Stress & Coping Chapter 42

Types of Stress External/ Internal Developmental Situational

General Adaptation Syndrome (GAS)

Initial stage of GAS Alarm Stage – Fight or Flight Stimulation of sympathetic nervous system Signs & Symptoms

2nd Stage of GAS Resistance Stage Attempts to maintain homeostasis

3rd Stage of GAS Exhaustion or Recovery Stage

Indicators of Stress Physiological Psychological Cognitive Clinical Manifestations pg. 1082 Psychological Cognitive

Anxiety Mild Moderate Severe Panic

Fear Anger Depression

Group Work- Defense mechanisms Compensation Denial Displacement Identification Intellectualization Minimization

Defense Mechanisms ( cont.) Projection Rationalization Reaction formation Regression Repression Sublimation

Coping Strategies Adaptive coping - Making healthy choices that decrease negative effects of stress. Maladaptive coping – Does not promote adaptation.

Assessment Nursing history Physical examination Emotional & behavioral responses Cognitive responses

Diagnosing Anxiety Caregiver Role Strain Compromised Family Coping Defensive Coping Disabled Family Coping Ineffective Coping Ineffective Denial

Planning Decrease or resolve anxiety Increase ability to manage or cope with stressful events or circumstances Improve role performance

Nursing Process Ineffective coping R/T ineffectiveness of usual coping mechanisms AEB verbalization of inability to cope. Will demonstrate effective coping mechanisms by completion of program.

Encouraging Health Promotion Strategies Exercise Nutrition Sleep Time Management

Minimizing Stress and Anxiety Listen attentively Atmosphere of warmth, trust, care Include client in plan of care Promote feeling of safety and security Minimize additional stressors Help with recognition of stressors and coping mechanisms

Relaxation Techniques (See pg. 341-345) Breathing Massage Progressive relaxation Imagery Biofeedback Mediation Therapeutic touch Music Humor & laughter

Stress Management for Nurses Daily relaxation Regular exercise Assertiveness techniques Learn to accept failure Accept what cannot be changed Develop collegial support groups Participate in professional organizations Seek counseling if indicated

QUESTIONS????