Stressor

* A change in the environment that is perceived as a challenge, threat or danger.

* Disturbs person's equillibrium by iniation a physical or emotional response.

* Can have both positive and negative effects.

* Is part of everyday experience, and necessary for life.

Stressor

(cont'd)

*  Can affects all dimensions-physical, emotional, intellectual, social and spiritual.

* Perception and response are both individualized.

Types of Stressors

(Distress vs. Eustress)

* Distress threatens health and eustress is protective.

External vs. internal

*  Stressors may be external to the person. eg. death of family member, a hurricane,etc.

* Stressors may be internal.eg. disease, anxiety, nervous anticipation of an event

Developmental vs. Situational

* Developmental stressors are those that can be predicted to occur at various stages of a person's life. eg. Most young adult face the stress of leaving home and beginnihg a career.

*Situational stressors are predictable. eg. Can't predict you will have an automobile accident.

Physiological vs. psychosocial

* Physiological stressors  are those that affect the body structure or functions. eg chemical,physical,nuritional,biological and genetic

* Psychosocial stressors are external stressors that arise from our work, family dynamics, living situation, soical relationships and otehr aspect of our daily lives.

Factors that influence adaptation

* Personal perception of the stressor (a person perception may be realsitic exaggerated)

*Overall health status (stressors may cauwse a healthy person to engage in construct adaptive behaviours that improve health)

*Support System (includes friends, family,couseling,groups, church, or other like minded people who share common interests.

General Adaptation Syndrome

(Hans Seyle)

* biochemical model of stress (non specifi bodily responses shared by all people & occurs in resposne to distress and eustress)

* The statges it has are:

 a. alarm reaction

 b. resistance

 c. exhaustion

Factors that influence adaptation

(cont'd)

* Personal factors (age, developmental lvl, life experiences)all affect a person's response to stress.

Alarm stage

* stressor perceived and defense mechanisms activated.

*Body prepares to react- fight/flight response.

*phases

 a. shock (last between 1-2 minutes up to 24 hours)

 b. Endocrine and sympathetic nervous systems activated.

Alarm stage

* Counter-shock (all the changes privided in the shock phase are reversed, and they person becomes less able to deal with the immediate threat)

Alarm Stage

systems responses to stress

* cardiovascular

*respiratory

*metabolic

*urinary

*gastrointestinal

Alarm Stage

systems responses to stress

(cont'd)

* musculoskeletal

*Endrocrine

*Symapthetic nervous system

Resistance stage

* body tries to cope, protect itself against the stressor and maintain homestatis.

* Physical (vital signs, hormone levels, and energy production return to normal)

*psychosocial (use of coping ad mechanism)

Exhaustion Stage

* Stress continues and adaptive mechanisms become ineffective or are used up, a person enters final stage.

* Body either rests and mobilizes its defenses to return to normal. (disease or death)

*If adaption is successful, final stage is recovered.

Needs & Concerns of Hospitalized Clients

* Pain

*fatigue

*immobility

*role changes

*loss of independence

Needs & Concerns of Hospitalized Clients

(cont'd)

*Physical separation from supports

*Threats to self-concept

Psychologial responses to stress

* Feelings (emotional)

*Thoughts(cognitive)

*Behaviour

Emotional Responses to Stress

* depression

*anger

*Fear (is an emotion feeling of apprehension from an identified danger).

* Fear is a cognitive response.

*Anxiety(most common){is diffused and not easily defined}

Behavioral Reations to Stress

* attack behaviour

*withdrawal behaviour

*Compromise behaviour

Factors affecting stress and Adaptation

* sources of stress

*Types of stressors experienced.

*Personal factors

Adaptation to Acute and Chronic Illness

* General tasks- maintaining self-esteem and personal relationships

*Illness-related tasks- handling pain and disability

Effects of Long- Term Stress

* affects physical status.

*Increases risk for disease and injury

*compromise recovery and return to normal function

*Is associated with specific diseases

Family Stressors

* Changes in family structure and roles.

*Anger and feelings of helplessness and guilt.

*Loss of control over normal routines

*Concern for future financial stability

Nursing Process

* State ways to assess for each of the following:

 a. stressors and risk factors

 b. coping methods and adaptation

 c. physiological, emotional, behaviour and cognitive responses to stress & adequacy of support systems.

*Write a nursing diagnoses and goal for a client experiencing stress

Assessment

* Stressors

* Risk fActors

*Coping and adaptation

*response to stress

*support systems

*spiritual

Nursing Diagnosis

* Physical Domain

*Behavioral Domain

*Cognitive Domain

*Emotional Domain

*Interpersonal relationship domain

Outclome/Planning

client will:

*Report a reduction in physical symptoms of stress.

*Observed to have less physicla tension observed in face and other muscle groups

*Identify and use available support systems.

*Demosntrate relaxtion and stress reducing strategies

Evaluating the Plan ofCare

* pt. verbalizes  causes and effects of stress and anxiety

*Pt. identifies and uses sources of support

*Pt. uses problem solving to find solution to stressor.

*Pt. practices healthy lifestyle habits and anxiety-reducing techniques

Evaluating the Plan of Care

(cont'd)

*Pt. verbalizes decrease in anxiety and increase in comfort

Interventions/Implementation

Health Promoton activities

*Nutrition

*exercise

*sleep and rest

*lesiure activities

*Time managment skills to balance responsibilities

Interventions/Implementation

Health Promoton activities

(cont'd)

* Relieving anxiety

*anger management

*stress maangement techniques

*changing perception of stressors or self

*Identifying and using support system

Interventions/Implementation

Health Promoton activities

(cont'd)

*Providing referrals

*Avoiding maladaptive behaviours

Stress Management Techniques

* Relaxation--> Go to the spa

*Meditation-->Use yoga/chinese meditation

*Anticpatory guidance

*Guided imagery

*Energy therapies-->Reiki,Therapeutic

Stress Management Techniques

(cont'd)

* Biofeedback-->

*Humor-->