1. Mosby items and derived items © 2005 by Mosby, Inc. Chapter 30 Stress and Coping

2. Mosby items and derived items © 2005 by Mosby, Inc. Stress Stressors Crisis

3. Mosby items and derived items © 2005 by Mosby, Inc. Fight-or-Flight Response Medulla oblongata Reticular formation Pituitary gland

4. Mosby items and derived items © 2005 by Mosby, Inc. General Adaptation Syndrome (GAS) Alarm reaction Resistance stage Exhaustion stage

5. Mosby items and derived items © 2005 by Mosby, Inc. Reaction to Psychological Stress Primary appraisal: identification Secondary appraisal: coping strategies

6. Mosby items and derived items © 2005 by Mosby, Inc. Coping Mechanisms Compensation Conversion Denial Displacement Identification Dissociation Regression

7. Mosby items and derived items © 2005 by Mosby, Inc. Types of Stress Distress: damages Eustress: protects Work, family, chronic, acute, daily hassles, trauma, crisis Posttraumatic stress disorder (PTSD)

8. Mosby items and derived items © 2005 by Mosby, Inc. Crisis Developmental Situational

9. Mosby items and derived items © 2005 by Mosby, Inc. Neuman’s Systems Model Prevent or reduce stressors “Normal line of defense” Prevention strategies: primary, secondary, tertiary

10. Mosby items and derived items © 2005 by Mosby, Inc. Pender’s Health Promotion Model Avoid negative events Stress-reduction strategies

11. Mosby items and derived items © 2005 by Mosby, Inc. Related Factors Situational factors Maturational factors Sociocultural factors

12. Mosby items and derived items © 2005 by Mosby, Inc. Assessment Subjective findings Objective findings Client expectations

13. Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Compromised family coping Ineffective coping Post-trauma syndrome Disturbed sleep pattern Impaired social interaction

14. Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes – Example: enhanced coping abilities Setting priorities Continuity of care

15. Mosby items and derived items © 2005 by Mosby, Inc. Implementation Health promotion –Exercise –Support systems –Time management –Guided imagery and visualization –Progressive muscle relaxation –Assertiveness training

16. Mosby items and derived items © 2005 by Mosby, Inc. Implementation (cont'd) Health promotion (cont'd) –Journal writing –Workplace stress management Acute care –Crisis intervention

17. Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Client expectations Response to interventions