1. Human Response to Threat, Stress, and Anxiety NUR 210 Nursing Concepts, Processes, and Skills

2. General Adaptation Syndrome “GAS” Hans Selye (1947( Stressors: Internal and External stimuli that cause stress –Internal: originate inside a person –External: originate outside a person

3. STRESS Any situation in which a nonspecific demand requires an individual to respond or take action

4. HOMEOSTASIS Body’s adaptive mechanism to adjust to change and maintain equilibrium Physiological control –nervous –endocrine Adaptation: change in response –self-regulatory –automatic –negative feedback

5. MAJOR MECHANISMS OF ADAPTATION Medulla Oblongata Reticular Formation Pituitary Gland

6. MODELS OF STRESS Response-Based Adaptation Stimulus-Based Transaction-Based

7. RESPONSE_BASED MODEL Selye’s GAS model Stress nonspecific response to a stressor Physiological response Does not consider individual responses

8. ADAPTATION MODEL Experience stress/anxiety when unable to cope with a stressful event FOUR FACTORS: –ability to cope with stress –practice/norms of peer group –ability of social environment to assist –what resources are available to help

9. STIMULUS_BASED MODEL Holmes and Rahe (1976) Focuses on disturbing/disruptive events within an environment No flexibility, does not allow for individual differences in perception and response

10. TRANSACTION-BASED MODEL Lazarud and Folkman (1984) Persons and environment dynamic/interactive relationship Individual perceptional response rooted in psychological and cognitive process –beliefs –perception of control –uncertainty

11. RESPONSE TO STRESS Physiological functioning Personality Behavioral characteristics Nature of the stressor Influenced by: –intensity, scope, duration –# and nature of other stressors –predictability

12. PHYSIOLOGICAL RESPONSES Local Adaptation Syndrome (LAS) –response of a body tissue, organ, etc. to the stressor reflex pain response inflammatory response General Adaptation Syndrome (GAS) –a defense response of the whole body to stress alarm reaction resistance stage exhaustion stage

13. RESPONSES TO STRESS Psychological response Developmental factors Intellectual factors Emotional Behavioral Issues Family factors Lifestyle issues Sociocultural issues Spiritual considerations

14. ASSESSMENT Physiological indicators Psychological indicators Developmental indicators Emotional Behavioral indicators Intellectual indicators

15. ASSESSMENT Family indicators Lifestyle indicators Sociocultural indicators Spiritual indicators

16. NURSING DIAGNOSIS Requires the presence of appropriate defining characteristics Identify the probable etiology for the problem

17. PLANNING Select nursing interventions to promote adaptation to stress Consult Involve client, family and peers Identify community resources

18. IMPLEMENTATION Health Promotion –time management, exercise, diet, rest, support system Acute Care –crisis intervention Restorative Care –humor, enhancing self-esteem, relaxation techniques, spirituality, stress management workshops

19. EVALUATION Reassess presence of new or recurring stress related problems/symptoms Determine if change in care promoted the client’s adaptation to stress Ask of the client’s expectations are being met