Stress response

acute stress:

flight or fight response

prolonged stress:

maladaptive response that can harm physical and mental well being

stress response pattern:

life situation → perceived stress → emotional arousal → physiological arousal → consequences

acute stress findings:

• headache

• N/V/D

• decreased appetite

• increased HR,RR,BP

• decreased drive

• increased glucose

• decreased immune system

• muscle tension

prolonged stress findings:

• increased risk for stroke or MI

• weight gain or loss

• HTN

• poor diabetes control

• increased risk for infection

• gastric ulcers

• physical pain

ADJUSTMENT DISORDER

adjustment disorder is:

unhealthy emotional or behavioral response to an identifiable stressor

begins with 3 months of stressor and lasts no longer than 6 months after stressor ends

you have different types such as:

• w. depressed mood

• w. anxiety

• w. mixed anx and depressed mood

• w mixed disturbance or conduct

• w. mixed disturbance of emotions and conduct

• unspecified

treatment for adjustment disorders:

• individual therapy

• family therapy

• behavioral therapy

• self help groups

• crisis intervention

• no specific medication

stress assessment priorities are:

1. physiological needs

2. safety

3. psychological needs

SI risk is higher in patients that experience maladaptive stress

ACUTE STRESS DISORDER VS PTSD

acute stress disorder:

• begins less than 28 days after trauma

• 3 days to 4 weeks

• depersonalization/derealization

• short term psychotherapy and anti depressants

PTSD:

• symptoms go beyond a month

• lasts longer than 1 month

• avoidance, flashbacks, hyperaware

• long term psychotherapy and meds

4 main symptom groups in PTSD:

• intrusion symptoms

• avoidance of trauma related stimuli

• negative changes in cognition and mood

• alterations in arousal and reactivity

nursing care for PTSD:

• assess SI risk

• use PTSD screening tools

• identify support system

priority goals for PTSD:

• meet physiological and functional needs

• provide crisis stabilization and safety

• decrease symptoms and increase social skills

interventions for PTSD:

• establish trust

• allow discussion of trauma at clients own pace

• reassure safety

treatment for PTSD:

• CBT

• prolonged exposure therapy

• group and family therapy

Anxiety

this is the emotional response to the anticipated danger

different levels of anxiety

mild

moderate

severe

panic

mild anxiety:

alert, restless, increased motivation

learning is enhanced

moderate anxiety:

narrowed attention span, increased HR, BP,RR, sweating

learning is possible but it is decreased

severe anxiety:

fear, trembling, nauseous, hyperventilation

learning isn’t effective

panic:

terror, impending doom, hallucinations, delusions

cant learn or follow directions

PANIC DISORDER

panic disorder:

sudden, overwhelming feeling of terror or impending doom

panic disorder involves recurrent panic attacks

GENERALIZED ANXIETY DISORDER

GAD:

persistent, unrealistic, excessive worry about life’s stressors

must be 6 months or longer

significant impairment in personal, occupational, or social function

no pharmacological or pathological explanantion

what are some findings of GAD:

• muscle tension

• restlessness/constant worry

• seeking reassurance

• procrastinating with decisions