-mild anxiety:

Prepares people for action

Increase motivation for productivity

Increase perceptual field

Results in heightened awareness of the environment

-moderate anxiety:

Extend of perceptual field diminishes

Attention span/ability to concentrate decreases

Increased muscular tension and restlessness

-severe anxiety:

-attention on one detail only

Physical symptoms HA, palpitations, insomnia) emotional (confusion, dread, horror) evident

Difficulty completing most simple task

-panic

Unable to focus on any detail

Misconceptions are common

Loss of contact of reality

Hallucinations/delusions

Wild desperate actions/extreme withdrawal

Human function and communication with others is ineffective

Associated with terror

1. accept the patient as they are, treat the patient as an able stranger and relate until evidence shows otherwise

1. specific answers to questions formulated with relation to a larger problem.

-peplau's role

1. learning needs and information required by client or family to improve health situation

1. democratic leadership in nursing situations implies that the patient will be permitted to be an active participant in designing nursing plans for him.  Autocratic leadership promotes overvaluation of nurse and clients’substituition of the nurse’s goals for their own.  Lassiez faire leaders convey a lack of personal interest in the client

1. symbols of others individuals as a mother figure, sibling, teacher, or prior nurse

1. interpersonal techniques to help adapt to difficulties or changes in life experiences

1. Active listening

SOLER

S-sit facing the client

O-observe open posture

L-lean forward to client

E-establish eye contact

R-relax

*verbal

-vocal cues/paralanguage (pitch, tone, loudness, rate of speaking, pauses, emphasis); active listening, active listening, feedback

*nonverbal

-physical appearance and dress, body movement and posture, touch, facial expression, eye behavior

1. LPS Act-

-(healthy)said to occur when an individual’s physical or behavioral response to any change in his or her internal or external environment results in preservation of individual integrity or timely return to equilibrium

-(unhealthy, disrupts integrity of individual) an individual’s physical or behavioral response to any change in his or her internal or external environment results in disruption of individual integrity or in persistent disequilibrium

biological, psychological, social, or chemical factor that causes physical or emotional tension and may be a factor in the etiology of certain illnesses

*stress as a biological response*

(general adaptation syndrome)

Alarm reaction stage

1. fight or flight syndrome

*stress as a biological response*

(general adaptation syndrome)

Stage of resistance

1. uses the response of first stages as defense to adapt to stressor, if adaptation occurs, 3^rd stage is prevented or delayed.  Physiological symptoms may disappear

*stress as a biological response*

(general adaptation syndrome)

Stage of exhaustion

1. occurs when prolonged exposure to the stressor to which the body has become adjusted.  Adaptive energy is depleted, and the individual can no longer draw from the resources for adaptation described in the first two stages.  Diseases associated with adaptation may occur.

*stress as an environmental event*

-change from the existing steady state of the individual’s life pattern

*stress as a transaction between the individual and the environment*

-Relationship between the individual and the environment

-parallels the concept of the etiology of disease

     perceived by the individual in a specific manner

     -determination that a particular person/environment relationship is stressful depends  

on individual’s cognitive appraisal of the situation

2.Individual’s perception of the event (2 types):

   a. primary appraisal:

irrelevant: holds no significance

benign-positive: producing pleasure

stress: harm/loss, threat, and challenge

harm/loss: damage or loss already experienced

threatening: anticipated harms or losses

challenging: gain or growth, rather than risks

   b. secondary appraisal

assessment of skills, resources, knowledge

Predisposing factors:

-genetic influences

-past experiences

-existing conditions

Coping Strategies:

-awareness-aware of the factors that create stress and feelings associated with it

-relaxation-exercise, breathing exercise, stress relief

-meditation

-interpersonal communication with a caring other

-problem solving

-pets

-music

refusing to accept a situation or the feelings associated with it.

            Ex: a woman drinks alcohol everyday and can’t stop, failing to admit that she has a problem.

the transfer of feelings from one target to another that is considered less threatening or neutral.

            Ex: a boy who is bullied at school goes home and kicks his dog.

attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors.

            Ex: Anthony tries on a shirt from Metro Park and finds out the price is expensive so he says to the clerk he’s not gonna buy it cuz he doesn’t look good in that color.

preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors.

            Ex: nancy was emotionally abused as a child by her mother and hates her but when she talks about her to her friends she says how great she is.

– retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning.

            Ex: when a 4 year old gets a new sibling he cries and soils his clothing even though he’s been potty trained for the last 6 months.

– an attempt to increase self worth by acquiring certain attributes and characteristics of an individual one admires.

            Ex: a teenage girl dresses like a pop star to look like her.

an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis.

            Ex: sandy’s husband is being transferred to a job out of state and hides the anxiety by telling her parents the advantages with the move.

integrating the beliefs and values of another individual into one’s own ego structure.

            Ex: a small child develops her conscience by integrating what her parents believe is right and wrong and literally become part of the child. The child says to her play friend, “don’t hit people, it’s not nice.”

– separating a thought or memory from the feeling tone or emotion associated with it.

            Ex: a woman describes being attacked and raped without showing any emotion.

attributing feelings or impulses unacceptable to one’s self to another person. The individual passes the blame for these undesirable feelings or impulses to another, thereby providing relief from the anxiety associated with them.

            ex: sue feels a strong sexual attraction to her track coach and tells her friend, “He’s coming on to me!”

– is the involuntary blocking of unpleasant feelings and experiences from one’s awareness.

            Ex: an accident victim can remember nothing about his a accident.

rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive.

            Ex: a teenage boy with strong competitive and aggressive drive becomes the star football player on his high school team.

the voluntary blocking of unpleasant feelings and experiences from one’s awareness.

            Ex: scarlett o’hara says I’ll think about that tomorrow.

symbolically negating or canceling out an experience that one finds intolerable.

            Ex: joe yells at his wife and on his way home he buys her flowers.