1.pdf

SESSION: 2 HOMEOSTASIS, STRESS & ADAPTATION Page 78-94 Prepared by Mr. Norman P. Gutierrez, RN, MAN Learning Objectives Upon completion of this session, the students will be able to:  Identify the significance...

SESSION: 2 HOMEOSTASIS, STRESS & ADAPTATION Page 78-94 Prepared by Mr. Norman P. Gutierrez, RN, MAN Learning Objectives Upon completion of this session, the students will be able to:  Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state.  Compare physical, physiologic, and psychosocial stressors.  Describe the various nursing interventions used in managing stress.  Identify individual, family and group measures that are useful in reducing stress. What is Homeostasis? Homeostasis - is the steady state within the body or an equilibrium between the internal and external environment. Stress is a state produced by a change in the environment that is perceived as challenging, threatening or damaging to the person’s equilibrium caused by a stressor. Stressors Is an external or internal event or change that will produce stress that creates potential changes:  Physiologic  Emotional  Cognitive  Behavioral Adaptation  Adjustment to the change  Person has energy and ability to meet new demands. TYPES OF STRESSORS Physical stressor: e.g. Cold, heat, or chemical agents Physiological stressor: e.g. Pain & fatigue Psychosocial stressor: e.g. Fear of failing exam or losing job or normal life transition. Other examples of Stressors: Day to day frustration (traffic, argument. computer down), Major complex occurrence (War, flood), Stress occur Less frequently & involve fewer people (death, birth, divorce), functional disability (chronic illness) CS2-Outline Notes Prepared by: Mr. Norman 1  #adult SESSION: 2 HOMEOSTASIS, STRESS & ADAPTATION Page 78-94 Prepared by Mr. Norman P. Gutierrez, RN, MAN Learning Objectives Upon completion of this session, the students will be able to:  Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state.  Compare physical, physiologic, and psychosocial stressors.  Describe the various nursing interventions used in managing stress.  Identify individual, family and group measures that are useful in reducing stress. What is Homeostasis? Homeostasis - is the steady state within the body or an equilibrium between the internal and external environment. Stress is a state produced by a change in the environment that is perceived as challenging, threatening or damaging to the person’s equilibrium caused by a stressor. Stressors Is an external or internal event or change that will produce stress that creates potential changes:  Physiologic  Emotional  Cognitive  Behavioral Adaptation  Adjustment to the change  Person has energy and ability to meet new demands. TYPES OF STRESSORS Physical stressor: e.g. Cold, heat, or chemical agents Physiological stressor: e.g. Pain & fatigue Psychosocial stressor: e.g. Fear of failing exam or losing job or normal life transition. Other examples of Stressors: Day to day frustration (traffic, argument. computer down), Major complex occurrence (War, flood), Stress occur Less frequently & involve fewer people (death, birth, divorce), functional disability (chronic illness) CS2-Outline Notes Prepared by: Mr. Norman 1 CATEGORY OF STRESSOR (DURATION) Acute – time limited stressor: e.g. Studying for final exam Stressor sequence: e.g. Job loss or divorce Chronic Intermittent: e.g. Daily frustration Chronic enduring: e.g. chronic illness/ Poverty RESPONSE TO STRESS  Psychological: An individual consciously or unconsciously react to manage stressful situation. E.g. Cognitive appraisal; Emotions (negative- fear & anger) (positive-challenge)  Physiologic: e.g. General Adaptation syndrome: Alarm, Resistance & Exhaustion and Local Adaptation syndrome: Inflammatory response and repair process at the site of tissue injury PHYSIOLOGICAL RESPONSE TO STRESS (sympathetic nervous systems response) table 6-1 page 82  Increased heart rate & BP  Increased blood glucose level  Mental acuity: alert state  Dilated pupils  Increased tension of skeletal muscles  Increased ventilation (maybe rapid or shallow)  Increased coagulability of blood  Weak immunity MALADAPTIVE RESPONSES TO STRESS  When responses to stress are ineffective they are referred as maladaptive  Maladaptive coping process: use of alcohol, drugs  Type A| behaviors- impatience, competitiveness and achievement orientation – prone to stress- related illnesses. INDICATORS OF STRESS: Refer to Chart 6-1 on page 83! CS2-Outline Notes Prepared by: Mr. Norman 2 NURSING MANAGEMENT: (Page 88-92)  Possible Nursing diagnoses: Anxiety, Ineffective coping, Defensive coping, and Ineffective denial – indicates poor adaptive responses  Other nursing diagnoses: Social Isolation, Risk for spiritual distress, Readiness for enhanced family processes, Decisional conflict, Risk for compromised resilience and Risk for powerlessness 1. Promoting a healthy lifestyle  Stop smoking  Periodic screening exam 2. Enhancing Coping Strategies  Trying to be optimistic about the outcome  Using social support, spiritual resources  Trying to maintain control: over the situation or over feelings  Trying to accept the situation 3. Teaching Relaxation Techniques  Progressive muscle relaxation  The Benson Relaxation response  Guided imagery Relaxation with Guided Imagery:  Is the purposeful use of imagination to achieve relaxation or direct attention away from undesirable sensation? 4. Educating about Stress Management  Provide sensory information and procedural information (e.g. preoperative education such as lesson in childbirth preparation for expectant mothers, a review of how an implantable cardioverter defibrillator works to a cardiac patient)  Giving patients information also reduces the emotional response so that they can concentrate and solve problems more effectively. 5. Promoting Family Health  Family plays a central role in the life of the patient and a major part of the context of the patient’s life.  It is within the families that people grow, nurtured, acquire a sense of self, and develop beliefs and values about life and progress through life’s developmental stages. CS2-Outline Notes Prepared by: Mr. Norman 3 6. Enhancing Social Support  Has demonstrated to be an effective moderator of life stress where people believed that they are cared for, loved, esteemed and valued.  It facilitates a person’s coping behaviors.  Emotional support from family provides love and a sense of sharing the burden.  Social networks assist in managing the stress by providing the people with o A positive social identity o Emotional support o Material aid and tangible services o Access to information o Access to new social contacts and new social roles 7. Recommending Support & Therapy groups  Support groups exist especially for people in similar stressful situations (e.g. people with ostomies, mastectomies, with cancer, other serious diseases, chronic illness and disabilities) or groups for single parents, substance abusers, homicide, bereavement and victims of child abuse. CS2-Outline Notes Prepared by: Mr. Norman 4 6. Enhancing Social Support  Has demonstrated to be an effective moderator of life stress where people believed that they are cared for, loved, esteemed and valued.  It facilitates a person’s coping behaviors.  Emotional support from family provides love and a sense of sharing the burden.  Social networks assist in managing the stress by providing the people with o A positive social identity o Emotional support o Material aid and tangible services o Access to information o Access to new social contacts and new social roles 7. Recommending Support & Therapy groups  Support groups exist especially for people in similar stressful situations (e.g. people with ostomies, mastectomies, with cancer, other serious diseases, chronic illness and disabilities) or groups for single parents, substance abusers, homicide, bereavement and victims of child abuse. CS2-Outline Notes Prepared by: Mr. Norman 4