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Mental Health > Week 6 > Flashcards

Week 6 Flashcards

1
Q

Why study stress?

A

People exposed to high levels of stress as children particularly during stress sensitive developmental periods – have a greater incidence of all mental illness as adults.

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2
Q

What is the nurses role in stress?

A

to intervene to reduce stress by promoting a healing environment, facilitating successful coping and developing future coping strategies

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3
Q

What are 2 types of stimuli of stress?

A

psychological or physical

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4
Q

What has stress been seen as in the last century?

A

a response, a stimulus, or a transaction

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5
Q

Who were the pioneers of the study of stress?

A

Cannon and Selye

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6
Q

What is Cannon known for?

A

coined term homeostasis and ‘fight or flight’ response

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7
Q

Cannon believed that changes in _____ are perceived as threats to perusal integrity or safety and signal a ______

A

environment

compensatory

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8
Q

What is the compensatory response mediated by?

A

Sympathetic nervous system (part of ANS)

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9
Q

What things are fundamental to the stress response?

A

emotions (fear, anger)

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10
Q

The theory of fight or flight.

A

we respond to perceived threats all the time and that this response puts a physical and mental strain on our bodies

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11
Q

What does GAS stand for?

A

General adaptive syndrome

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12
Q

What did Selye contribute on stress?

A
  • GAS
  • fight or flight response along with differentiation between stress (nonspecific response of the body to any demand placed on it) and stressors (events that initiate the response; physical, psychological or social)
  • the perception of a stressor triggers an automatic total-body response.
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13
Q

Define stress.

A

nonspecific response of the body to any demand placed on it

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14
Q

Define stressors.

A

events that initiate the response (physical, psychological or social)

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15
Q

What are the 3 stages of GAS

A
  1. Alarm stage
  2. Resistance stage
  3. Exhaustion stage
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16
Q

What happens in the alarm stage of GAS?

A
  • all systems respond
  • cortex and hypothalamus sigmal adrenal glands to release CATECHOLAMINE ADRENALIN; increase SNS activity thus increased HR, resp., BP, pupils dilate, blood shunted away from digestive tract (dry mouth and kidneys
  • hypothalamus sends messages to adrenal cortex which produces CORTICOSTEROIDS to increase muscle endurance and stamina
  • ENDORPHINS are released decreasing sensitivity to pain
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17
Q

What do corticosteroids inhibit?

A

reproduction
growth
immunity

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18
Q

What happens in the resistance stage?

A
  • stressor continues for hours or days

- adaptation stage (optimal resistance to stress occurs) or moves to exhaustion

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19
Q

What happens in the exhaustion stage?

A
  • resources are depleted and stress becomes chronic

- psychological and physiological responses occur maybe even death

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20
Q

What is Lazarus and Folkman’s theory on stress?

A

The body CANNOT DIFFERENTIATE between the energy generated by positive and negative stimuli

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21
Q

Define distress.

A

negative stimuli, darting energy tat leads to anxiety, depression, confusion, helplessness, hopelessness, fatigue; may be caused by stressors such as death in family, financial overload, school or work demands

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22
Q

Define eustress.

A

positive, beneficial energy that motivates and leads to feelings of happiness, hopefulness, purposeful movement; buying a new car, birth of a baby

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23
Q

Who focuses on distress and eustress?

A

Lazarus and Folkman

24
Q

What is the neurotransmitter stress response?

A
  • serotonin synthesis is more active during times of stress

- may impair serotonin receptor sites and brain’s ability to use serotonin

25
Q

What is the immune stress response?

A
  • Interaction between nervous system and immune system during alarm phase of GAS
  • Negatively affects body’s ability to produce factors
  • Corticosteroids are realized in response to stress and inhibit the immune system
26
Q

What are physical stressors?

A

changes to environmental conditions (trauma, excessive cold or heat).

27
Q

What are physical condition stressors?

A

infection, hemorrhage, hunger, pain

28
Q

What are psychological stressors?

A

cognitive or emotion-based changes (divorce, loss of a job, financial issues, death of a loved one, retirement, fear of terrorist attack, marriage, new baby, unexpected stress).

29
Q

Name 3 types of stressors.

A

physical
physical condition
psychological

30
Q

What effects perception of stress?

A

age, gender, culture, life experience, and lifestyle

31
Q

What are some mediators of stress?

A
  • Individual temperament/personality

- Social support (groups, culture, spirituality/religion)

32
Q

What scale can be used to measure stress?

A
  • Social Readjustment Rating Scale (Holmes and Rahe, 1967, 1978, 1997).
  • measure level of + or - stressful life events over 1 year in questionnaire
33
Q

What is assessed when covering coping styles (Rahe, 1995)

A

4 personal attributes:

  1. Health sustaining habits
  2. Life satisfactions
  3. Social supports
  4. Effective healthy responses to stress
34
Q

What stress relieving techniques can the nurse use to relieve stress?

A
  1. deep breathing
  2. progressive muscle relaxation
  3. reduce caffeine
  4. meditation (hypometabolic state)
  5. Guided imagery
  6. Biofeedback
  7. Exercise
  8. Cognitive reframing
  9. Journaling
  10. Humour
  11. Mindfulness
35
Q

Define hypometabolic state.

A

a rare state of reduced metabolism with symptoms resembling hypothyroidism but with some tests for thyroid gland function normal; also used to describe the reduced metabolic activity seen in true hypothyroidism.

36
Q

What is biofeedback?

A

uses sensitive instrumentation (recording device) and provides information regarding muscle activity, brain waves, skin temperature, heart rate, blood pressure, other bodily functions.

37
Q

Define Cognitive Reframing.

A

change perceptions of stress by reassessing a situation and replacing irrational beliefs; reframe a disturbing event or experience as less disturbing and to give the patient a sense of control over the situation.

38
Q

When does disaster and crisis occur?

A
  • when normal coping fails
  • disrupts normal psychological homeostasis
  • inability to function as usual
  • acute TIME-LIMITED
39
Q

What do outcomes of crisis depend on?

A

Realistic perception of the event.
Adequate situational supports.
Crisis intervention

40
Q

Describe crisis intervention.

A

process focused on resolution of the immediate problem through personal, social, environmental resources.

41
Q

Where are coping mechanism acquired from?

A

culture
modelling
life opportunity
adaptive coping response

42
Q

How long does crisis last?

A

TIME LIMITED

4-6 weeks and resolve on their own

43
Q

What did Lindemann study?

A

grief reaction; focused on PREVENTATIVE INTERVENTION

44
Q

Who advanced crisis theory and interventions?

A

Caplan

45
Q

Anguilera and Mesnick framework for nurses for crisis assessment and intervention.

A

examines individual’s reactions, education, coping, problem-solving .

46
Q

What are the 7 stages of Albert R. Roberts-Seven Crisis Intervention Model?

A
  1. Plan and assess
  2. Rapport/therapeutic rel’n
  3. Identify problems
  4. Deal with emotions through active listening and validation
  5. Generate and explore alternatives
  6. Develop action plan
  7. Follow-up plan/agreement
47
Q

What is a maturational crisis?

A

process of maturation that occurs across the life cycle; each developmental stage represents a maturational crisis; leaving home, birth of a child, retirement, death of a parent.

48
Q

Why are stages of development so relevant in crisis?

A

(maturational crisis)

  • new developmental stage reached
  • old coping skills no longer effective
  • leads to increased tension and anxiety
49
Q

What is a situational crisis?

A

situational: extraordinary, external, often unanticipated

50
Q

What is an adventitious crisis?

A
  • unplanned and accidental; natural disaster, national disaster, crimes of violence, can leads to ptsd
51
Q

What are Caplan’s phase 1 of crisis?

A 
Conflict or problem.
Self-concept threatened.
Increased anxiety.
Use of problem-solving techniques and defence mechanisms.
Resolve conflict or problem.
Reduce anxiety.
52
Q

What are Caplan’s phase 2 of crisis?

A 
Defence mechanisms fail.
Threat persists.
Anxiety increases.
Feelings of extreme discomfort.
Functioning disorganized.
Trial-and-error attempt to solve problem and restore normal balance.
53
Q

What are Caplan’s phase 3 of crisis?

A

Trial-and-error attempts fail.
Anxiety can escalate to severe level or panic.
Automatic relief behaviours mobilized (i.e., withdrawal and flight).
Some form of resolution may be devised(i.e., compromising needs or redefining situation).

54
Q

What are Caplan’s phase 4 of crisis?

A
  • Problem is unsolved and coping skills ineffective
  • Overwhelming anxiety
  • Possible serious personality disorganization, depression, confusion, violence against others, or suicidal behaviour
55
Q

slide 40

A

slide 40

Mental Health (5 decks)

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