1. Stress & Coping
Chapter 42

3. Types of Stress
External/ Internal
Developmental
Situational

4. General Adaptation Syndrome (GAS)

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

6. 2nd Stage of GAS
Resistance Stage
Attempts to maintain homeostasis

7. 3rd Stage of GAS
Exhaustion or Recovery Stage

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

9. Anxiety
Mild
Moderate
Severe
Panic

10. Fear
Anger
Depression

11. Group Work- Defense mechanisms
Compensation
Denial
Displacement
Identification
Intellectualization
Minimization

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

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

14. Assessment Nursing history Physical examination
Emotional & behavioral responses
Cognitive responses

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

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

17. 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.

18. Encouraging Health Promotion Strategies
Exercise
Nutrition
Sleep
Time Management

19. 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

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

21. 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

22. QUESTIONS????