biophysical and psychosoical concepts in nursing practice.pdf

Biophysical and psychosocial concepts in nursing practice Obj 1: Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state. Obj 1: Identify the significance of the body’s compensatory mechanisms in promoting adaptation and...

Biophysical and psychosocial concepts in nursing practice Obj 1: Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state. Obj 1: Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state. Fundamental Concepts Each body system performs specific functions to sustain optimal life for an organism. Compensatory mechanisms for adjusting internal conditions promote the steady state of the organism, ensure its survival, and restore balance in the body. Obj 1: Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state. Stress is a state produced by a change in the environment that is perceived as challenging, threatening, or damaging to a person’s dynamic balance or equilibrium. The person may feel unable to meet the demands of the new situation. The change or stimulus that evokes this state is the stressor. The process of coping with the stress, a compensatory process that has physiologic and psychological components. Obj 1: Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state. Bernard’s principle of “constancy” underpins the concept of homeostasis, which refers to a steady state within the body. Control of steady state: Negative feedback: reduce or stop the change. Functions regulated through such compensatory mechanisms include blood pressure and blood glucose level. Positive feedback: amplify or reinforce the change. Such as formation of blood clotting.  Types of stressors Physical Physiologic Psychosocial temperature extremes, Pain and fatigue Fear of failing an radiation, electrical shock, examination, losing a job, and mechanical trauma, waiting for a diagnostic can cause injury to the test result. cells or to the entire body.  Types of stressors An acute, time-limited stressor: such as studying for final examinations. A stressor sequence: a series of stressful events that result from an initial event such as job loss or divorce. A chronic intermittent stressor: such as daily hassles. A chronic enduring stressor: that persists over time, such as chronic illness, a disability, or poverty. Obj 3: Describe the various nursing interventions used in managing stress Assessment In the assessment of people who seek health care, both objective signs and subjective symptoms are the primary indicators of existing physiologic processes. The following questions are addressed: Are the heart rate, respiratory rate, and temperature normal? What emotional distress may be contributing to the patient’s health problems? Are there other indicators of steady-state deviation? What are the patient’s blood pressure, height, and weight? Are there any problems in movement or sensation? Are there any problems with affect, behaviour, speech, cognitive ability, orientation, or memory? Are there obvious impairments, lesions, or deformities? Obj 3: Describe the various nursing interventions used in managing stress Diagnosis Anxiety Ineffective coping, defensive coping, and ineffective denial Social isolation, risk for spiritual distress, readiness for enhanced family processes, decisional conflict, risk for compromised resilience, impaired resilience, readiness for enhanced resilience, and risk for powerlessness.  Obj 3: Describe the various nursing interventions used in managing stress Reducing and controlling stress and improving coping 1. Promoting a healthy lifestyle: health risk appraisal: Obj 3: Describe the various nursing interventions used in managing stress Nursing Interventions 2. Enhancing coping strategies The five predominant ways of coping with illness identified in a review of 57 nursing research studies were as follows (Jalowiec, 1993): Trying to be optimistic about the outcome Using social support Using spiritual resources Trying to maintain control either over the situation or over feelings Trying to accept the situation Obj 3: Describe the various nursing interventions used in managing stress Nursing Interventions Obj 3: Describe the various nursing interventions used in managing stress Nursing Interventions 3. Relaxation techniques The goal of relaxation training is to produce a response that counters the stress response. When this goal is achieved, the action of the hypothalamus adjusts, decreasing sympathetic and parasympathetic nervous system activity. a. Progressive muscle relaxation b. The Benson relaxation response c. Guided imagery Obj 3: Describe the various nursing interventions used in managing stress Nursing Interventions 4. Educating about stress management Two commonly prescribed nursing educational interventions— providing sensory information and providing procedural information (e.g., preoperative education)—aim to reduce stress and improve the patient’s coping ability. 5. Promoting family health Obj 4: Identify individual, family and group measures that are useful in reducing stress. Seven traits that enhance coping of family members under stress have been identified (Burr, Klein, Burr, et al., 1994). Communication skills Spirituality. Cognitive abilities Emotional strengths Relationship capabilities Willingness to use community resources Individual strengths and talents were also associated with effective coping. Obj 4: Identify individual, family and group measures that are useful in reducing stress. As nurses work with families, they must not underestimate the impact of their therapeutic interactions, educational information, positive role modelling, provision of direct care, and education on promoting health. Maladaptive coping may result if health care team members are not perceived as actively supporting family members. Often, denial and blaming of others occur. Obj 4: Identify individual, family and group measures that are useful in reducing stress. The first type of information leads people to believe that they are cared for and loved. This emotional support appears most often in a relationship between two people in which mutual trust and attachment are expressed by helping one another meet their emotional needs. The second type of information leads people to believe that they are esteemed and valued. This is most effective when an individual recognizes favourable position. Known as esteem support, this elevates the person’s sense of self-worth. The third type of information leads people to feel that they belong to a network of communication and mutual obligation. Members of this network share information and make goods and services available to the members as needed. Obj 4: Identify individual, family and group measures that are useful in reducing stress. Social networks assist with management of stress by providing people with: A positive social identity emotional support material aid and tangible services access to information access to new social contacts and new social roles