CH 5 Homeostasis, Adaptation and Stress

These flashcards cover key concepts related to homeostasis, adaptation, and stress response mechanisms as outlined in the lecture notes.

A nurse is assessing a client who has a relatively stable state of physiologic equilibrium. This state is known as:

A. Metabolism
B. Homeostasis
C. Allostasis
D. Adaptation

Answer: B. Homeostasis

Rationale: Homeostasis is defined as a relatively stable state of physiologic equilibrium. It is the body's internal balance despite external changes.

Which of the following are the four primary categories of stressors that can disrupt a client's homeostasis? (Select all that apply)

1. Physiologic

2. Psychological

3. Social

4. Environmental

5. Spiritual

Answer: 1, 2, 3, and 5.

Rationale: The categories of stressors affecting homeostasis include physiologic (biological), psychological (mental), social (relationships/environment), and spiritual (beliefs/purpose).

True or False: According to the concept of holism, the mind and body are separate entities that do not influence each other in regards to health.

Answer: False.

Rationale: Holism implies that both the mind and body directly influence one another and contribute to a human's overall wellbeing and health.

Fill in the Blank: _ act as chemical messengers that mediate homeostatic adaptive responses between the nervous system and the rest of the body.

Answer: Neurotransmitters.

Rationale: Neurotransmitters are the chemical substances used to communicate signals during adaptive responses to maintain equilibrium.

A nurse identifies that a client is experiencing a 'rest and digest' response. Which branch of the autonomic nervous system is active?

• Sympathetic
• Parasympathetic

Answer: Parasympathetic.

Rationale: The parasympathetic nervous system is responsible for restoring equilibrium and inhibiting the stimulation caused by the sympathetic system.

How is 'stress' defined in physiological and behavioral terms?

Answer: Physiologic and behavioral responses to disequilibrium.

Rationale: Stress occurs when the body or mind perceives a threat to its state of balance (homeostasis).

A client is in the 'Alarm' stage of the General Adaptation Syndrome (GAS). Which physiological change should the nurse expect to observe?

A. Decreased heart rate
B. Release of norepinephrine
C. Exhaustion of resources
D. Lowered blood pressure

Answer: B. Release of norepinephrine.

Rationale: The alarm stage is the immediate 'fight-or-flight' response characterized by the release of catecholamines like norepinephrine and hormones like cortisol.

During the 'Resistance' stage of the General Adaptation Syndrome (GAS), what is the body's primary goal?

Answer: To return to a state of equilibrium.

Rationale: In the resistance stage, the body attempts to compensate for the stressor and restore physiological balance after the initial alarm.

What occurs during the 'Exhaustion' stage of the General Adaptation Syndrome (GAS)?

Answer: Depletion of physical and mental resources.

Rationale: This stage occurs when adaptive mechanisms are no longer able to protect the individual, leading to potential illness or death.

A client presents with a rapid heart rate, irritability, and difficulty sleeping. These are clinical manifestations of:

Answer: Stress.

Rationale: Increased Heart Rate (\uparrow HR), insomnia, and irritability are common signs and symptoms of a body responding to stressors.

Which factor most significantly influences a client's physiological response to a stressor?

A. Age
B. Intensity and duration of the stressor
C. Occupation
D. Diet

Answer: B. Intensity and duration of the stressor.

Rationale: The impact of stress depends heavily on how intense the stressor is and how long the client is exposed to it.

What is the primary function of the Sympathetic Nervous System during a stress response?

Answer: To prepare the body for the fight-or-flight response.

Rationale: It accelerates physiological functions (pulse, respiration, alertness) to deal with a perceived threat.

Which autonomic system is responsible for slowing down the heart rate after the threat has passed?

Answer: Parasympathetic nervous system.

Rationale: The parasympathetic system inhibits the stimulation from the sympathetic system to bring the body back to a resting state.

A nurse is caring for a client with a history of chronic stress. The client is frequently ill. Which stage of GAS is the client likely in?

Answer: Exhaustion stage.

Rationale: Chronic stress leads to resource depletion and a weakened immune system, which is characteristic of the exhaustion stage.

True or False: Coping mechanisms are conscious tactics used by individuals to solve problems efficiently.

Answer: False.

Rationale: Coping mechanisms are often defined as unconscious tactics used to defend the psyche and maintain mental equilibrium.

A nurse organizes a support group for caregivers of clients with Alzheimer's disease. This is an example of which level of prevention?

Answer: Primary or Secondary (depending on the goal; usually Secondary if targeting a specific at-risk group to reduce stress effects).

Rationale: Prevention levels focus on preventing the disorder (Primary), early detection (Secondary), or rehabilitation (Tertiary).

A nurse screens a client for early signs of stress-induced hypertension. This nursing action is documented as:

Answer: Secondary prevention.

Rationale: Secondary prevention focuses on screening and early detection of diseases to prevent progression.

A client undergoes physical therapy to regain function after a stress-induced stroke. This is an example of:

Answer: Tertiary prevention.

Rationale: Tertiary prevention involves rehabilitation and minimizing the long-term effects of a permanent or chronic condition.

Which nursing activity is essential when caring for a client suffering from stress?

Answer: Identifying the stressors and supporting coping strategies.

Rationale: Nurses must assess the cause of stress (stressors) and implement management techniques to help the client adapt.

What happens to the pupils during a Sympathetic Nervous System response?

A. Constriction
B. Dilation
C. No change
D. Nystagmus

Answer: B. Dilation.

Rationale: Mydriasis (pupillary dilation) occurs to allow more light in, improving visual acuity during a threat.

Which of the following is considered a physiologic stressor?

A. Financial debt
B. Bacterial infection
C. Low self-esteem
D. Marital conflict

Answer: B. Bacterial infection.

Rationale: Physiologic stressors are biological in nature, such as injury, illness, or infection.

Fill in the Blank: The _ response is the initial, immediate physiological reaction to stress.

Answer: Alarm.

Rationale: The alarm stage is the 'call to arms' for the body's defense systems.

A nurse is teaching a client about stress management. Which statement by the client indicates an understanding of the Sympathetic response?

"My digestion will speed up during stress."
"My heart rate will increase if I feel threatened."

Answer: "My heart rate will increase if I feel threatened."

Rationale: Sympathetic activation increases heart rate and inhibits digestion.

Which system restores the body to a state of 'equilibrium' after a stressful event?

Answer: Parasympathetic nervous system.

Rationale: Its role is to counteract the sympathetic system and promote homeostasis.

True or False: Social support is a factor that can positively affect a client's response to stress.

Answer: True.

Rationale: Strong social support networks can buffer the effects of stress and provide better coping resources.

In GAS, which hormone released from the adrenal cortex helps mobilize energy but suppresses the immune system over time?

Answer: Cortisol.

Rationale: Cortisol is a glucocorticoid released during the alarm and resistance stages to manage stress.

A client experiencing chronic stress reports frequent tension headaches. How should the nurse categorize this symptom?

Answer: A physiologic sign of stress.

Rationale: Physical ailments like headaches, muscle tension, and GI upset are common manifestations of stress.

What is the role of neurotransmitters in the 'Holistic' view of health?

Answer: They act as the link between the mind and body.

Rationale: Neurotransmitters facilitate the communication that allows mental states (psychological stressors) to cause physical responses.

Which nursing level of prevention involves immunizations and stress-reduction education for healthy populations?

A. Primary
B. Secondary
C. Tertiary
D. Quaternary

Answer: A. Primary.

Rationale: Primary prevention focuses on health promotion and preventing the onset of disease.

True or False: Physical health has no impact on how an individual responds to psychological stress.

Answer: False.

Rationale: Factors such as physical health status directly influence the body's ability to cope with any form of stress.

A client is unable to focus on instructions provided by the nurse due to severe anxiety. This is an example of:

Answer: Impaired attention due to stress.

Rationale: High stress levels can cause cognitive narrowing and difficulty processing information.

Which of these is an example of a spiritual stressor?

A. High blood pressure
B. Loss of faith or purpose in life
C. Crowded living conditions
D. Exam anxiety

Answer: B. Loss of faith or purpose in life.

Rationale: Spiritual stressors involve a person's beliefs, values, and sense of meaning.

Fill in the Blank: A _ is a relatively stable state of physiologic equilibrium.

Answer: Homeostasis.

Rationale: This is the core term for the balance the body strives to maintain.

During the Resistance stage, the body's vital signs usually:

Answer: Stabilize or return toward normal levels.

Rationale: Once the initial alarm passes, the body tries to adapt and maintain functions while still dealing with the stressor.

What is the effect of the Sympathetic Nervous System on the respiratory rate?

Answer: It increases the respiratory rate.

Rationale: This occurs to ensure the blood is highly oxygenated for physical activity.

True or False: Adaptive responses are only mediated by the brain.

Answer: False.

Rationale: While the brain/CNS is the center, neurotransmitters and the autonomic nervous system mediate responses throughout the whole body.

Which level of prevention is a nurse practicing when teaching a client how to use an insulin pump after a diagnosis of diabetes?

Answer: Tertiary prevention.

Rationale: This involves managing an established disease to prevent further complications.

Multiple Choice: Which of the following is a behavioral symptom of stress?

A. Rapid heart rate
B. Dilated pupils
C. Increased irritability
D. Norepinephrine release

Answer: C. Increased irritability.

Rationale: Options A, B, and D are physiologic symptoms; irritability is a behavioral/psychological symptom.

What is the definition of a 'Psychological' stressor?

Answer: A stressor pertaining to the mind and emotions.

Rationale: Examples include fear, anxiety, and grief.

Fill in the Blank: The _ stage of GAS is when the body can no longer sustain its defense against a stressor.

Answer: Exhaustion.

Rationale: At this point, the 'batteries' are drained, leading to system failure.

A nurse notice a client's airways are dilating during a stressful event. What is the physiological term for this and why does it happen?

Answer: Bronchodilation.

Rationale: The sympathetic nervous system dilates the bronchioles to increase airflow (\uparrow oxygenation) for the fight-or-flight response.

What liver process is stimulated during the Alarm stage of stress to increase blood glucose levels?

Answer: Glycogenolysis.

Rationale: The liver converts glycogen into glucose to provide immediate fuel (Energy) for cells.

Why does a client's skin become cool and pale during an acute stress response?

A. Decreased blood volume
B. Peripheral vasoconstriction
C. Parasympathetic activation
D. Excessive sweating

Answer: B. Peripheral vasoconstriction.

Rationale: Blood is shunted away from the skin and toward vital organs like the heart and skeletal muscles.

How does the Parasympathetic nervous system affect the Sinoatrial (SA) node of the heart?

Answer: It inhibits or slows down the firing of the SA node.

Rationale: This leads to a decrease in heart rate (\downarrow HR) during the recovery phase.

Which specific part of the adrenal gland releases Epinephrine and Norepinephrine during the stress response?

Answer: Adrenal Medulla.

Rationale: The medulla is responsible for the immediate catecholamine release, while the cortex releases corticosteroids.

A client in a high-stress state has 'hypertonic' skeletal muscles. What does this mean clinically?

Answer: Increased muscle tension or readiness.

Rationale: Muscles tighten to prepare for rapid physical movement (fighting or fleeing).

Describe the physiological effect of chronic cortisol release on White Blood Cells (WBCs).

Answer: It suppresses their function/count (Immunosuppression).

Rationale: Long-term cortisol exposure inhibits the immune system, making the client more susceptible to infections.

What is the effect of the Sympathetic Nervous System on Gastrointestinal (GI) motility?

Answer: It decreases or inhibits motility (peristalsis).

Rationale: The body redirects energy away from digestion to focus on survival.

Which neurotransmitter is the primary mediator for the Parasympathetic Nervous System?

Answer: Acetylcholine.

Rationale: Acetylcholine is the chemical messenger that promotes 'rest and digest' activities.

True or False: During the Resistance stage, the respiratory rate usually remains slightly elevated to supply ongoing metabolic demands.

Answer: True.

Rationale: The body is still actively compensating and requires more oxygen than a non-stressed state.

Why does a client sweat (diaphoresis) during a sympathetic 'fight-or-flight' response?

Answer: To help dissipate heat.

Rationale: Increased metabolism generates internal heat; sweating is a homeostatic mechanism to prevent overheating.

What is the effect of the Parasympathetic Nervous System on the bladder's detrusor muscle?

Answer: It causes the muscle to contract.

Rationale: Parasympathetic stimulation encourages bladder emptying (urination).

Fill in the Blank: During stress, blood vessels in the _ muscles undergo vasodilation to increase blood flow.

Answer: Skeletal.

Rationale: Dilating these vessels ensures that muscles have the nutrients and oxygen needed for physical exertion.

Where do neurotransmitters typically travel to transmit a signal between two neurons?

Answer: Across the synaptic gap (synapse).

Rationale: This is the microscopic space where chemical signaling occurs in the nervous system.

In the Exhaustion stage of GAS, why do electrolyte imbalances occur?

Answer: Because the body's homeostatic hormonal and renal mechanisms fail.

Rationale: The prolonged strain causes the systems responsible for maintaining chemical balance to break down.