NURS 4200 CH 7.pdf

Chapter 7 Stress Management Overview Stress Management: The inability to cope with perceived demands or threats to mental, emotional, and spiritual well-being. Types of Stress: Physiologic and emotional/psychologic stressors, both positive or negative. Prevalence of Stress: Stress is more pre...

Chapter 7 Stress Management Overview Stress Management: The inability to cope with perceived demands or threats to mental, emotional, and spiritual well-being. Types of Stress: Physiologic and emotional/psychologic stressors, both positive or negative. Prevalence of Stress: Stress is more prevalent in women, anxiety and depression, and men are more likely to die from stress-related illness. Perception of Stressors: Perception influences response to stress. Stressors: Physiological, emotional/psychologic, and can be real or imagined. Stress Response: Our bodies react with the same stress response to both real and imagined stress. Importance of Stress: Stress is key for survival, but too much is detrimental. Stressor Variables: Type, duration, intensity, and factors affecting response to stress. Key Personal Characteristics: Resilience, hardiness, attitude, and optimism. Interrelation of Body Systems: Neurochemical links among the nervous, endocrine, and immune systems. J.R.'s Case Study: His wife is planning lifestyle changes for diabetes. The wife's emotional response to stress is a reflection of his resilience, hardiness, attitude, and optimism. Stress Response and its Impact on Health Physiologic Responses to Stress Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, releasing corticotropin-releasing hormone (CRH) and stimulating the anterior pituitary to produce adrenalocorticotropic hormone (ACTH). The adrenal cortex secretes corticosteroids, which increase blood glucose levels, potentiate catecholamine action on blood vessels, and inhibit the inflammatory response. Corticosteroids are essential for the stress response, supporting the body’s adaptive response to a stressor. Impact of Stress on Health Chronic stress can cause immunosuppression, decreasing the number and function of natural killer cells, lymphocyte proliferation, cytokines, and phagocytosis. Chronic stress is linked to leading causes of death, impaired cognitive function, and negative changes in lifestyle behaviors. Stress and Nursing Chronic, unrelieved stress is linked to leading causes of death, impaired cognitive function, and negative changes in lifestyle behaviors. Behaviors and Actions to Deal with Stress Coping strategies are crucial in managing stress, with positive strategies including exercise and spending time with friends and family, and negative strategies like substance abuse or denial. Coping strategies include emotion-focused coping, problem-focused coping, and relaxation strategies. Breathing deeply and slowly can help decrease stress levels in body and mind. Patient Stress Management Strategies J.R., a business executive, expresses concern about a heart attack and hyperventilation. Immediate intervention includes using electrodes or sensors to measure breathing, heart rate, and muscle activity. Relaxation strategies include biofeedback, meditation, guided imagery, and massage. Biofeedback involves focused focus on a sound, object, visualization, breath, or movement. Meditation involves generating images that have a calming effect on the body and incorporating all senses to create physiologic and emotional changes. Guided imagery involves images suggested by another person or technology. Imagery can be used to target a disease, problem, or stressor, enhance performance, and deal with stressful or painful procedures. Massage is a form of meditation that can reduce tension or pain, promote sleep, stimulate circulation, and consider cultural and social beliefs. Prayer is a form of meditation that may relieve stress, increase perspective, strength, and inspiration. J.R.'s busy lifestyle, including his work schedule and coffee consumption, limits his exercise. Stress response symptoms include physical, behavioral, and cognitive symptoms.  Coping and relaxation strategies should be discussed with J.R., including demonstrating positive coping strategies, reducing stress levels, and enhancing coping and adaptation. J.R. feels that meditation goes against his religious beliefs. A patient diagnosed with cancer should be advised to talk to family and friends about negative feelings, go away for a few days, seek information about the cancer and treatment options, and wait for the oncologist's recommendations for treatment.