All YOU EVER WANTED TO KNOW ABOUT STRESS

1. All YOU EVER WANTED TO KNOW ABOUT STRESS Psychiatric Mental Health Nursing Eve Karpinski, APHN-BC, RN-BC Lecture 1

2. Your psychiatric book does not have a chapter on Stress Adaptation. • Review notes below. • Visit youtube.

3. Youtube sites to review • Stress and Memory • http://www.youtube.com/watch?v=OHl7BewJ0yU • How the Body Works : Center of Emotion and Memory • http://www.youtube.com/watch?v=lZ4mdXAtnEs • How the Body Works : Physical Responses to Emotion • http://www.youtube.com/watch?v=SS_qMHPI0XM • Stress and Stressors • http://www.youtube.com/watch?v=bCtLTVFlhz4 • Stress Management 1 - Stress Exhaustion • http://www.youtube.com/watch?v=sEq7fB9jDyQ

4. Question 1 • How stress are you now? • 1. Not at all. • 2. Mildly • 3. Moderately • 4. Severely What are you feeling related to your stress level?

5. Stress • The word stress lacks a definitive definition. • Adaptation is defined as restoration of homeostasis to the internal environmental system. • Adaptation includes responses directed at stabilizing internal biological processes and psychological preservation of self-identity and self-esteem.

6. Stress as a Transaction Between the Individual and the Environment • Individual’s perception of the event: The way you interpreted the event is how you respond to the event. • Primary appraisal – a judgment about the situation in one of the following ways: • Secondary appraisal – • Precipitating event–

7. The physiological of stress • . “Fight or Flight” Response • When the body encounters a stressor, it prepares itself for “fight or flight.” Identify the adaptation responses that occur in the initial stress • response in each of the physical components listed. • Physical component Adaptation Response • Adrenal medulla • Eye • Respiratory system • Cardiovascular system • Gastrointestinal system • Liver • Urinary system • Sweat glands • Fat cells

8. Releases norepinephrine and epinephrine. Pupils dilate. Secretion is increased from lacrimal glands. Bronchioles dilate. Respiration rate is increased. Increased force of cardiac contraction Increased cardiac output Increased heart rate Increased blood pressure Decreased gastric and intestinal motility Decreased secretions Sphincters contract Increased glycogenolysis and gluconeogenesis Decreased glycogen synthesis Increased ureter motility Bladder muscle contracts Bladder sphincter relaxes Increased secretion Lipolysis

9. Stress Mastery • Stress Mastery is the utilization of coping strategies in the response to stressful situations. • Adaptive coping strategies protect the individual from harm and restore physical and psychological homeostasis. • Coping strategies are considered maladaptive when the conflict being experienced goes unresolved or intensifies.

10. Effects of chronic Stress • Increase Gluconeogenisis • Decrease Immune • Decrease inflammatory response • Retention of sodium and water • Decrease in libido, frigidity and impotence • Increase in blood pressure

11. The parasympathetic nervous system • Relaxation • Body repair and restoration • Lower heart rate • Lower blood pressure • Lower glucose and insulin • Blood directed to digestion • Decrease in oxygen consumption CO2 elimination.

12. Unhealthy Coping Strategies • Smoking • Drugs • Alcohol • Over eating/poor eating habits. • What other unhealthy coping strategies can you think of?

13. Healthy Coping Strategies • Awareness • Relaxation • Meditation • communication with caring other • Problem-solving • Pets • Exercise • Your own thoughts • Laughter • Aromatherapy • Massage • Journaling • Music • Hydro-therapy

14. What are your coping strategies? • Are they healthy strategies?

15. From the following case study, identify the predisposing factors (genetic influences, past experiences, and existing conditions) that influence Robert’s adaptation response. What is the precipitating stressor in this situation? • Robert, age 56, was admitted to the emergency room of a large hospital at 2:00 a.m. after vomiting a large • amount of blood. In doing the admitting assessment, the nurse learned the following about Robert: • His father and brother are both recovering alcoholics. • B. Robert had his first drink at age 12 and has been continually increasing the amount and requency of drinking since that time • C. His mother died of lung cancer when Robert was 23. She was a heavy smoker. Robert smokes three packs of cigarettes a day. • D. He has been hospitalized only once before, about 3 months ago, and diagnosed with an ulcer. • The doctor told him at that time he must stop drinking and smoking in order for the ulcer to heal. • E. Robert is married and has three children. He has a long history of moving from one job to • another, staying only until his drinking interferes with his work performance and attendance. He was fired from his job yesterday and spent the evening and nighttime hours drinking two fifths of bourbon. He was engaged in this activity at the time the hematemesis began. • F. Because of the erratic job history, Robert and his wife experience severe financial difficulties. • His wife shows much concern for Robert’s condition and stays by his side during the emergency admission. She states to the nurse, “I want so much for our marriage to work, but he is drinking more and more all the time and still doesn’t see his drinking as a problem. Every time he gets fired, he blames his boss.”