Stress/Coping and Sensory Alterations

Any actual or perceived threat to the body’s homeostasis is called ____. This canses ____ in the body/mind and can be physiologic/psychologic.

It can be ____ like a loss of loved one or it can be ____ like feeling unprepared for an exam.

Anything that triggers a stress respone is called ____. These can differ in scope, ____, and duration. It can be:

1. ____ like cold, heat, and injury

2. ______ like environmental pollutants, meds, smoking, diet

3. ____ like feeling anxious, irritable

We must respond when having stress adn can lead to personal ___ if you overcome it or it can worsen and lead to chronic/illness if there are ineffective _____ mechanisms.

stress; tension; actual; perceived; stressor; strength; physical; chemical; emotional; growth; coping

Learned behaviors that are used to help decrease the impact of a stressor are called ____ ____. These are usually without ____ thought and can be positive or _____.

A person’s goals, beliefs, social ____, and personal resources determines how they cope w stress

coping mechanisms; concious; negative; support

____ mechanisms help to regulate emotional distress and give a personal protection from anxiety/stress.

An example would be ego-defense:

1. Refusing to acknowledge a stressful situation is called ____. 

2. Transferring emotions/thoughts to another person/object is called ____. 

3. Reverting back to an earlier development period to help cope w stress is called ___

4. Making up for a deficiency in one area by strongly emphasizing a feature considered an asset is called _____

defense; denial; displacement; regression; compensation

People rely on ____ stimuli to give meaning/order to events. The body has a kinesthetic sence that enables a person to be aware of the ____ and movement of body parts.

_____ allows a person to recognize size, shape, and texture of an object.

When these sensory functions are ___, patients lose their ability to interact meaningfully/safely in the world.

Examples include:

1. ____ or visual

2. ____ or auditory

3. ____ or tactile

4. _____ or olfactory

5. ____ or gustatory

sensory; position; stereognosis; altered; sight; hearing; touch; smell; taste

Effects of sensory deprivation include:

1. Cognitive effects like the inability ot ___ or problem solve.

2. Affective effects like anxiety, restlessness, and _____.

3. Perceptual changes like changes in visual/motor ____ and ability to ___ shape/size.

think; depression; coordination; perceive

Changes in sensory capacity is a ____ part of aging. These can severely impact their ____ skills. Vision and hearing abilities can _____.

All interventions should focus on _____, orienting the patient, and respectful/____ communication.

For vision decreases:

1. Ensure the patient is using corrective lenses/____.

2. Provide adequate _____ and clear pathways of clutter

3. Explain procedures/reasons for touching ___ and orient patients

4. Take eye meds

5. Acknowlede your presence in a room and speak in a ____ tone.

6. Keep the ___ light in reach of patient.

7. These care plans should include focus on risk for ____.

For hearing decreases:

1. Ensure they use their hearing assistive devices.

2. Speak ____ and clearly

3. Orient the person

4. Decrease ____ noise

5. Talk directly w the patient and ___ them,

6. Make sure there adequate lighting for patients to lip read. ‘

For decreases sense of ____ such as patientes with paralysis or neuropathy.

1. Protect the patient’s skin from extreme ____ (shorthand)

2. Do skin ____ for breaks

3. Use assistive devices to ambulate.

normal; communication; decrease; safety; therapeutic; glasses; lighting; clearly; normal; call; falls; slowly; background; face; touch; temps; assessments

Physiological responses to stress include ____, nausea, and ___ tension.

Psychological stress includes ____ and fear. It can also include ____ which is the most common response and consists of a vague uneasy feeling.

The stress response causes the release of ___ , epinephrine, NE, and vasopressin. This cause the liver to convert glycogen to ____, dec digestive system activity, and ____ of bronchioles. 

headaches; muscle; insomnia; anxiety; cortisol; glucose; dilation

The ____ ____ syndrome is a model of the physiologic response to stress. It prepares the body for ____ so that an individual is more likely to survive when faced w a threat. It consists of 3 stages:

1. The first stage is the ____ stage and consists of the initial responses to a streessor. This is when the threat is ____ and the ____ (acronym) is activated. This leads to ____ in BP, HR, CO, RR, and mental aletness. 

2. The 2nd stage is called _____. This is when the body stabilizes and vital signs, hormone levels, BP, and CO return to ______. This is when the body attempts to ____ to the stressor. 

3. The 3rd stage is called _____. This is when the adaptive can no longer provide defense and there is ____ of comp mechanisms. The body cannot fight the stress and the body has depleted its _____ to maintain adaptation. 

The allostatic load describes how ____ stress cna lead to long-term physiologicalproblems. This includes depression, HTN, ____ disease, and can also impair the ____ function, cancer, and inc risk of infection and impair ____ healing. 

general adaptation; danger; alarm; perceived; SNS; increases; resistance; normal; adapt; exhaustion; breakdown; energy; chronic; heart; immune; wound

A sudden, short term threat is called ____ stress and can include a car accident. 

A long term threat is called a ___ stressor which can include long-term illnesses and jobs. 

______ (acronym) occurs when a person experiences/witnesses a trumatic event. The person responds with intense ___ and helplessness. It is very common among _____ personnel, police, and those who have been assault. Common symptoms include anxiety associated with ____ and emotional ____ and inability to sleep. _____ are also common as well as depression. 

acute; chronic; PTSD; fear; military; nightmares; detachment; flashbacks

During your assessment, first establish a ____ relationship as sensitive info will be shared.

Use ____ communication like the phrase, “Tell me more..”

Assess for S/S by looking at the patient’s ___ signs and observe the overall ___ of the patient. 

Invovle the ____ in the plan of care and set ___ goals. Sometimes it is not possible to remove the stressor but the nurse can teach effective ways to ____ and manage the distress. 

Effective coping strategies can include:

1. A regular ____ and rest

2. The use of ____ systems like friends/family

3. Mental health organizations

4. Deep ____, guided imager, and relaxation. 

trusting; therapeutic; vital; appearance; patient; realistic; cope; diet; support; breathing

Impaired, absent or declining functioning in one or more senses is called sensory ____. For these patients you want to help them to adapt to maintain ____ function such as the use of glasses/hearing aids. 

When a patient experiences decreased sensory input or input that is meaningless, the patient is experiencing sensory ____. For these patients, provide optimal sensory _____. Patients at high risk for this include:

1. Patients in ____ homes, confined to their homes, on bed rest, or in ___. 

2. Patients with impaired hearing or _____, with bandages or casts which can interfere w vision or ____ stimulation. 

3. Patients with ____ (acronym) which makes them unable to process environmental stimuli. 

When the brain experiences too much sensory stimuli, or is overwhelmed this is called sensory ___. This makes the brain unable to respond _____ or ignore the stimuli. For these patients reduce unecessary ____ and interruptions. Patients most at risk of this include:

1. Patients in busy/high acuity areas like the _____. There many lights, sounds, odors, movement, and constant presence of ____.

2. Patietns with ____ lines, IV lines, and gastric tubes.

3. Patients undergoing ___ procedures, diagnositc tests, treatments.

deficit; safe; deprivation; stimulation; nursing; isolation; vision; tactile; SCI; overload; meaningfully; noise; ICU; strangers; invasive; intrusive

Nursing interventions for sensory losses include:

1. For vision changes include ____/amber lenses or shades/blinds to minimize glare. These patients at most at risk for ____ and their safety is most at ris. 

2. For hearing, amplify sounds and use ___ frequency, and remove cerumen. 

3. For taste/smell, use flavorings that ____ taste and use smells they like. 

4. For touch, use ____ touch like back rubbing, etc. Patients with reduced sensation is at risk for imparied skin ____ and injuries. 

yellow; falls; low; enhance; therapeutic; integrity

Difficulty speaking, understanding, and write is called ____. For these patients, give enough ____ for them to respond. Use short and ___ questions and use ___ gestures to give them cues. These should be yes/no questions and be ___ and calm and do not pressure.

For unconcious patients, always assum they can ___- you as hearing is the last sense to be lost. Speak in a ____ tone and way. Always speak ___ touching the patient and explain all procedures before doint them. Keep environmental ____ as low as possible and avoid overstimulation.

For patients who are confused, use face to ___ contact. Speak calmly, simply, and ____ and allow the patient sufficient time to think before responding. Re-orient the patient to surroundings by reinforcing ____ and not delusions.

aphasia; time; simple; facial; patient; hear; normal; before; noises; face; directly; reality