h and i exam 1

What specific hormones are released by the body during a Sympathetic Nervous System (SNS) "fight-or-flight" response?

Cortisol, Aldosterone, Epinephrine, Norepinephrine, and Dopamine.

What immediate changes happen to a patient's heart rate, blood pressure, and cardiac output when the Sympathetic Nervous System is activated?

Heart rate increases, blood pressure increases, and cardiac output increases.

What specific structural changes happen to a patient's eyes, airways, and blood glucose during an SNS fight-or-flight response?

Pupils dilate, bronchioles (airways) dilate, and blood glucose increases.

During an acute sympathetic stress response, where is blood perfusion shunted away from, and where is it directed toward?

shunted away from the gastrointestinal (GI) tract and directed toward the skeletal muscles to prepare for physical action.

What is the primary nickname/state of the Parasympathetic Nervous System (PNS), and what is its ultimate goal?

rest & digest and its goal is to return the body's dynamic systems back to a stable state of equilibrium

What specific physical actions does the Parasympathetic Nervous System (PNS) take on the heart, pupils, and airways?

The heartbeat slows down, pupils constrict, and airways constrict.

How does the Parasympathetic Nervous System (PNS) affect stomach/GI activity and glucose release?

It stimulates digestion/GI tract movement and inhibits glucose release.

What is Phase 1 of Selye's General Adaptation Syndrome, and what happens physiologically?

Alarm Reaction, where sudden exposure to a stressor triggers an immediate, automatic fight-or-flight hormonal cascade.

What is Phase 2 of Selye's General Adaptation Syndrome, and how does the body respond?

Resistance / Adaptation, where the body attempts to adapt to the stressor and restore internal balance.

hormone levels remain altered and the body stays on high alert.

What is Phase 3 of Selye's General Adaptation Syndrome, and what is the outcome?

Exhaustion, where if stress continues without recovery, finite adaptive energy reserves run completely dry and physical defenses fail.

What is the general medical definition of an Adverse Childhood Experience (ACE), and when must it occur?

toxic exposures including abuse, neglect, or severe household dysfunction that must occur during childhood before the individual reaches age 18.

The instructor explicitly said to "understand examples" of ACEs. What are classic examples from your slides?

Incarceration of a parent/household member, parental divorce or separation, physical/emotional/sexual abuse, and neglect (such as not having food).

How does unbuffered, toxic childhood stress from ACEs physically affect a child's neurodevelopment?

It physically damages and alters developing brain architecture and permanently changes and sensitizes the baseline biological stress response system.

What long-term chronic adult health risks are directly linked to high ACE scores?

Severe stress-related mental illnesses, cognitive/learning impairments, substance use disorders/severe addictions, and chronic physical conditions like heart disease or autoimmune failure.

What internal personality characteristics serve as protective factors to buffer an individual against stress?

High natural resilience, optimism (seeing the world as manageable), and cultivating a "Growth Mindset" to evaluate a stressor as neutral rather than a threat.

What external and environmental systems serve as protective factors against stress and anxiety?

Strong social support networks (family/friends), cultural factors/shared identity, spiritual/religious practices of well-being, safe living environments, and affordable basic services.

What is an Adaptive Coping Strategy, and what are some healthy examples?

Healthy, reality-based thoughts and behaviors used to manage stress and return to balance, such as active coping, planning, seeking emotional/instrumental support, humor, positive reframing, writing down feelings, or exercise.

What is a Maladaptive Coping Strategy, and what are some unhealthy examples?

Unhealthy escape mechanisms that rely on ignoring, negating, or distorting reality to temporarily reduce pain, such as substance use, denial, venting, self-blame, behavioral disengagement, or self-distraction.

What is the nurse's primary operational goal when managing a client's coping strategies?

encourage and reinforce the client's adaptive coping strategies while screening for and discouraging maladaptive patterns like binge eating or substance use.

The instructor specifically called out Denial in the lecture. Define this mechanism and state why people utilize it.

maladaptive ego defense mechanism involving the absolute refusal to acknowledge a painful or stressful reality.

It operates outside conscious awareness to temporarily protect self-esteem and block out immediate anxiety or pain.

While denial protects a person's ego in the short term, what is its long-term clinical danger?

It relies on misrepresenting and distorting reality, leaves the stressor unresolved, and is linked to increased mental illness symptoms, negative health outcomes, and personality disorders later.

How long must trauma-related symptoms persist before an individual can clinically qualify for a diagnosis of PTSD?

Symptoms must persist for greater than one month and actively interfere with daily functioning.

What are the specific requirements and examples for the Re-experiencing and Avoidance symptom clusters in PTSD?

Re-experiencing (Need >=1): Flashbacks, intense nightmares, or intrusive distressing memories. Avoidance (Need >=1): Intentionally avoiding trauma-related thoughts, feelings, places, or conversations.

What are the specific requirements and examples for the Arousal/Reactivity and Cognition/Mood clusters in PTSD?

Arousal & Reactivity (Need >=2): Hypervigilance, an exaggerated startle reflex, irritability, or severe insomnia. Cognition & Mood (Need >=2): Persistent distorted guilt/self-blame, emotional numbing, or a negative belief about the world.

What specific factors in a patient's historical profile increase their baseline risk for developing PTSD after a trauma?

Female gender, pre-existing history of mental illness or substance abuse, severe childhood exposure to trauma/abuse/neglect, and a family history of psychiatric illness.

What environmental and situational factors after a trauma occur that heavily worsen a patient's risk of developing PTSD?

A critical lack of emotional or practical social support, combined with facing additional compound life stressors immediately after the trauma (e.g., financial strain, job loss).

When performing a nursing assessment on a suspected PTSD patient, what objective data should you gather?

Objective Vitals: Check for autonomic hyperarousal (hypertension, tachycardia, tachypnea).

Validated Screening Tools: Use self-report measures like the PTSD Checklist for DSM-5 (PCL-5) or the Injured Trauma Survivor Screen (ITSS).

What specific objective, focused physical assessment findings point to a severe anxiety or panic state?

Sudden acute hypertension, tachypnea (rapid breathing), tachycardia (racing heart rate), diaphoresis (excessive sweating), and gastrointestinal distress.

What specific findings on a Mental Status Exam (MSE) help a nurse identify severe anxiety or panic?

Psychomotor agitation (uncontrollable pacing/shaking), rapid/pressured speech, confusion, impaired short-term memory, and cognitive markers like depersonalization or derealization.

The instructor asked: "How do you know it's anxiety and not something else?" What organic medical conditions must you rule out with diagnostic testing?

Cardiopulmonary (arrhythmias, PE, angina, acute asthma), Endocrine (hyperthyroidism, hypoglycemia), and substance intoxication, drug abuse, or acute drug withdrawal.

What are the nursing interventions for Primary Prevention of anxiety and panic disorders?

Fostering healthy/supportive parent-child relationships early, providing preventative educational programs for substance abuse, and teaching healthy lifestyle changes (exercise, avoiding caffeine/stimulants, improving sleep).

What constitutes Secondary Prevention for anxiety and panic disorders, and what is its goal?

Implementing routine, early clinical screening using validated assessment questionnaires (e.g., GAD-7 scale or the Severity Measure for Panic Disorder) to identify symptoms early and limit progression.

What are your priority nursing interventions under Tertiary Prevention when managing a patient in an acute panic attack?

Maintain Safety, Reduce Stimulation, Communication, and Breathing (model and guide slow, deep diaphragmatic breathing).