Chapter 9 vol 1
Stress and Adaptation Study Notes
Learning Outcomes
After completing this chapter, you should be able to:
Define stress.
Explain the difference between adaptive and maladaptive coping strategies.
Explain the relationship between stressors, responses, and adaptation.
Compare and contrast the stages of Selye’s General Adaptation Syndrome (GAS) with Local Adaptation Syndrome (LAS), including both physical and psychological changes that occur.
Describe physical changes occurring during the three stages of Selye’s GAS.
Discuss the inflammatory response: what triggers it, and what physiological changes occur?
Explain how anxiety, fear, and anger relate to stress.
Describe specific psychological responses to stress and their relationships to the concept of stress.
Provide examples and definitions of ego defense mechanisms.
Briefly describe hypochondriasis, somatization, somatoform pain disorder, and malingering.
Describe the physiological effects of prolonged stress and unsuccessful adaptation on various body systems.
Compare and contrast crisis and burnout.
State three ways to assess for:
Stressors and risk factors
Coping methods and adaptation
Physiological responses to stress
Emotional and behavioral responses to stress
Cognitive responses to stress
Adequacy of support systems
Plan interventions or activities for preventing and managing stress.
Key Concepts
Adaptation & Coping
Stress is an inherent aspect of daily life, perceived and responded to uniquely by individuals.
Failure to adapt to stress may link to physical and mental illnesses.
Two key concepts in this chapter: Stress and Adaptation.
Definitions and examples are crucial for health and illness understanding.
What is Stress?
Definition: Any disturbance in a person’s normal balanced state.
Stressors: Stimuli perceived as challenges or threats disrupting well-being, eliciting physical or emotional responses.
Coping Responses
Coping responses: Voluntary and involuntary actions aimed at reducing stress.
Adaptation: Ongoing effort to maintain equilibrium or homeostasis.
Stress can be beneficial (eustress) if not overwhelming, maintaining alertness and motivation.
Types of Stressors
Distress vs. Eustress:
Distress: Health-threatening stress.
Eustress: Beneficial stress (e.g., marrying vs. divorce on the Holmes–Rahe stress scale).
External/Internal Stressors:
External: Death, natural disasters, heat.
Internal: Anxiety, chronic illness, negative self-talk.
Developmental Stressors:
Occur at specific life stages, predictable (e.g., young adulthood, middle age).
Situational Stressors: Unpredictable and temporary stress (e.g., accidents, job changes).
Time Stressors: Connect with time management anxiety (feeling overwhelmed by multiple tasks).
Anticipatory Stressors: Pertains to concerns about future events.
Physiological Stressors: Affect body structure or function (e.g., toxins, diets, infections).
Psychosocial Stressors: Arise from social relationships, finance, and work pressures.
Psychological Responses to Stress
Common Emotional Responses
Anxiety, depression, anger, fear, and feelings of inadequacy.
Defense Mechanisms
Defined by Freud, these include avoidance, compensation, conversion, denial, and rationalization among others (detailed in Table 9-1).
Physiological Effects of Prolonged Stress
Chronic stress impacts cardiovascular, endocrine, immune, gastrointestinal, musculoskeletal, and respiratory systems.
For example:
Cardiovascular: Hypertension, risk of heart attack.
Endocrine: Diabetes and thyroid issues.
Immune: Autoimmune diseases due to impaired immunity.
Selye’s General Adaptation Syndrome (GAS)
Stages of GAS
Alarm Stage:
Initial response includes shock (endocrine system activation).
Physiological effects include increased heart rate, respiratory rate, and blood flow alterations.
Hormonal responses trigger fight or flight: Epinephrine release increases alertness, adrenaline assists muscle function.
Resistance Stage:
Body attempts to cope with stressor; stabilization achieved through physiological and psychological mechanisms.
Exhaustion Stage:
Depletion of bodily resources as the body can no longer maintain homeostasis leading to potential health crises.
Local Adaptation Syndrome (LAS)
Definition: A localized response (e.g., reflex pain response, inflammatory response).
Inflammatory Response: Triggered by injury; involves vasodilation and immune response to protect the body.
Symptoms include redness, swelling, heat, and pain.
Crisis and Burnout
Crisis: Characterized by overwhelming stress leading to ineffective coping, often requires intervention.
Burnout: Results from chronic stress, feelings of helplessness, and surface in professional settings like nursing, manifesting as irritability, exhaustion, and cynicism.
Practical Knowledge of Stress Assessment
Recognizing Cues
Assess physiological, emotional, cognitive, and behavioral responses.
Understand the holistic nature of stress, affecting every domain of human functioning.
Nursing Diagnosis Examples
Stress-related nursing diagnoses include risks for anxiety, ineffective coping, and impaired social interaction.
Stress Management Strategies
Intervention Planning
Tailor interventions based on the individual’s prognosis and coping abilities:
Health-Promotion Activities: Encourage nutrition, exercise, sleep hygiene, and leisure activities.
Avoiding Maladaptive Behaviors: Suggest alternatives to harmful drugs and alcohol.
Therapeutic Techniques
Relaxation techniques, mindfulness, cognitive restructuring, and identifying support systems help in managing stress.
Spiritual and Emotional Responses
Offer spiritual support, facilitate connection to faith-based communities, and explore meaning in stress-related experiences.
Conclusion
Understanding, assessing, and implementing stress management techniques tailored to individual needs is pivotal in promoting mental health and mitigating stress-related health issues. Knowledge and skill in effectively addressing stress can improve the overall care for patients in any healthcare setting.