stress and adaptation

stress

response

human system response to change/disruption of balance

stressors

cause

trigger

anything threatening/challenging

physiologic stressors

something affecting the body directly

chemical

physical

infectious

nutritional imbalance

hypoxia

genetic/immune disorder

psychosocial stressors

affect mental + social well-being

trauma

fam/friend stress

major events

fear

social isolation

work-like imbalance

adaptation

body adjust to stress

change that takes place as result of response to stressor

homeostasis

balance maintained

self-regulating process help body maintain balance and equilibrium despite changes in internal/external env

adaptation and homeostasis balance depends on

perception of stressor

coping ability

support system

adaptation and homeostasis

poor coping → imbalance → sickness

physiologic homeostasis LAS

local adaptation syndrome

localized response

one specific part of body

• reflex pain response

• inflammatory response

physiologic homeostasis GAS

general adaptation syndrome

body general response to stress

stages

• alarm

• resistance

• exhaustion

reflex pain response

automatic response (withdrawn from pain)

sensory neuron → spinal cord → motor response

happens before brain processes pain

inflammatory response

wound heal

homeostasis

inflammatory

proliferation

maturation

inflammatory response homeostasis

ASAP

goal: stop bleeding

1. blood vessel constrict; stop blood loss

2. platelet form clot; aggregation

3. blood vessel dilate; increase blood flow with plasma

4. exudate form; plasma and blood

inflammatory response inflammatory

2-3 days

Purpose: clean wound

1. leukocyte clean

2. macrophages clean, promote growth of epithelial cells

3. Fibroblast fills in wound

inflammatory response proliferation

weeks

build new tissue

1. Fibroblasts produce collagen

2. new blood vessels grow

3. granulation tissue form

inflammatory response maturation

3 weeks to years

Purpose: scar formation

1. collagen remodeling

2. scar strengthen

GAS alarm reaction

fight or flight; emergency mode

min-hours

increase BP, HR, glucose, hormones, alertness

dilated pupil/bronchi

defense mechanisms activated

phases

• shock

• counter-shock

GAS resistance

body tries to adapt to stressors

VS, hormone level, energy production return to normal

body regains homeostasis or adaptive mechanisms fail

GAS exhaustion

body is worn out from too much stress

adaptive mechanism can no longer provide defense

decreased BP, increase fatigue

body:

• depleted, rest, mobilize defense to return to normal or dies

risk of illness or death

chronic stress

psychological homeostasis MASLOW physiologic needs

body ability to maintain balance during stress → adjust + survive

air, water, food, shelter, sleep, clothing, reproduction

sleep, appetite, activity changes

elimination changes

increased pulse, RR, BP

psychological homeostasis MASLOW safety and security

personal security, employment, resources, health, property

threat or nervous

ineffective coping mechanisms

inattentive

poor coping

psychological homeostasis MASLOW love and belonging

friendship, intimacy, family, sense of connection

withdrawn and isolation

blames others

aggressive behavior

overly dependents

psychological homeostasis MASLOW self-esteem

respect, self-esteem, status, recognition, strength, freedom

workaholic

attention-seeking behavior

psychological homeostasis MASLOW self-actualization

desire to become most that one can be

refuse to accept reality

center own problems

demonstrate lack of control

emotional response to stress

mind-body interaction

coping mechanisms

anxiety

• mild, helpful

• moderate, focused

• severe, motivated by relief, difficult thinking

• panic, out of control

coping mechanisms

behavior used to decrease stress/anxiety

Crying, laughing, sleeping, cursing 

Physical activity, exercise 

Taking deep breath, mindfulness exercise 

Smoking, drinking 

Lack eye contact, withdrawal 

Limiting relationship to those with similar values and interests

defense mechanisms

Compensation → Denial 

Refuse reality → Displacement 

Redirect emotion 

Dissociation 

Introjection

Projection → Blames others 

Rationalization → Excuses behavior 

Reaction formation 

Regression → Childlike behavior 

Repression → Unconscious blocking 

Sublimation → Healthy outlet  

Undoing 

long-term stress effects

affects physical and emotional status

increase risk disease/injury → decrease healing

compromise recovery and return to normal function

family stressors

• Role changes 

• Financial worries 

• Caregiver burnout 

• Feeling helplessness and guilt 

• Signs:

  • Burnout 

  • Fatigue 

  • Anxiety 

  • Poor sleep

categories of stress developmental

each life stage = new challenge, cope/experiment stress

developmental stress = stress from growing up

predictable → life stages, growth task

categories of stress situational

does not occur in predictable pattern

unexpected, unpredictable

nursing stressors

unprepared and responsibilities

unsupportive env

death/dying pt

ethical dilemmas → moral distress

conflict

health promotion

Exercise 

Sleep, rest 

Nutrition 

Support system 

Stress management techniques

Stress management techniques

Relax 

Meditation 

Anticipatory guidance prepare pt for stress 

Guided imagery 

Biofeedback