Stress, Coping, Hospice, and End-of-Life Nursing Flashcards part 1

What is stress?

The psychological, emotional, or physical response and adaptation to real or perceived changes and challenges.

What is a stressor?

Any event, experience, or environmental stimulus that causes stress.

What is eustress?

Positive stress that can produce well-being, inspiration, motivation, or achievement.

What is distress?

Negative or unhealthy stress that can cause physical and emotional fatigue and poor health.

What is homeostasis?

The body’s balanced internal state.

What is allostasis?

The process in which the body adjusts to meet new challenges.

Which brain areas process emotional responses to stress?

The amygdala, hippocampus, and prefrontal cortex.

What is the sympathetic-adrenal-medullary (SAM) system?

A system that quickly prepares the body to respond to stress.

Which chemicals does the SAM system release?

Norepinephrine, epinephrine, and dopamine.

What physical changes occur during fight-or-flight?

Heart rate, blood pressure, cardiac output, blood glucose, airway size, and pupil size increase.

What does the HPA axis stand for?

Hypothalamic-pituitary-adrenal axis.

What is the HPA-axis hormone pathway?.

The hypothalamus releases CRH, the pituitary releases ACTH, and the adrenal glands release cortisol.

What body functions does cortisol help regulate?

Stress response, immunity, metabolism, fertility, and autonomic function.

How does short-term cortisol affect immunity?

It enhances some immune functions.

How does long-term high cortisol affect immunity?

It suppresses immunity, promotes inflammation, increases infection risk, and slows healing

What is General Adaptation Syndrome (GAS)?

The body’s three-stage response to stress: alarm, resistance, and exhaustion.

What happens during the alarm stage of GAS?

The CNS activates fight-or-flight and increases heart rate, blood pressure, glucose, oxygen intake, alertness, and pupil size.

What happens during the resistance stage of GAS?

The body resists the stressor while the parasympathetic system reduces the acute response, but full balance is not restored.

What may occur during the resistance stage?

Poor concentration, irritability, and fatigue.

What happens during the exhaustion stage of GAS?

The body’s resources become depleted, increasing the risk of illness and disease.

What is allostatic load?

Wear and tear on the body caused by long-term stress responses.

What happens when a person experiences a real or perceived threat?

The body releases a series of biological chemicals.

What is physiological stress?

Stress generally associated with an injury or illness.

What can cause physiological stress?

Extreme temperatures, trauma, injury, illness, or pain.

Why is the body’s response to acute physiological stress important?

The response is immediate and necessary for survival.

What can chronic physiological stress cause?

Debilitating health conditions.

What is psychological stress?

Emotional unease caused by something a person interprets as negative or threatening.

What can be a psychological stressor?

An event, situation, comment, condition, or interaction viewed as threatening.

What are examples of psychological stressors?

Work or school pressure, financial problems, a change in marital status, or a natural catastrophe.

What can chronic psychological stress cause?

It can become debilitating and incapacitating.

What is acute stress?

A brief and immediate response to a perceived stressor.

Is acute stress always negative?

No. Acute stress can be positive or negative.

What response does acute stress trigger?

The fight-or-flight response.

What events can cause acute stress?

A motor vehicle accident, loss of a loved one, or being the victim of a crime.

What are physical signs of acute stress?

Chest tightness, headache, stomach problems, sweaty palms, and shortness of breath.

What is a psychological sign of acute stress?

Irritability.

Does most acute stress cause lasting health effects?

No. Most episodes do not have lingering health effects.

What can severe or prolonged stress cause?

Poor health outcomes or unhealthy psychological reactions.

What is episodic acute stress?

Frequent episodes of acute stress.

Who may experience episodic acute stress?

A person who takes on too much responsibility and often feels rushed and disorganized.

What is chronic stress?

Long-lasting stress that continuously activates the nervous system.

What health problems can chronic stress cause or worsen?

Anxiety, depression, and cardiovascular disease.

What is traumatic stress?

Stress caused by an event that exceeds a person’s ability to cope.

What events can cause traumatic stress?

Natural disasters, accidents, or violence.

What disorder can develop from traumatic stress?

Posttraumatic stress disorder (PTSD).

What is environmental stress?

Stress caused by difficult surroundings.

What are examples of environmental stressors?

Noise, pollution, crowded spaces, unstable housing, food insecurity, or neighborhood violence.

How can environmental stress affect a person?

It can harm physical and mental health and cause discomfort or uneasiness.

What are common signs of anxiety caused by stress?

Shakiness, increased heart rate, chest tightness, rapid breathing, and racing thoughts.

What are other possible signs of anxiety?

Worry, restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep problems.

How might mild anxiety affect vital signs?

It may cause few or no physical changes.

How might moderate anxiety affect a client?

The client may appear animated and have slightly elevated vital signs.

What is acute stress disorder (ASD)?

An intense and dysfunctional reaction to an overwhelming event.

What happens if ASD symptoms last longer than one month?

PTSD may be diagnosed.

What dissociative symptoms may occur with ASD?

Numbness, disconnectedness, and depersonalization.

What other symptoms can occur with ASD?

Poor sleep, irritability, poor concentration, and being easily startled.

How may clients with ASD respond to reminders of the trauma?

They may reexperience the event and avoid people, places, or things connected to it.

What is posttraumatic stress disorder (PTSD)?

Prolonged and heightened stress following a traumatic event.

What are common manifestations of PTSD?

Intrusive memories, flashbacks, nightmares, sweating, increased heart rate, and an exaggerated startle response.

When can PTSD symptoms begin?

Days, months, or years after the trauma.

What does TTSC stand for?

Transactional Theory of Stress and Coping.

How does TTSC describe stress?

As a dynamic transaction between a person and the environment.

According to TTSC, what determines a person’s response to a stressor?

How the person appraises or evaluates the stressor.

What factors can affect a person’s appraisal of stress?

Cognitive, physiological, emotional, psychological, and neurological skills and resources.

What are the two stages of appraisal in TTSC?

Primary appraisal and secondary appraisal.

What happens during primary appraisal?

The person decides whether the situation is threatening, irrelevant, or harmless.

What happens if a stressor is judged not to be a threat?

It is dismissed.

What happens during secondary appraisal?

The person evaluates whether available resources are enough to cope with the stressor.

What situational demands may be considered during secondary appraisal?

Risk, uncertainty, and difficulty.

What coping resources may be considered during secondary appraisal?

Social support, knowledge or expertise, and past successes.

What is reappraisal?

Repeating primary and secondary appraisal as the situation changes.

Why is TTSC called a transactional model?

Appraisals affect responses, responses change the person or situation, and those changes affect later appraisals.

What may happen after reappraisal?

The person may continue, change, or abandon a coping strategy.

What does Leininger’s Transcultural Nursing Theory emphasize?

Understanding and respecting the cultures, beliefs, and values that influence nursing care.

What are cultural stressors?

Stressors caused by not fitting into a society or receiving care that ignores cultural beliefs.

Why may cultures view the same stressor differently?

Culture influences how people perceive and respond to stress.

Are coping strategies the same in every culture?

No. Coping strategies vary among cultures.

Do all people react to the same stressor in the same way?

No. A situation that is stressful for one person may not be stressful for another.

What major life events can trigger stress?

Work problems, financial pressure, death, family problems, illness, crime, noise, overcrowding, and fear of the unknown.

What affects the onset and severity of stress-related disorders?

The stressor’s type, frequency, and intensity; the person’s perception; support systems; and coping ability.

What is coping?

Conscious and intentional thoughts and actions used to manage stress.

How is coping different from a defense mechanism?

Coping is deliberate, while defense mechanisms are automatic or unconscious.

What is a coping style?

A usual pattern that shapes how a person responds to stress over time.

What is reactive coping?

Coping that occurs after a stressor is encountered.

What is proactive coping?

Taking action to prevent or reduce future stress.

What factors affect coping across the lifespan?

Appraisal, social support, importance and severity of the stressor, and the ability to cope healthfully.

What is problem-focused coping?

Trying to change or solve the stressful situation itself.

What is emotion-focused coping?

Changing how the person thinks or feels about the situation to reduce stress.

Does emotion-focused coping change the stressful situation?

No. It changes how the situation affects the person.

What is adaptive coping?

A strategy that helps manage stress in both the short term and long term.

What is maladaptive coping?

A behavior that lowers stress briefly but makes the problem worse over time.

What is an example of maladaptive coping?

Misusing drugs to manage stress.

What is resilience?

The ability to recover and adapt during adversity, trauma, or stress.

What is mindfulness?

Purposefully paying attention to the present moment without judgment.

How can time management reduce stress?

It helps a person prioritize, reschedule, delegate, or remove tasks.

How does exercise help with stress?

It releases endorphins, increases energy, improves mood and sleep, and promotes relaxation.

How does adequate sleep help the body?

It allows the body to repair and restore itself and supports the sleep–wake cycle.

What is guided imagery?

Using relaxation, visualization, and imagination to focus on a pleasant image or experience.

What is progressive relaxation?

Tensing and releasing muscle groups from the head down to the toes.

How can journaling help with stress?

It provides a healthy outlet for thoughts, feelings, emotions, and gratitude.