release cortisol

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30
Q

the stress hormone

A

cortisol

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31
Q

cortisol causes what to happen in body

A

• ↑ mental alertness / focus
• ↓ pain receptors
immunosuppressive / anti-inflammatory effects

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32
Q

clarifiying some questionas

A

??

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33
Q

When individual disrupted by stress - body works to maintain equilibrium →how

A

initiating general adaptive syndrome (GAS)

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34
Q

(GAS), which consists of a three-stage response:

A

alarm, resistance/ exhaustion

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35
Q

alarm

A

 central nervous system becomes aroused
 body defense mechanisms mobilized
CLARIFY

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36
Q

resistance

A

 body resists / seeks to counter stress
 parasympathetic nervous system - attempts return body to homeostasis
 body remains on alert
 hormonal / other bodily functions return to normal
 body repairs any damage caused by threat

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37
Q

exhaustion

A

body can no longer defend against stressor
 chronic exposure - ↑ / fluctuating endocrine / neural responses
 causes ↑ wear / tear - body organs
 leads to allostatic load

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38
Q

ALLOSTATIC LOAD

A

 Wear and tear on body
 Repeated / chronic stress
 IE. Cumulative burden of chronic stress / life events

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39
Q

chronic exposure - ↑ / fluctuating endocrine / neural responses • can cause long-term physiological problems LIKE

A

• chronic hypertension / depression / autoimmune disorders

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40
Q

short spurts - CORTISOL

A

 cortisol ↑ immunity
 ↓ inflammation

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41
Q

cortisol levels heightened for prolonged period

A

 inflammation ↑
 may result ↓ immune function
 ↑ risk - infection - ↓ lymphocytes (WBC’S - fight off infection)

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42
Q

GAS may be triggered

A

physical / psychological stressors / events

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43
Q

physiological changes occur whether

A

§ perceived stressor considered positive (eustress) / negative (distress)

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44
Q

fundamental concept underlying GAS

A

Ø body will attempt → return steady state of internal / physical / chemical balance (homeostasis)

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45
Q

Chronic inflammation

A

development / exacerbation - immune-related disorders →
 cardiovascular disease / arthritis / psoriasis / inflammatory bowel disease / various cancers

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46
Q

As individuals age - immunological responses become

A

more taxed
 Biologically / energetically costly
 inflammation related - stress exposure
 ↑ likelihood - developing disease / exacerbate preexisting conditions

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47
Q

Transactional Theory of Stress / Coping (TTSC)

A

stress as a dynamic process
a transaction between a person / their environment

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48
Q

TTSC - HOW MANY STAGES

A

Primary / secondary - BOTH before responding to stress

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49
Q

PRIMARY STAGE

A

individual evaluates situation
 determine whether stressor poses a threat
 If stressor determined not - a threat - it is dismissed

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50
Q

IF STRESS DETERMINED AS THREAT THEN - SECONDARY STAGE - CONFIRM

A

 individual assesses whether can cope w/ situation
 examining balance of situational demands (risk / uncertainty / difficulty w/ available resources for addressing threat)
• including social support / expertise / past successes

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51
Q

SEQUENCE OF STEPS TTSC (4)

A

APPRAISALS
RESPONSES
CHANGE IN SITUATION
RE-APPRAISAL

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52
Q

WHY IS TTSC CONSIDERED A TRANSACTIONAL MODEL

A

 suggests appraisals impact responses
 which in turn result in changes in situation / individual
 these changes then influence ongoing reappraisals
 PROCESS OF REAPPRAISAL REPEATS PRIMARY / SECONDARY APPRAISALS
 ongoing endeavor
 continually reassesses both
• nature of stressor
• resources available for responding to stressor

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53
Q

POSIBLE OUTCOMES REAPPAISALS - TTSC

A

 individual may be able to cope effectively w/ stressor or
 person may have to ∆ / abandon coping strategy

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54
Q

How an individual appraises a stressor determines

A

how that person will respond to stressor

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55
Q

Appraisal of stressor influenced numerous personal / contextual factors

A

 Cognitive / physiological / affective / psychological / neurologic skills / abilities resources

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56
Q

2 CATEGORIES / TYPES OF STRESSORS

A

Ø acute or chronic

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57
Q

Physiological stressors - generally associated w/

A

INJURY / ILLNESS →
 EX: exposure → extreme temperatures / trauma / injury / illness / pain
 body’s reaction – immediate / necessary for survival

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58
Q

Psychological stressors - more common / generate

A

STATE - EMOTIONAL UNEASE
• Event / situation / comment / condition / interaction
• individual interprets - negative / threatening
 EX: Work / academic pressures / financial difficulties / ∆ marital status / victim - natural catastrophe

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59
Q

 Chronic physiological stress
 →

A

§ debilitating conditions

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60
Q

Stress - three types:

A

acute stress / episodic acute stress / chronic stress

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61
Q

Stress-related disorders may

A

result of prolonged / heightened levels of stress / anxiety

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62
Q

NAME?

A

most common / frequent
 brief
 either positive / negative
 causes IMMEDIATE REACTION / BIOLOGICAL response
 triggers FIGHT-OR-FLIGHT RESPONSE
 EX’s: motor vehicle accident / experiencing loss loved one / victim of crime
 Manifestations – irritability / chest tightness / headache / gastrointestinal disturbance / sweaty palms / shortness of breath
 Most episodes - NO lingering health effects

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63
Q

MOST COMMON / FREQUENT TYPE OF STRESS

A

ACUTE

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64
Q

WHICH STRESS STYPE TRIGGERS FLIGHT OR FIGHT

A

ACUTE

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65
Q

DOES ACUTE STRESS NORMALLY HAVE LINGERING HEALTH EFFECTS

A

NO

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66
Q

MAINIFESTATIONS (SIGNS / SYMPTOMS ) ACUTE STRESS

A

irritability / chest tightness / headache / gastrointestinal disturbance / sweaty palms / shortness of breath

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67
Q

POSSIBLE CAUSES ACUTE STRESS

A

: motor vehicle accident / experiencing loss loved one / victim of crime

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68
Q

 Severe / prolonged stress levels
 could →

A

mental health issues → post traumatic stress disorder (PTSD) / acute stress disorder

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69
Q

v Episodic Acute Stress

A

someone experiences frequent bouts acute stress

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70
Q

v Episodic Acute Stress often associated w/ individuals

A

responsibility > than can be handled

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71
Q

v Episodic Acute Stress clients often feel

A

disorganized / rushed

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72
Q

MAINIFESTATIONS (SIGNS / SYMPTOMS ) EPISODIC ACUTE STRESS

A

short-tempered / irritable / anxious
 may experience tension headaches / hypertension / migraines

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73
Q

v Clients w/ pattern of episodic acute stress WHAT TYPE OF OUTLOOK

A

 pessimistic outlook / negative worldview
 can negatively impact relationships / work / overall health

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74
Q

CHRONIC STRESS

A

 stress levels – HEIGHTENED / CONSTANT / PROLONGED

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75
Q

CHRONIC STRESS CLIENTS OFTEN BELIEVE

A

little / no control over situation / circumstances

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76
Q

CHRONIC STRESS PRODUCES CONTINOUS ACTIVATION OF

A

nervous system

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77
Q

MAINIFESTATIONS (SIGNS / SYMPTOMS ) CHRONIC STRESS

A

 ANXIETY / DEPRESSION / CARDIOVASCULAR DISEASE / CANCER / SUICIDE

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78
Q

CHRONIC STRESS OFTEN STEMS FROM

A

serious life problems →
 POVERTY / RACISM / ILLNESS / DISEASE
 dysfunctional family system

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79
Q

all populations across lifespan - susceptible to

A

v stress-related conditions

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80
Q

everyone reacts differently TO

A

stressful situations
 stressful for one person ≠ stressful for another

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81
Q

common major life events - trigger stress include

A

 work-related issues / financial pressures / bereavement / family problems / illness / fear of criminal victimization / excessive noise / overcrowding / fear of unknown

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82
Q

 Stress-related disorders - result OF

A

PROLONGED / ↑ LEVELS STRESS / ANXIETY

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83
Q

 Onset / severity STRESS RELATED DISORDERS affected by

A

 Type / frequency / intensity of stressor
 person’s perception of stressor
 access to support systems
 individual’s ability to effectively cope w/ stressor

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84
Q

v common stress-related disorders include

A

 ACUTE STRESS DISORDER / POSTTRAUMATIC STRESS DISORDER (PTSD) / IRRITABLE BOWEL SYNDROME

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85
Q

 Individuals diagnosed w/ ASD
 often been exposed

A

frightening / traumatic event →
 death of loved one
 threat of serious injury to themselves / others
 exposure to war
 other acts of violence

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86
Q

Individuals diagnosed w/ ASD may experience feelings

A

numbness / disconnectedness / depersonalization / other dissociative symptoms
 Other symptoms –
 disrupted sleep / irritability / difficulty concentrating / becoming easily startled

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87
Q

WHICH STRESS DISODRDER MAY CAUSE PERSON TO MENTALLY REEXPERIENCE TRAUMATIC EVENT

A

ASD
 avoid people / places
 things - remind them of traumatic event

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88
Q

TYPES OF SITUATIONS THAT COULD LEAD TO PTSD

A

accident / sexual abuse / naturally occurring disaster

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89
Q

WHICH STRESS DISORDER IS  among most common mental health disorders in United States

A

PTSD

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90
Q

PTSD ASSOCIATED WITH WHAT TYPE SYMPTOMS

A

CHRONIC COURSE / DEBILITATING SYMPTOMS

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91
Q

 most individuals WILL EXPERIENCE

A

ome type - traumatic event during lifetime
 most will NOT develop PTSD

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92
Q

MANIFIESTATIONS (SIGNS / SYMPTOMS) PTSD

A

 Recurring / intrusive memories
 flashbacks of trauma
 nightmares
 sweating
 ↑heart rate / exaggerated startle response - certain noises
 experiences - remind person of trauma
 Manifestations vary - individual to individual

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93
Q

PTSD MANIFESTATIONS MAY BE DELAYED HOW LONG

A

days / months / years

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94
Q

For some – PTSD symptoms CAN LAST

A

months / years

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95
Q

MANIFIESTATIONS (SIGNS / SYMPTOMS) IBS

A

 abdominal discomfort / cramping / bloating / diarrhea / constipation

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96
Q

IS IBS CONSIDERED A DISEASE

A

NO
 rather functional syndrome w/ no known cause
 significantly impacts individual’s quality of life

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97
Q

WHAT IS A COMMON TRIGGER FOR IBS

A

 Stress
 treatment planning should include stress-reducing techniques / activities

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98
Q

MULTIFACTORIAL DISORDER

A

condition caused by many contributing factors
 approaches to treatment - diverse
IS IBS MULTIFACTORIAL - CONFRIM

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99
Q

crisis

A

emotionally significant life event
major ∆ in an individual’s life
pushes person beyond ability - effectively cope

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100
Q

 Crises may include

A

 Unexpected / unanticipated event w/ insufficient time to prepare / respond
 highly threatening incident
 disaster
 radical ∆ in one’s life
 corresponding lack ability to respond effectively

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101
Q

EXS OF CRISIS

A

Ø traumatic injury / natural disasters / loss of financial security

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102
Q

Crisis severity ranges

A

Level 1 (least severe) to Level 4 (highest level)

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103
Q

LEVEL 1 - LOWEST /LEAST SEVERE

A

?

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104
Q

LEVEL 2

A

?

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105
Q

LEVEL 3

A

?

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106
Q

LEVEL 4 - HIGHEST

A

risk of harm - self (suicide) / others (homicide) is present
 providers must swing into action – PREVENT / ADDRESS IMMEDIATELY
CONFIRM THIS IS LEVEL 4

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107
Q

v Individuals who commit violence against others may have risk factors →

A

 history of substance misuse / addiction
 history of violence toward animals / people
 history of psychiatric illness
 Other risk factors associated w/ acts of violence directed toward oneself →
 history of depression / suicidal behavior
 family history of abuse / neglect
 ongoing relationship problems

108
Q

 During a crisis - person may

A

 threaten suicide
 display highly erratic / unusual behavior
 misuse alcohol /other substances
 refuse intervention

109
Q

Crises arise - various sources - generally categorized as STEMMING FROM

A

situational / developmental (maturational) / adventitious / socioeconomic / cultural stressors

110
Q

CRISIS -  Situational Stressors

A

Ø created by personal / family /work-related issues

111
Q

CRISIS - EX’s: personal stressors →

A

 Diagnosed / living w/ chronic illness
 financial strain
 victim - motor vehicle accident

112
Q

CRISIS - EX’s: Family stressors →

A

 death of a loved one
 ∆ in marital status
 being unable to conceive
 experiencing an unwanted pregnancy

113
Q

CRISIS - EX’s: work related issues →

A

 Downsizing
 sheltering in place
 changing work roles / responsibilities

114
Q

SIGNS A PERSON IS EXPERIENCING A MENTAL HEALTH EMERGENCY

A

 acting on suicide threat
 displaying hostile / belligerent behaviors
 throwing / breaking items
 threatening harm

115
Q

Crises - experienced by people

A

all ages / backgrounds / cultures / environments

116
Q

CRISES CAN BE OBVIOUS OR NOT

A

→ experiencing death of loved one / dealing w/ a natural disaster
→ internal fear of being exposed - infectious disease
EITHER WAY - sense of imbalance / confusion / situation where usual coping skills may be inadequate

117
Q

 Nurses / health care workers need - particularly alert - potential – work - related stress in themselves
 may lead

A

burnout / compassion fatigue / moral distress

118
Q

Moral distress - nurse

A

nurse placed in difficult situation - actions taken ≠ nurse feels ethically correct
 complicate nurse’s ability balance moral / emotional / professional duties - clients / themselves

119
Q

Moral distress - nurse can lead to feelings of

A

frustration / guilt / insomnia / fatigue / result in w/drawal / depersonalization of clients

120
Q

moral distress nurse can occur when

A

anytime during nursing care clients
 often heightened during time of crisis / disaster / tragedy

121
Q

crisis - Developmental Stressors also known as

A

 Developmental (maturational) stressors

122
Q

Developmental (maturational) stressors can occur when

A

 occur as individual moves through stages of life

123
Q

Children / preadolescents often identify developmental stressors →

A

physical appearance / family / friends / school

124
Q

Adolescents experience developmental stress →

A

§ Friendships / belongingness / identity formation / leaving family home

125
Q

Ø Adults developmental stressors →

A

§ Marriage / beginning a family / launching career / accepting physical aging

126
Q

 Seniors / older adults developmental stressors →

A

§ health problems / ∆’s in mobility / cognition

127
Q

CRISIS - Adventitious Stressors AKA

A

v DISASTER EVENTS
 disaster events - generally rare / unexpected
 can result from
 natural disasters →
• floods / earthquakes / war
 interpersonal disasters →
• physical / sexual assault
 Acts of terrorism - also considered adventitious events
 since previous methods coping may not be sufficient - dealing w/ magnitude of stress

128
Q

CRISIS -Socioeconomic Stressors

A

poverty / lower SES / homelessness

129
Q

low socioeconomic status (SES) / POVERTY CONTRIBUTE TO

A

 contribute to nearly every measure of mental health
 including measures of self-reported distress
 diagnoses of clinical disorders

130
Q

potential consequences socioeconomic stressors- not necessarily

A

fixed / universal
 EX: Bridger / Daly concluded cognitive ability may buffer long-term association between childhood socioeconomic disadvantage / poor mental health in adulthood CONFIRM

131
Q

CRISIS -CULTURAL STRESSORS

A

 live w/in society do not culturally fit
 when they receive care - ignores cultural beliefs

132
Q

Leininger’s Transcultural Nursing Theory AKA - _________
INVOLVES KNOWING WHAT

A

Culture Care Theory
knowing / understanding / appreciating different cultures/ beliefs / values that influence nursing care

133
Q

Culture Care Theory advocates

A

meaningful / effective nursing care in accordance w/
 individual’s cultural values / beliefs /patterns of behaviors

134
Q

 Cultural factors → RELATED TO CRISIS CULTURAL STRESSORS

A

 Beliefs / values that influence how individual perceives / responds to stress
• since all individuals appraise stressors w/in context of their own culture

135
Q

stressor that is perceived as highly stressful in one culture - MAY BE

A

minor stressor w/ in another culture
 Coping strategies - vary from culture to culture

136
Q

v During a crisis - nurse establishes / maintains therapeutic nurse – client relationship

A

 using effective communication skills
 providing safe / calming environment

137
Q

IS Crisis intervention process oriented

A

NO
 action / situation focused goal
 to help client identify precipitating events leading up to crisis
 utilize skills, resources,/available support systems to effectively deal w/ crises;/formulate a plan of care for current/future critical events CONFIRM

138
Q

goal of crisis intervention

A

help client identify events leading up to crisis
utilize skills / resources / available support systems
effectively deal w/ crisis /
formulate plan of care for current / future critical events

139
Q

Seven-Stage Model of Crisis Intervention

A
  1.  biopsychosocial crisis assessment
     suicidal / homicidal risk / Drug / alcohol abuse / need medical attention
     ineffective coping strategies / Assess resilience / protective factors / support systems
  2.  Establish rapport / therapeutic environment by conveying respect / acceptance
     Display neutrality / nonjudgmental attitude
  3.  Assess dimensions problem / crisis / Identify client issues / challenges / what precipitated crisis → insight into presenting problem
  4.  Encourage client to explore / express feelings / emotions / active listening / reflection / paraphrasing / respond w/ encouraging statements
  5.  Explore past positive coping strategies / alternatives / View client – resourceful / resilient - as possessing an array of potential resources / alternatives
  6.  Implement action plan / Identify supportive individuals / contact referral sources
  7.  Establish follow-up plan after initial intervention - determine client’s status - ensure crisis has been resolved
140
Q

Cramer defined - ego defense mechanism

A

 mental operation - occurs outside conscious awareness
 functions to protect individual’s self-esteem
 keep person from experiencing excessive anxiety
 extreme cases - protect integration of self

141
Q

v Holland - defense mechanisms

A

 psychological strategies - help individuals separate from / distance between themselves / unpleasant events / feelings / thoughts

142
Q

Defense mechanisms

A

psychological strategies / mental operations
outside conscious awareness
protect individual’s self-esteem
keep person from ex
periencing excessive anxiety
extreme cases - protect integration of self
normal / natural part - psychological development
useful in protecting human psyche from anxiety / fear

143
Q

Defense mechanisms usually occur outise

A

conscious awareness

144
Q

Defense mechanisms normal / nautural part of

A

psychological development

145
Q

Defense mechanisms usefule in protecting human psyche from

A

anxiety / fear

146
Q

defense mechanisms can be misused / distorted →

A

 cognitive distortions / thinking errors
 Thinking errors - faulty patterns thinking
 unhealthy ways - coping that become self-defeating
 often occur unconsciously

147
Q

role of nurse FOR CLIENTS EXPERIENCING STRESS

A

conducting comprehensive assessment - client’s condition

148
Q

evidence-based assessment tools to evaluate physiological, psychological / emotional / behavioral signs / symptoms of stress

A

Psychological General Well-Being Index (PGWBI)
Beck Depression Inventory (BDI)
Ways of Coping Questionnaire (WCQ) confirm

149
Q

Ø Psychological General Well-Being Index (PGWBI)

A

 measures client’s level of subjective psychological well-being
 self-representations of affective / emotional states
• reflects client’s sense of subjective well-being
• distress full scale provides subscales to assess
• anxiety / depression / positive well-being / self-control / general health / vitality

150
Q

Before conducting – assessment - nurse must first

A

 establish rapport / build trusting nurse / client relationship - provide safe / confidential environment - conducive to sharing personal / sensitive information

151
Q

therapeutic communication techniques - build

A

TRUSTING RELATIONSHIPS

152
Q

therapeutic communication technique INCLUDE

A

 active listening / asking open-ended questions / seeking clarification / offering observations

153
Q

Nurses - all areas nursing practices need to recognize

A

physiological / psychological signs / symptoms of stress in clients
implement / evaluate effective interventions
provide ongoing client education

154
Q

v Signs / symptoms – stress associated health alterations MANIFEST HOW

A

variety of ways / w/ varying levels severity

155
Q

nursing process provides a five-step, systematic approach to

A

assess client’s condition
implement a client-centered
individualized / holistic plan of care

156
Q

v five sequential steps NURSING PROCESS

A

Ø assessment / diagnosis / planning / implementation / evaluation

157
Q

v Assessment

A

 nursing process begins w/ detailed assessment - client’s condition
 Objective / subjective information - obtained through
• Interviews / observation / examination
• Ideally will take place – private / quiet / uninterrupted setting
• free from distractions

158
Q

Ø During initial assessment – NURSE CONDUCTS

A

mental status exam
 gathers relevant client information →
• presenting symptoms
• personal / family health history
• substance use / abuse history
• previous hospitalizations
• mental health treatment
• coping strategies
• health beliefs / practices

159
Q

Ø EX’s: objective client information →

A

 vital signs / appearance / behavior / physical exam findings
• •

160
Q

Vital signs often vary - depending -

A

level of anxiety client experiencing

161
Q

client w/ mild anxiety may exhibit –
•

A

minimal / no physiological manifestations – anxiety

162
Q

client w/ moderate anxiety - may appear

A

animated / have slightly ↑ vital signs
•

163
Q

Clients w/ severe anxiety - likely exhibit

A

↑ vital signs / diaphoresis / heart palpitations / muscle tension

164
Q

Ø EX’s: subjective client information →

A

 somatic complaints / current relationship / work situations / client’s perceptions - current stressors / problems
• nurse may consult family members / other individuals knowledgeable about client (w/ client’s permission)
• health records / assessments conducted - other members mental health care team
• fully understand client’s unique situation

165
Q

Analysis

A

 After conducting comprehensive assessment - nurse analyzes client-related information→
 develop statement of client’s problem / health alteration

166
Q

Ø To analyze actual / potential client concerns / health alterations

A

 nurses use clinical judgment skills
 Analysis may include - actual description of problem (eg, loss of appetite)
 as well as assessment of client’s potential risk - developing additional health conditions

167
Q

Nurses use information obtained from analysis TO DETERMINE

A

client plan of care

168
Q

 Planning
 Based on

A

assessment information
 nurse collaborates w/ client / family / members health care team
 to establish measurable short / long-term goals (outcomes)
• which are used to formulate plan of care
• plan of care should take into account –
• client’s level of knowledge / available support systems / access to care / personal beliefs / health habits / cultural / spiritual preferences

169
Q

Ø Plan of care - →

A

 identified client problems
 require priority / immediate attention
 treatment goals
 nursing actions needed to achieve desired goals
 ways to evaluate goal achievement

170
Q

§ EX’s: goals requiring immediate attention →

A

• client staying w/ a friend/family member to ↓ suicide potential
• client identifying at least 2 individuals who can be called if client begins to have suicidal feelings
• client identifying at least one goal for future

171
Q

§ EX’s: long-term goals →

A

• client implementing effective coping strategies - deal w/ stress / anxiety
• client identifying personal strengths
• client using available resources / support systems

172
Q

 EX’s: nursing actions →

A

• developing trusting relationship w/ client
• through use of therapeutic communication
• providing calm presence
• acknowledging client’s feelings
• helping client determine which situations / events tend to contribute – stress / anxiety
• discussing coping mechanisms used in past
• which mechanisms - most helpful
• teaching client about / encouraging use - new coping skills
• → physical activity / progressive relaxation / deep breathing /positive self-affirmations
• referring client - community resources - help alleviate situational stressors

173
Q

v Implementation

A

 implementing nursing actions / interventions outlined in plan of care
 accurately documenting client’s progress / response to treatment
• ensure continuity of client care

174
Q

Client outcomes / goals - achieved by

A

accomplishing nursing interventions detailed in plan of care
 designed to prevent / promote / maintain / restore mental / physical health

175
Q

Ø During implementation phase - nurses may implement / coordinate / delegate

A

aspects of plan of care

176
Q

v Evaluation

A

 Evaluation – ongoing / iterative / thorough assessment - client’s health status / plan of care
 step - critical - determine if plan of care - been effective ↑ client’s condition / health status

177
Q

client’s status / effectiveness of plan of care - continuously

A

evaluated
 plan of care modified as needed

178
Q

Ø When evaluating plan of care - nurse reviews all steps - nursing process

A

Assesses / reassesses plan - determine whether desired outcomes achieved

179
Q

Coping

A

strategies an individual adopts to deal w/ a stressor

180
Q

coping strategies are highly influenced by

A

psychological / sociological /cultural factors

181
Q

Stressors / coping mechanisms - vary across lifespan

A

 depend on individual’s appraisal of stressor
 amount / type of social support available to manage stressor
 importance placed upon stressor
 severity of stressor
 ability to cope effectively / in a healthy manner

182
Q

positive outcome - not necessarily associated w/

A

v adequately managed stress

183
Q

individuals might adopt either

A

problem-focused/emotion-focused coping styles

184
Q

problem-focused approach - involves

A

Ø dealing w/ situation itself by trying to ∆ it into something more palatable

185
Q

v emotion-focused approach - requires

A

 altering association w/ situation to ↓ stress it may be causing
 can include - avoiding situation / reframing its meaning
 this approach does not ∆ nature of situation itself
 does ∆ how situation affects individual

186
Q

Coping strategies are classified as

A

adaptive / maladaptive

187
Q

adaptive

A

help individual manage stress in short / long terms
→ changing an unhealthy habit

188
Q

maladaptive

A

reduce stress short term
often exacerbate problem longer term
 EX: → misusing drugs to cope

189
Q

Health promotion is

A

art / science of helping individuals ∆ their lifestyle to achieve optimal health

190
Q

Health promotion enables people to

A

↑ control over personal health by addressing / preventing root causes of ill health /not just focusing on treatment / cure

191
Q

how does health promotion help people gain control over their personal health

A

by addressing / preventing root causes of ill health / not just focusing on treatment / cure

192
Q

 According - World Health Organization - health promotion
 focuses on

A

interventions that support healthy lifestyle

193
Q

 By practicing health promotion

A

 people can be proactive / take control of personal health
 rather than having to respond to illness / disease

194
Q

 Health promotion activities → interventions

A

 Mitigate / reduce stresss - producing situations
 ↑ resistance to stress

195
Q

Strategies / techniques to help individuals cope effectively w/ stressors include

A

maintaining a healthy diet / nutrition /
learning time management /
building personal resilience /
rest / relaxation / (PROGRESSIVE RELAXATION)
practicing complementary / alternative therapies /
journaling

196
Q

Healthy Diet/Nutrition

A

 healthy diet can help offset impact of stress
 strengthening immune system
 lowering blood pressure
 supporting overall good health

197
Q

 According to WebMD - consumption - complex carbohydrates
 stimulates production of

A

serotonin
 chemical that ↑s sense of well-being
 ↓s stress
 stabilizes blood sugar levels

198
Q

v Good choices - complex carbohydrates

A

 whole grains / oatmeal / lentils / beans

199
Q

 Oranges - good source vitamin C
 can help

A

↓ stress hormone levels
 strengthening immune system

200
Q

omega-3 fatty acids - found in

A

fish / seafood / nuts / seeds / plant oils
 may provide protection against disorders →
 heart disease / depression / premenstrual syndrome

201
Q

Drinking black tea - may help individuals recover - FROM

A

stressful events more quickly

202
Q

Seeds / nuts /avocados - sources of

A

v healthy fats

203
Q

v healthy fats

A

 help ↓ cholesterol levels
 reduce inflammation
 protect against effects of stress

204
Q

mechanical effects munching raw vegetables (ie. celery / carrot sticks)

A

• helps reduce tension
• releasing clenched jaw

205
Q

 drink plenty of water
 drink two glasses of water WHEN

A

UPON WAKING

206
Q

Exercise

A

 One of best stress-reducing strategies – exercise / ↑ physical activity
 Cardio (cardiovascular) exercise
 boosts oxygen circulation
 spurs body - produce feel - good chemicals
• endorphins
 Exercise programs →
 Pilates / yoga / tai chi - effective ↓ stress

207
Q

Ø According to Mayo Clinic - virtually any form exercise

A

can act as stress reliever

208
Q

 Exercise ↑s
 Regular movement / physical activity

A

↑s overall health / sense of well-being / reducing stress
 Regular movement / physical activity
 Can ↑energy
 ↑ mood / self-confidence
 create sense of relaxation

209
Q

Ø Exercise - also ↑ sleep

A

often disrupted by stress / depression / anxiety

210
Q

 Time Management
 Managing time well / staying organized - can be

A

stress ↓ strategy
identifying tasks / activities - require immediate attention vs tasks can wait
 Starting each day w/ a to-do list / prioritizing list of tasks - high - low
 can help ↓ stress levels
 lower-priority tasks may be rescheduled / delegated - someone else / or eliminated
 Managing multitasking
 controlling urge - immediately respond every text / email - helps ↓ stress

211
Q

Building Personal Resilience

A

 Resilience - ability bounce back - life’s various challenges
 adapt well in face of adversity / trauma / stress
 can be fostered by practicing mindfulness activities

212
Q

Mindfulness -

A

state of paying attention / being fully present / alert to your surroundings / environment
 means focusing attention - purposeful way - present moment
 becoming aware of what is happening in here-and-now
 being cognizant of internal / external worlds w/out judgment

213
Q

MINDFULNESS STEPS OR PROCESS

A

 Stand outdoors
 Breathe deeply / notice elements / environment (Is sun shining, etc)
 30 to 60 seconds to perform
 can be done any time / formidable way - turning brain - mindful / contemplative mode
 Throughout day - pause for moment / slow breaths (in through nose / exhale through mouth)
 Focus breathing / sensations lungs filling / rib cage falling
 Clear your mind/relax as you continue breathing
 Handwashing – impressive / uncomplicated mindfulness activity - can be done anywhere
 As you wash hands - be mindful of all sensations (temp / friction hands moving along your wrists / suds washing away / enjoy sensation

214
Q

Rest/Relaxation

A

 Establishing - regular routine - getting adequate rest / sleep
 essential - ensuring overall good health / ↓ stress

215
Q

Adequate sleep - necessary –

A

 body to repair / restore itself
 release melatonin
• essential hormone - regulating sleep / wake cycles

216
Q

Ø Sleep quality can be enhanced – by

A

 going to bed / rising same time each day
 avoiding nicotine / caffeine / alcohol before bedtime
 unplugging from media devices
 keeping a comfortable / cool / dark sleeping space

217
Q

Guided imagery -

A

helpful technique - ↓ stress –

218
Q

Ø using combination relaxation / visualization / imagination

A

 assume relaxed / comfortable position
 focus on pleasurable image / experience / event
 while practicing progressive relaxation

219
Q

Progressive relaxation →

A

tensing / releasing each muscle group – body
 begin by tensing / relaxing - facial muscles → neck → arms → torso → abdomen → legs
 down to toes

220
Q

Ø positive affirmation →

A

“Stress is leaving my body; my work as a nurse is very important; I am making a positive difference in lives of my patients; what I do matters”

221
Q

v Complementary/Alternative Therapies

A

Ø aromatherapy / herbal medicine / acupuncture / massage / biofeedback / meditation
• offer clients new avenues - may ↑ overall health

222
Q

v Journaling

A

 personal journal – thoughts / feelings / emotions
 provide meaningful / productive outlet for stress

223
Q

Ø Expressing gratitude - another way ↓ anxiety

A

 When stressed / anxious / overwhelmed - individual can reflect upon
• Person / experience / event / thing
• which they are grateful
• record their reflections in journal

224
Q

may be one of most effective strategies – achieving / maintaining contented life

A

Conveying gratitude -

225
Q

v acute stress

A

Ø The most common type of stress It is usually brief,/triggers fight-or-flight response

226
Q

v acute stress disorder (ASD)

A

Ø An intense/dysfunctional reaction to a traumatic event / SYMPTOMS lasts less than a month

227
Q

v adventitious stressors

A

Ø Stress that results from events of disaster; they are generally rare, unexpected,/can result from natural disasters

228
Q

v chronic stress

A

Ø Occurs when stress is heightened, constant,/prolonged Continuous activation of nervous system can cause/exacerbate health problems

229
Q

v coping strategies

A

Ø The strategies that an individual adopts to deal w/ a stressor, which is highly influenced by psychological, sociological,/cultural factors Adaptive coping strategies include maintaining a healthy diet/nutrition, exercise, time management techniques, building personal resilience, rest/relaxation, mindfulness activities, complementary/alternative therapies,/journaling

230
Q

v crisis

A

Ø threatening situation triggered by a precipitating event whereby an individual experiences a strong behavioral, emotional,/psychiatric response Crises arise from various sources
 pushes person beyond ability - effectively cope

231
Q

v cultural stressors

A

Ø Stress that individuals may experience by living w/in a society in which they do not culturally fit and/or receiving care that ignores their cultural beliefs

232
Q

v developmental (maturational) stressors

A

Ø Stress that occurs as an individual moves through stages of life

233
Q

v ego defense mechanism

A

Ø Defense mechanisms are psychological strategies that help individuals separate from/put distance between themselves/unpleasant events, feelings,/thoughts Common ego defense mechanisms include denial, rationalization, projection, repression, regression,/compartmentalization

234
Q

v episodic acute stress

A

Ø Characterized by frequent bouts of acute stress, usually associated w/ taking on too much responsibility

235
Q

v fight-or-flight response

A

Ø When a stressful situation is perceived, hypothalamus secretes corticotropin releasing factor (CRF), which activates sympathetic nervous system/signals anterior pituitary gland to secrete adrenocorticotropic hormone (ACTH) release of ACTH by pituitary stimulates adrenal cortex to release hormone cortisol

236
Q

v general adaptive syndrome (GAS)

A

Ø The body’s attempt to maintain equilibrium/homeostasis Consists of three stages: alarm, resistance,/exhaustion

237
Q

v health promotion

A

Ø The process of enabling clients to↑control over/↑ment of all aspects of their general health

238
Q

v irritable bowel syndrome (IBS)

A

Ø A COMMON gastrointestinal condition characterized by abdominal pain/changes to bowel elimination patterns that can include diarrhea and/or constipation

239
Q

v posttraumatic stress disorder (PTSD)

A

Ø A prolonged/heightened stress reaction to a traumatic event /SYMPTOMS that lasts more than a month

240
Q

v Seven-Stage Model of Crisis Intervention

A

Ø An action plan for nurses to help a client identify precipitating events leading up to a crisis, utilize skills, resources,/available support systems to effectively deal w/ crises/to formulate a plan of care for current/future critical events

241
Q

v situational stressors

A

Ø Stress that stems from personal, family,/work-related issues

242
Q

v socioeconomic stressors

A

Ø Stress that occurs from factors → poverty, socioeconomic status (SES),/homelessness

243
Q

v stress

A

Ø The mental, emotional,/physical response/adaptation to real/perceived changes/challenges Stress response: Initiated by nervous/endocrine systems when a stressor is perceived as a serious threat

244
Q

v stress-related disorders

A

Ø Stress-related disorders include acute stress disorder (ASD), posttraumatic stress disorder (PTSD),/irritable bowel syndrome (IBS)

245
Q

v Transactional Theory of Stress/Coping (TTSC)

A

Ø Describes stress as a dynamic process/a transaction between a person/their environment How an individual appraises a stressor determines how they will respod to stressor

246
Q

1 A nurse is assessing a client who is working at home due to COVID-19 restrictions client reports abdominal cramping/bloating w/ diarrhea/states, “I am completely stressed out from working at home” nurse should identify that client is experiencing manifestations of which of following stress-related conditions?

A

Irritable bowel syndrome

247
Q

2 A nurse is planning care for a client who is recently divorced w/ two young children client Reports difficulty sleeping, feeling hopeless,/being estranged from family nurse should plan to monitor client for which of following potential manifestations of chronic stress

A

Suicide

248
Q

3 A nurse is interviewing a client who recently experienced an act of workplace violence when an Armed person held workers at gunpoint before police intervened client now reports being anxious/fears gunman might return nurse should identify that client is experiencing which of following types of crisis?

A

Adventitious

249
Q

4 A nurse in a health clinic is interviewing a client who is upset/reports that their stress “is too much to handle” client is unemployed, a single guardian to young children,/has periodic asthma attacks Which of following stress-related conditions is client experiencing?

A

Allostatic load

250
Q

5 A nurse in a community clinic is interviewing a client who is distressed/reports being unable to sleep following a neighborhood fire several days ago client has hypertension, tachycardia,/is diaphoretic nurse should identify that client is experiencing which of following types of stress?

A

Acute stress

251
Q

6 A nurse is caring for a client who reports experiencing stress over an upcoming surgical procedure Which of following statements describes characteristics of stress?

A

body responds to physical, emotional,/environmental changes affecting one’s state of equilibrium

252
Q

7 A nurse is caring for a client who is in crisis following breakup of a long-term relationship client tells nurse, “I might as well just die My life is over” Which of following actions should nurse take first?

A

Conduct a suicidal risk evaluation

253
Q

8 A nurse is assessing a client who was sexually assaulted 6 months ago/has been diagnosed w/ post-traumatic stress disorder (PTSD) Which of following manifestations should nurse expect? (Select all that apply)

A

Intrusive memories of event
Flashbacks of event
Exaggerated startle response when reminded of event

254
Q

9 A nurse is providing discharge teaching about health promotion to a client who has a new diagnosis of type 2 diabetes mellitus Which of following instructions should nurse include? (Select all that apply)

A

Practice mindful breathing
Start each day w/ a to-do list
Develop habits to mitigate stress

255
Q

10 A nurse is caring for a college student admitted for acute alcohol intoxication client reports feeling overwhelmed/expresses an inability to cope w/ stressors at school Which of following statements should nurse make?

A

“Let’s talk about coping methods that have worked for you in past”

256
Q

11 A nurse is caring for a client who has delivered a healthy newborn client tells nurse that while they are somewhat stressed about being a new parent, they are thrilled by birth of their child nurse should identify that client is experiencing which of following types of stress?

A

Eustress

257
Q

12 A nurse is caring for a client who has delivered a healthy newborn client is tense, refuses to hold baby,/tells nurse, “I have no idea how to handle having a baby I wish this pregnancy had never happened” Which of following statements should nurse make?

A

“Becoming a parent is a new experience for you Let’s talk about your concerns”

258
Q

13 A nurse is caring for a client who has pancreatic cancer that is unresponsive to treatment client is experiencing significant weight loss/fatigue, but when nurse asks how they are feeling, they respond w/, “Great! I’m going to beat this cancer” Which of following defense mechanisms is client using?

A

Denial

259
Q

14 A nurse is caring for a client who has migraine headaches/reports that they are “getting worse” Which of following questions should nurse ask client to determine if headaches are a stress-related disorder? (Select all that apply)

A

“What is intensity of your migraine headaches?”
“How often do migraine headaches occur?”
“What type of support is available to you when you have a migraine headache?”
“What coping strategies do you use when you experience a migraine headache?”

260
Q

15 A nurse is caring for a client whose partner was recently hospitalized w/ COVID-19 client is experiencing manifestations related to alarm stage of general adaptation syndrome (GAS) For which of following manifestations should nurse monitor? (Select all that apply)

A

Hypertension
Dilated pupils
↑d state of arousal

261
Q

16 A nurse is interviewing a client who is in distress/tells nurse, “My ex-partner is suing for full custody of my children I am so worried/don’t know what to do” Which of following questions should nurse ask to evaluate client’s coping skills?

A

“What strategies have you used in past to deal w/ stress?”

262
Q

17 A nurse is caring for a client who has been charged w/ partner violence against their spouse client is angry, pacing,/yells out, “I wouldn’t lose my temper if my spouse would just leave me alone It’s their fault” nurse should identify client is displaying which of following defense mechanisms?

A

Projection

263
Q

18 A nurse is talking about implementing self-care strategies to cope w/ stress of caregiving w/ partner of a client who has dementia Which of following strategies reported by partner should nurse identify as an EX: of effective coping?

A

Practicing deep breathing while sitting outside

264
Q

19 A nurse is conducting an educational session for clients who report experiencing stress-related disorders A client asks nurse which part of body activates stress response Which of following responses should nurse provide?

A

Hypothalamus

265
Q

20 A nurse is caring for an older adult client who reports being stressed about their health status due to problems w/ short-term memory, slower reaction times when driving,/urinary frequency nurse should recognize that client is experiencing which of following types of stressors?

A

Developmental stressors

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

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