STRESS AND ADAPTATION

DEFINITIONSStressa condition in which the body responds to changes in its normal balanced stateStressorAnything that a person perceives as challenging, threatening, or demandingAdaptationThe change that takes place as the result of a persons response to stress.

BODYS RESPONSE TO STRESSFight or Flight ResponsePsychosomatic DisordersLocal Adaptation Syndrome (LAS)Reflex Pain ResponseInflammatory Response

GENERAL ADAPTATION RESPONSEAlarm Reaction perceives stressor, defense mechanism activated (fight or flight)Shock phase body changes occurCountershock body changes reverseResistance body attempts to adaptExhaustion adaptive mechanism are exhausted

PSYCHOLOGICAL RESPONSESMild anxietyModerate anxietySevere anxietyPanic

COPING MECHANISMSBehaviorsCrying laughing, sleeping, cursingPhysical activitySmoking, drinkingWithdrawal eye contact avoidanceLimiting relationshipsTask oriented behavior - taking steps to resolve stressAttack behaviorWithdrawal behaviorCompromise behavior

DEFENSE MECHANISMSCompensation emphasize more desirable traitDenial refuse to acknowledge disturbanceDisplacement transfers emotional reaction from one object to anotherIntrojection incorporated another persons qualities or values into his own ego structureProjection attribute own thoughts or impulses to another

MORE DEFENSE MECHANISMSRationalization use of logic to justify actionReaction formation conscious actions and attitudes that are opposite of what one really wantsRegression return to an earlier way of behavingRepression involuntarily exclude anxiety producing stimulus from awarenessSublimation substitute an acceptable method of behavior for one that is not.Undoing act used to negate a previous act.

STRESS MANAGEMENT TECHNIQUESRelaxationMeditationAnticipatory GuidanceGuided ImageryBiofeedback

CRISIS INTERVENTIONIdentify the problemList alternativesChoose from among alternativesImplement the planEvaluate the outcome

STRESS IN NURSINGBurnout similar to the exhaustion phase of anxietyStudent NursesNclex examLife and schoolFinancesNew Graduates New responsibilities

WAYS TO COPE FOR NURSESBecome involved in constructive changeSupport each other; be a team playerTake time to relaxEatExercise regularlyLearn something newBe assertive; Just say NODevelop and maintain support systems

**Stressors are neither positive nor negative but can positive or negative effects on the bodyGoal maintain homeostasis physicalpsychologicalResults of adaptation: optimal functioning in all dimensionsNormal growth and developmentNormal reactions to physical and emotional stressAbility to tolerate changing situations*Parasympathetic keeps things normalSympathetic functions in times of stress. Stimulates hr, dilates blood vessels to muscles and brain, stimulates release of glycogen storesAdrenal glands releases epinephrine to support sympathetic system. Secretes glucocorticoids to raise glucose levels mineralocorticoids aldosterone helps regulate fluids/electrolytes.

Name ways body responds to stress. Loss or excess appetite, diarrhea, constipation, stomachache, sweating, nervous movement. Rashes allergiesLAS short term adaptive only involves specific organ Acid Base balanceReflex pain. Local to pain or injury, touch stoveInflammatory local to injury or infection. Bleeding histamine released to increase vascular permeability increase wbcs to sight of injury. #2 exudate released from wound. Usually serous fluid, cells response byproducts #3 damaged cells are repaired or scar tissue formed

*Bodys general response to stress. Developed by Hans SelyeGood illustration on pg 959 *Mild. Present everyday increases alertness a n perceptual fields . Impact on sleep. Stimulates problem solvingModerate narrows perceptual field focus on immediate concerns slight unease, queasy, shakySevere narrower focus on specific detail behavior geared toward getting relief increased motor activity, communication difficulty, tachycardia , hyperventilation, nausea headache,fearful expressionPanic loss of control dread and terror unable to learn distorted perception, loss of rational thought, may lead to exhaustion and death. Sweats, sensory changes poor motor coordination, agitation, trembling same as severe anxiety and morePalpitations, chest pain pressure.Behavior used to decrease stressTask oriented involves conscious thought and deliberate actions to reduce stressGreater the stress the more complex the coping behavior. Attack can be constructive or destructive. Physical or emotional withdrawal from a threat. ApathyCompromise usually constructive involves substitution of goals or negotiation to meet needs*Pg 963 table 32-2 know for test.Review each in class.

**Stress can be good or bad. Ex in book. Fear of developing lung cancer motivate to stop smoking. Prolonged stress long term affects physical well being. Developmental stress occurs in normal development. Stress of fitting in at school. Situational stress. Moving, job change, nursing school.*Similar to the nursing processCrisis is disturbance caused by precipitating event like loss, threat of loss challenge. foreclosure**Other include fear of injuring patientsDemands of nursing school