module 5 stress/coping

stress and coping

stimulus and response to the perception of a physical or emotional threat

positive stress

keeps us alert and awake

ex: test anxiety

negative stress

patient becomes fearful and has poor concentration

main coping technique

relaxation

deep breathing

anxiety physiology

everything increases/speeds up

anxiety assessment

family history

psychosocial history

mental health problems

coping strategies (what works for them)

primary prevention for anxiety

promotion for coping, health, and well-being

maintain proper nutrition

regular exercise

positive relationships/support system

coping strategies

anxiety

mental condition characterized by excessive apprehensiveness about real/perceived threats, typically leading to avoidant behaviors or increased HR and muscle tension

mild anxiety

restlessness/difficulty sleeping

fidgeting

"butterflies"

hypersensitivity to noise

moderate anxiety

pounding pulse

GI upset

muscle tension

severe anxiety

nausea, vomiting, diarrhea

vertigo

tachycardia

chest pain

panic

distorted perceptions

loss of rational thought

bolt/run, or totally immobile/mute

fight, flight, freeze

anxiety major concern

safety

anxiety and sleep

insomnia

few hours of sleep

waking up early

anxiety medications

benzodiazepines - may become dependent and drowsy, fall risk

nonbenzodiazepines - may take days to work, used for people who drink

panic disorder

aburpt recurrent episodes of severe anxiety that include intense apprehension, terror, and impending doom

*suicide risk

nursing interventions for panic disorder

stay with pt at all times

calm/reassuring tone (pt will begin to mimic)

crises

internal experience of confusion and anxiety to the degree that formerly successful coping mechanisms fail

*suicide risk

crisis physiology

coping is not working anymore and they feel overwhelmed

maturational crisis

ex: parent becomes an empty nester

situational crisis

ex: feeling guilty over something that they had no control over

adventitious crisis

ex: natural disasters

three factors of crisis

individual's perception of the event

availability of emotional support

availability of adequate coping mechanisms

positive events

crisis can occur from these events such as childbirth/celebrations

crisis goal

return client to previous state of functioning

anorexia nervosa

restriction of intake

significantly low weight

intense fear of gaining weight

disturbed body image

unaware of serious condition

bulimia nervosa

repeated episodes of binge eating

eating followed by self-induced vomiting, misuse of laxatives, diuretics, fasting, excessive exercising

health promotion for eating disorders

set realistic goals related to food

avoid discussing food with pt and family

offering liquid-protein

obsessive compulsive disorder

lifelong disorder characterized by the need to repeat uncontrollable thoughts and behaviors

OCD symptoms

checking rituals

counting rituals (washing/scrubbing)

praying/chanting

touching/tapping/rubbing

aggressive urgers

OCD goal

lessening the frequency of rituals

coming up with a scheduled routine (structure decreases anxiety)

post traumatic stress disorder

psychological stress after exposure to a traumatic event

PTSD symptoms

recurrent distressing dreams/flashbacks

exaggerated startle response

irritability, angry outburst

increasingly isolated over time (avoiding negative feelings)

PTSD screening

life event checklist

monitor eating disorders

blood glucose

if they use the restroom after meals