Stress, Anxiety, and Grief Management

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Questions and Answers

What effect does norepinephrine have on the respiratory system?

  • It decreases the breathing rate.
  • It induces hypoventilation.
  • It causes irregular breathing patterns.
  • It increases the breathing rate and bronchodilates. (correct)

Which symptom is NOT associated with the gastrointestinal effects of stress?

  • Increased peristalsis.
  • Nausea/vomiting.
  • Hyperactive bowel sounds.
  • Increased appetite. (correct)

Which condition is indicated by prolonged tension in the musculoskeletal system?

  • Muscle spasms in back, shoulders, and neck. (correct)
  • Enhanced strength in smaller muscles.
  • Decreased muscle tension overall.
  • Increased flexibility in larger muscles.

Which cardiovascular symptom is specifically linked to the effects of epinephrine and norepinephrine?

<p>Irregular heartbeat and rhythm changes. (A)</p> Signup and view all the answers

What nonverbal signs should a nurse observe for in a patient with ineffective coping?

<p>Signs of anxiety, fear, anger, irritability, and tension. (D)</p> Signup and view all the answers

Which of the following are sources of clinical stress for nurses?

<p>Poor patient outcomes (C), Risk for harm (D)</p> Signup and view all the answers

What potential health issues can chronic stress contribute to?

<p>Cardiovascular diseases (C)</p> Signup and view all the answers

How does moderate anxiety manifest in an individual?

<p>Increased muscle tension (C)</p> Signup and view all the answers

Which condition is primarily a physiological response to a stimulus?

<p>Stress (A)</p> Signup and view all the answers

What is a common characteristic of severe anxiety?

<p>Fearful facial expression (A)</p> Signup and view all the answers

What can be an effect of stress on the immune system?

<p>Impairment of immune function (B)</p> Signup and view all the answers

Which of the following is not listed as a source of stress for patients?

<p>Excessive workload (C)</p> Signup and view all the answers

What degree of anxiety is Mrs. Jones experiencing if she cannot perform daily tasks due to worrying about her sick brother?

<p>Severe (B)</p> Signup and view all the answers

Which nursing diagnosis is specifically related to the emotional toll of caregiving?

<p>Caregiver role strain (C)</p> Signup and view all the answers

What is a key benefit of regular exercise in managing stress?

<p>Improved muscle tone and posture (C)</p> Signup and view all the answers

Which method uses imagination to help reduce stress?

<p>Guided imagery and visualization (B)</p> Signup and view all the answers

What is essential in managing time effectively to reduce stress?

<p>Prioritizing tasks (C)</p> Signup and view all the answers

In crisis intervention, what is the primary focus of the approach?

<p>Problem solving related to the crisis (B)</p> Signup and view all the answers

Which diagnosis indicates a high likelihood of experiencing a post-trauma response?

<p>Risk for post-trauma syndrome (A)</p> Signup and view all the answers

Which of the following is NOT a benefit of having a support system?

<p>Minimizing stress altogether (C)</p> Signup and view all the answers

What is a primary characteristic of progressive muscle relaxation?

<p>Alternating tension and relaxation of muscles (B)</p> Signup and view all the answers

What factor significantly influences an individual's coping strategies related to loss?

<p>Life experiences (B)</p> Signup and view all the answers

Which of the following is NOT a medical criterion used to certify death?

<p>Pupil dilation (D)</p> Signup and view all the answers

How does socioeconomic status impact an individual's grief response?

<p>It influences access to support and resources. (A)</p> Signup and view all the answers

What is the primary focus when considering the nature of the loss?

<p>Quality and meaning of the lost relationship (D)</p> Signup and view all the answers

What is a key responsibility of nurses after a patient has passed away?

<p>Meeting the needs of the grieving family (C)</p> Signup and view all the answers

What is a characteristic of normal grief?

<p>Universal reaction with complex responses (D)</p> Signup and view all the answers

What defines anticipatory grief?

<p>Absorbing loss gradually over a long period of time (A)</p> Signup and view all the answers

Which symptom is NOT common in dysfunctional grief?

<p>Gradual acceptance of loss (D)</p> Signup and view all the answers

What duration of symptoms characterizes complicated grief?

<p>One year or longer (D)</p> Signup and view all the answers

Which of the following is a typical physical symptom of grief?

<p>Sleep disturbances (B)</p> Signup and view all the answers

Which stage of grief is characterized by a refusal to accept the reality of loss?

<p>Denial (D)</p> Signup and view all the answers

What emotion might a person express during the bargaining stage of grief?

<p>Fear of punishment for past sins (C)</p> Signup and view all the answers

What common behavior might someone exhibit during extreme grief?

<p>Difficulty functioning in daily life (C)</p> Signup and view all the answers

What is mandated in cases of unusual deaths?

<p>Postmortem examination (B)</p> Signup and view all the answers

Which statement best defines a good death?

<p>A death that allows the person to die with dignity and free of pain (C)</p> Signup and view all the answers

Why is it important for families of the deceased to understand organ donation?

<p>To comprehend the process and importance of organ donation (A)</p> Signup and view all the answers

Which nursing action is essential when providing care after a death?

<p>Meeting the needs of the family during their grief (B)</p> Signup and view all the answers

What should nurses focus on to promote a supportive environment for dying patients?

<p>Providing care based on the patient’s needs and dignity (D)</p> Signup and view all the answers

Which role does the nurse fulfill in supporting the family at the time of death?

<p>Providing emotional support and information (D)</p> Signup and view all the answers

What aspect is NOT typically part of the definition of a good death?

<p>Extended periods of unconsciousness (D)</p> Signup and view all the answers

What should a nurse avoid when discussing a patient’s condition with family members?

<p>Using medical jargon that may confuse them (D)</p> Signup and view all the answers

Flashcards

Cardiovascular effects of stress

Stress hormones like epinephrine and norepinephrine increase heart rate, blood pressure, and can lead to irregular heartbeats and angina.

Respiratory effects of stress

Stress increases breathing rate and widens airways. Hyperventilation, dizziness, and tingling can result.

Stress on the GI system

Stress can cause loss of appetite, nausea, vomiting, and increased bowel activity (like diarrhea).

Muscle response to stress

Stress causes muscle tension, especially in larger muscles, and potentially tremors in smaller muscles. This tension can lead to spasms.

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Observing patient stress

Look out for nonverbal clues like body language changes in patients who are struggling to cope.

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Clinical Stress Sources - Patients

Uncertainty, fear, pain, cost, lack of knowledge, risk of harm, and unknown resources are sources of clinical stress for patients.

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Clinical Stress Sources - Nurses

Poor patient outcomes, risk of errors, unfamiliar situations, excessive workload, and inadequate resources are sources of clinical stress for nurses.

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Stress-Related Harm

Stress can cause cardiovascular risks (heart rate, blood pressure, heart attack, stroke), immune system impairment, physical effects (weight gain, hair/skin problems, diabetes, digestive issues, loss of libido), and mental health issues (depression, anxiety, PTSD).

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Anxiety Definition

Anxiety is a constant feeling of worry or fear.

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Stress vs. Anxiety

Stress is the body's physiological response to a stimulus, while anxiety is the psychological response to a threat.

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Mild Anxiety

Mild anxiety is common in daily life, increasing alertness and motivating learning. It can slightly interfere with sleep but aids problem-solving.

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Moderate Anxiety

Moderate anxiety involves physical symptoms such as a trembling voice, muscle tension, and a feeling of nervousness (butterflies). It also causes increased breathing and pulse.

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Severe Anxiety Symptoms

Severe anxiety greatly impacts learning and communication. Symptoms include difficulty speaking, increased physical activity, fear, headaches, nausea, dizziness, rapid heartbeat, and rapid breathing.

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Stress Nursing Diagnoses

Examples of nursing diagnoses related to stress include anxiety, caregiver role strain, ineffective coping, fear, risk for post-trauma syndrome, insomnia, situational low self-esteem, and stress overload.

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Health Promotion (Stress)

Strategies like regular exercise, support systems, time management, and guided imagery/visualization to reduce stress.

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Regular Exercise (Stress)

Physical activity improving muscle tone, posture, weight control, tension reduction, and relaxation, and benefiting cardiovascular health.

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Support Systems (Stress)

Family, friends, and colleagues providing listening, advice, and emotional support to a stressed individual.

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Time Management (Stress)

Prioritizing tasks and planning effectively to avoid last-minute rushes, leading to reduced stress and a sense of control.

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Guided Imagery (Stress)

Using imagination to reduce stress by promoting a relaxed state.

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Progressive Muscle Relaxation (Stress)

Technique involving alternately tightening and releasing muscle groups, promoting relaxation.

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Crisis Intervention (Stress)

Problem-solving approach to address a crisis, helping individuals resolve issues and coping within a defined timeframe (approximately 6 weeks).

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Acceptance Stage

The final stage of grief where a person comes to terms with the loss. They may show decreased interest in their surroundings and support people and start making plans for the future.

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Factors Influencing Grief

Various personal, social, and cultural factors impact how individuals experience and manage grief.

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Impact of Relationships on Grief

The quality and significance of the lost relationship strongly influences the grief response.

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Socioeconomic Status and Grief

A person's socioeconomic status affects their access to resources and support networks for coping with loss.

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Clinical Death Criteria

Medical criteria used to certify death include cessation of breathing, lack of response to stimuli, absence of reflexes, and no spontaneous movement.

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Autopsy

A medical examination performed after death to determine the cause of death.

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When is an autopsy mandated?

An autopsy is legally required in situations where the death is considered unusual or suspicious.

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Organ Donation

The process of donating organs from a deceased person to someone in need of a transplant.

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Who are responsible for organ donation referral?

Healthcare institutions have policies and procedures for referring potential organ donors to procurement agencies.

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A Good Death

Dying on one's own terms, with minimal pain, and feeling a sense of fulfillment and dignity.

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What are crucial factors for a good death?

Control of symptoms, preparing for death, feeling like one's life is complete, and a positive relationship with healthcare professionals.

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Nursing Role in a Good Death

Nurses focus on the needs of the dying person and their family, providing care and support.

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What does a good death allow?

A good death allows a person to die on their own terms, with minimal pain, and feeling a sense of fulfillment and dignity. It is also about feeling supported and empowered in this process.

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Grief

An emotion experienced after a loss, not just death, involving complex emotional and physical reactions.

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Normal Grief

A common, universal reaction to loss and death with emotional, cognitive, and physical responses.

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Anticipatory Grief

Grief experienced over time as a loss becomes more likely, a process of gradually preparing for the inevitable.

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Dysfunctional Grief

Grief causing extreme sadness, inability to cope, and difficulty re-establishing relationships.

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Complicated Grief

Grief with symptoms lasting a year or more after a loss, affecting daily life and interpersonal relationships.

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Physical Symptoms of Grief

Physical reactions to grief such as sleep difficulties, weight changes, energy loss, and headaches.

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Stages of Grief (Denial, Anger, Bargaining, Depression)

Common emotional responses to loss: denial, anger, bargaining, and depression, can be experienced in different sequences.

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Types of Loss

Grief can be triggered by any loss event, not just death, such as a job loss or relationship breakup.

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Study Notes

Stress, Anxiety, Adaptation, Loss, and Grief

  • Stress/distress is a part of life; everyone experiences it at some point.
  • Stress is a disturbance in a person's physical or emotional state, affecting their "normal" physiological state, requiring adaptation.
  • A stressor is any event or stimulus causing stress, which can be internal (e.g., illness, fear) or external (e.g., loud noise).
  • Sources of stress include internal stressors (e.g., infection, depression), external stressors (e.g., moving, death in family), developmental stressors (e.g., starting school, leaving home), and situational stressors (e.g., marriage/divorce, illness).
  • Stress can significantly impact physical health, emotional state, cognitive abilities, social relationships, and spiritual well-being.

Effect of Stress

  • Stress can threaten physiological homeostasis.
  • Stress can produce negative or nonconstructive feelings about the self.
  • Stress can influence a person's perceptual and problem-solving abilities.
  • Stress can alter a person's relationships with others.
  • Stress can challenge one's beliefs and values.

Clinical Stress

  • Uncertainty, fear, pain, cost, lack of knowledge, risk for harm, and unknown resources are important sources of stress for patients.
  • Poor patient outcomes, risk of making an error, unfamiliar situations, excessive workload, and inadequate resources are important sources of stress for nurses.
  • Stress can lead to physiological harmful effects (e.g., heart disease, immune system impairment, weight gain, hair loss, diabetes).

Mild Anxiety

  • Mild anxiety is a normal part of daily life.
  • It increases alertness and awareness of surroundings (e.g., vision, hearing).
  • Mild anxiety might interfere with sleep but can be beneficial for problem-solving.

Moderate Anxiety

  • Moderate anxiety is characterized by tremors, quavering voice, muscle tension, and a feeling of "butterflies."
  • Respiration and pulse rate may slightly increase.

Severe Anxiety

  • Severe anxiety is characterized by impaired learning, difficulty communicating, increased motor activity, a fearful facial expression, headache, nausea, dizziness, tachycardia, and hyperventilation. It negatively affects a person's ability to function and requires intervention.
  • This is often a significant problem.

Coping Responses

  • Coping responses are immediate involuntary responses to threatening situations.
  • Coping is essential for normal growth and development, the ability to tolerate change, and responding to stressors.
  • A balance between perception of stressors and the resources available is crucial for coping.

Factors Affecting Coping Patterns

  • Diet, activity, sleep, and safety/security significantly impact coping.
  • Previous experiences shape how one reacts to stress. Positive experiences can build resilience, while negative ones may hinder coping.

Loss and Grief

  • Loss is the experience of losing something or someone significant.
  • Loss can be actual (e.g., death) or perceived (e.g., loss of a job).
  • Grief is the complex emotion felt in response to loss, involving emotional, cognitive, social, physical, behavioral, and spiritual aspects.

Types of Loss

  • Actual loss involves a tangible loss (e.g., death of a loved one).
  • Perceived loss involves a felt loss not always tangible (e.g., loss of body image).
  • Physical loss is tangible loss of something physical (e.g., loss of limb).
  • Psychological loss is a felt loss which is intangible (e.g., loss of self-esteem).

Types of Grief

  • Normal grief is a common and universal reaction to loss, with a duration of typically 6 weeks.
  • Anticipatory grief is a gradual acceptance of a loss that is impending.
  • Dysfunctional grief is characterized by extreme sadness, and inability to function, often lasting longer than typically expected.
  • Complicated grief is experiencing symptoms of grief over a year after a loss; these symptoms can be very distressing.

Dying and Death

  • Medical criteria for death include cessation of breathing, unresponsive to painful stimuli, and lack of reflexes (e.g., corneal).
  • Traditional clinical signs were cessation of respiration and blood pressure.

Care After Death

  • Nursing responsibilities include respecting the body and its dignity and maintaining privacy (e.g., preventing injuries and damage to the body).
  • Legal aspects include determining and following procedures (e.g., autopsy). In some cases, organ donation is applicable and should be addressed.
  • Supporting the grieving family is also crucial.

Good Death

  • A good death is characterized by relative freedom from pain, dying on their own terms, and having feelings of fulfillment.
  • Nurses play an important role in focusing on the needs of the dying person and family members.

Nursing Process: Implementation

  • Key aspects of nursing process implementation include developing trusting relationships, explaining the patient's condition & treatment, promoting self-esteem, teaching family members how to assist, fulfilling the needs of the patient and their family, and providing postmortem care.

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