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Stress & Coping (Critical Thinking (Scientific Knowledge Base (General…

- - - - monitors the physiological status of the body through connections with sensory and motor tracts
    - - produces hormones necessary for adaptation to stress such as adrenocorticotropic hormone, which in turn produces cortisol
      - Feedback Mechanism
        
        Maintains homeostasis of hormone levels in the blood
    - - The heart rate increases in response to impulses from sympathetic fibers and decreases with impulses from parasympathetic fibers.
    - - Resistance Stage
        
        body stabilizes and responds in an attempt to compensate for the changes induced by the alarm stage
      - Exhaustion Stage
        
        continuous stress causes progressive breakdown of compensatory mechanisms.
        
        Allostatic Load
        
        Wear and tear caused by chronic stress
      - Alarm Stage
        
        Flight or Flight
      - Immune Response
        
        Impaired immune system
      - Reaction to Psychological Stress
        
        primary appraisal
        
        Evaluating an event for its personal meaning related to stress
        
        secondary appraisal.
        
        Evaluating one's possible coping strategies when confronted with a stressor.
        
        Coping
        
        cognitive and behavioral efforts to manage a stressor
        
        Coping Mechanisms
        
        Ego-Defense Mechanisms
        
        Displacement
        
        redirecting of thoughts feelings and impulses directed at one person or object, but taken out upon another person or object
        
        Identification
        
        Adopting behaviors of a person percieved as a threat or norms of a new anvironment to fit in
        
        Denial
        
        Blocking external events from awareness
        
        Dissociation
        
        Subjective sense of numbing & reduced awareness of surroundings
        
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        Conversion
        
        occurs where cognitive tensions manifest themselves in physical symptoms
        
        Regression
        
        Process of moving back to a previous developmental stage
        
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        Compensation
        
        Compensation is a process of psychologically counterbalancing perceived weaknesses by emphasizing strength in other arenas.
    - - PTSD
        
        Begins when a person experiences, witnesses, or is confronted with a traumatic event and responds with intense fear or helplessness
        
        Complications
        
        Flashbacks
        
        recurrent and intrusive recollections of a traumatic event
      - Secondary Traumatic Stress
        
        trauma a person experiences from witnessing other people’s suffering.
        
        component of compassion fatigue and is common in health care workers and first responders.
        
        Complications
        
        Nightmares
        
        Anxiety
        
        Insomnia
        
        Difficulty relating to others
        
        Anti social/Isolation
      - Crisis
        
        Types of Crises
        
        Situational Crises
        
        Disasters or Adventitious Crises
        
        Maturational or Developmental Crises
  - - - Neumans Model
        
        views a patient, family, or community as constantly changing in response to the environment and stressors.
      - Penders Health Promotion Model
        
        focuses on promoting health and managing stress
        
        Lifestyle changes
    - - Maturational Factors
        
        Children identify stressors related to physical appearance, families, friends, and school
        
        Preadolescents experience stress related to self-esteem issues, changing family structure as a result of divorce or death of a parent, or hospitalizations.
        
        As adolescents search for 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.
        
        Stress for adults centers around major changes in life circumstances including starting a family and a career, losing parents, seeing children leave home, and accepting physical aging
        
        old age stressors include the loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition
      - Sociocultural Factors
        
        Income
        
        Altered family structures
        
        Environment
        
        Violence
        
        Culture
        
        Cultural differences creates stress
      - Situational Factors
        
        Chronic illnesses
        
        personal, job, or family changes
        
        Burnout
        
        chronic condition in which perceived demands (e.g., workload, difficult patients, insufficient equipment) outweigh perceived resources
- - - - Perception of Stressor
        • What do you believe is stressing you right now?
        • What impact does this stressor have on your lifestyle?
        • How does this stressor impact you now? How will it impact you in the future?
      - Available Coping Resources
        • Which strategies have you used in the past to deal with stress?
        • Are you able to confide in friends or family?
        • What is relaxing for you?
      - Maladaptive Coping Used
        • Have you started drinking or smoking?
        • Do you use any over-the-counter or herbal medications?
        • Do you use any street drugs?
      - Patient Safety
        • Do you have any thoughts of harming yourself or others?
        • Are you having difficulty with sleeping? Falling asleep? Staying awake?
        • Is there any change in eating patterns?
        • Have you had any accidents at home, in the car, at school, or on the job?
      - Adherence to Healthy Practices
        • How long since you saw a health care provider?
        • What is your exercise pattern?
        • Which type of meals do you eat? Are your meals regular?
        • Are you taking your prescribed medications as ordered?