Stress, Coping, Loss, & Grieving

Identify stressors and stress responses holistically.

Stressors can be physiological or psychological.

- Physiological stressors are physical in nature and often related to illness or injury, triggering immediate survival responses.

- Psychological stressors involve emotional or perceived threats, such as fear or anxiety, and depend on how the individual interprets the situation.

Stress responses are holistic, affecting the body, mind, emotions, and behavior. When stress is perceived, the body activates neuroendocrine and autonomic responses to restore balance

Recognize typical physiological and psychological responses to stress.

Physiological responses include activation of the fight-or-flight response through the sympathetic nervous system, resulting in:

- Increased heart rate and blood pressure

- Increased cardiac output and blood glucose

- Bronchodilation and pupil dilation

- Release of cortisol, which increases alertness, focus, and decreases pain perception

Psychological responses may include:

- Anxiety and fear

- Emotional distress

- Use of ego defense mechanisms such as denial, repression, projection, or rationalization to protect self-esteem and reduce anxiety

Predict responses to stress based on various stress models.

General Adaptation Syndrome (GAS):

Alarm stage: Immediate activation of body systems

- Resistance stage: Body attempts to adapt and cope

- Exhaustion stage: Prolonged stress depletes resources and increases risk for illness

This response occurs with both positive (eustress) and negative (distress) stressors and aims to restore homeostasis.

Transactional Theory of Stress and Coping:

- Stress is a dynamic interaction between the person and the environment

- Individuals perform primary appraisal (Is this a threat?) and secondary appraisal (Do I have the resources to cope?)

- The way a stressor is appraised determines the individual’s response and coping effectiveness

Identify stress management strategies to promote a healthy lifestyle for the nurse and for the client

Effective stress management focuses on healthy coping strategies that support physical, emotional, and psychological well-being. These include:

- Eating nutritious foods

- Exercising regularly

- Building personal resilience

- Implementing consistent self-care activities

Nurses should apply these strategies both personally and when teaching clients, recognizing that coping is influenced by psychological, sociological, and cultural factors. Promoting healthy coping helps prevent acute stress from progressing into episodic or chronic stress.