stress and coping

Question 1

what is stress?

Answer 1

• An actual or alleged hazard to the balance of homeostasis
• Physical, chemical, or emotional factor that produces tension in the body or the mind
• Appraisal: how a person interprets the impact of the stressor
  
  • personal evaluation of the meaning of the event
• a consideration of the resources to help manage the stressor
  
  • An individual considers the event as a threat and the ability to respond to the demands by the event is overwhelming= STRESS
• Outcomes of stress
  
  • Personal growth and development (like doing clinicals)
  • Illness, worsening of acute or chronic illness

Question 2

alarm

Answer 2

• CNS arousal, body defenses mobilized, fight-or-flight
• increase in epi, heart rate, blood glucose, blood volume
• blood flow goes from organs to muscles
• pupils dilate

Question 3

resistance

Answer 3

• body stabilizes and responds, attempting to compensate for changes induced by alarm stage
  
  • Energy and resources are consumed

Question 4

exhaustion

Answer 4

• progressive breakdown of compensatory mechanisms
• can no longer resist the stressor
• energy necessary to maintain adaption has been depleted

Question 5

reactions to stress

Answer 5

• People respond differently to stress
• Same threat produces different reactions in different people
  
  • Intensity and duration of threat
  • Other stressors that may be present
  • Anticipation of stressor
    
    • Unexpected more difficult cope
  • Level of support, feelings of competence (how equipped do they feel)

Question 6

coping

Answer 6

• A person’s cognitive and behavioral efforts to manage a stressor
• Effectiveness varies based on age, cultural background, personal circumstances, previous strategies
• Combination of problem and emotion-focused strategies

Question 7

stress and coping: older adults

Answer 7

• More hassles of day-to-day living
• Draw from life experiences
  
  • Some problems insignificant
• Improved resilience and coping based on past experiences
• Impaired coping affects overall health of older adults more than in younger
• Assess for suicidal thoughts
  
  • High incidence of depression
• Social support and relationships

Question 8

types of stress

Answer 8

• Post traumatic stress
• Secondary traumatic stress
• Crisis

Question 9

post traumatic stress

Answer 9

• Experiences or witness a traumatic event
• Response
  
  • Intense fear and helplessness
• Anxiety manifests by nightmares and emotional detachment
• Flashbacks possible
  
  • Recurrent and intrusive recollections
• Depression common
• police, military, sexual assault survivors, nurses, etc

Question 10

secondary traumatic stress/vicarious

Answer 10

• Trauma from witnessing others suffering
• Common in health care
  workers

Question 11

second victim syndrome

Answer 11

• Medical error causes significant harm or death to a patient
• Haunt nurses through their lives
  
  • Guilt, shame, isolation, remorse, humiliation
  • Unable to move on
  • Suicide

Question 12

types of crisis

Answer 12

• A turning point in life
• Previous coping methods no longer work
• Types of crisis
  *Maturational/ Developmental
  
  • Occur as people move through the stages of life
• Situational
  
  • External factors (job, move, severe illness or injury)
• Disasters or adventitious crises
  
  • Natural disaster, recipient of violent crime

Question 13

NURSING PROCESS AND
STRESS: ASSESSMENT

Answer 13

• Establish a trusting relationship
• Verbal and non-verbal responses
• Open-ended questions
• Determine what the patient needs most from the nurse
  
  • Someone to listen
  • Information/advice
  • Guidance and support

Question 14

nursing diagnosis – powerlessness

Answer 14

• lack of control or influence over ones situation

Question 15

nursing diagnosis – difficulty coping

Answer 15

• struggling to adjust or adapt to challenging situations

Question 16

nursing diagnosis – post-trauma response

Answer 16

• emotional or physical symptoms associated with a distressing event which overwhelms one’s ability to cope

Question 17

nursing diagnosis – caregiver stress

Answer 17

• emotional, physical, or mental strain due to caring for a person with a chronic injury, illness, or disability

Question 18

last nursing diagnosis

Answer 18

• relocation stress

Question 19

goals

Answer 19

• effective coping
• family coping
• improved mental health

Question 20

projected outcomes

Answer 20

• the client will verbalize improved coping/decreased stress
• the client will verbalize feeling more relaxed
• the family will verbalize using coping mechanisms during discussions
• make it with them
• very individualized

Question 21

interventions

Answer 21

• Encourage regular exercise and rest
• Building support systems
• Building time management skills
• Education on guided imagery and visualization methods
• Progression muscle relaxation therapies
• Assertiveness training
• Journal writing
• Mindfulness-based stress reduction training
• Work with IP team

Question 22

evaluation

Answer 22

• Patients perceptions
  
  • do they think they have improved
• Effectiveness of coping strategies
• Expectations from nursing met?
  
  • did we help you w/ your problems
• how are their stress levels
• are they able to handle their stress better

Question 23

CULTURAL VARIATIONS IN
STRESS AND COPING

Answer 23

• Culture defines what is stressful and ways of coping
• Stressors and coping styles vary with different cultures
• Reflect on your own perceptions of stress and coping in a cultural context
• Assess the influence of culture on a patient’s appraisal of stress
• Identify the presence of individualized cultural practices related to stress
  management
• Determine resources in a patient’s culture that facilitate coping