Focus on StressWhy Study Stress?HistoryStressTypes of StressExamples of StressorsFactors Affecting Response to StressorsResilience and AttitudeSlide 9General Adaptation Syndrome (GAS)GAS Alarm ReactionGAS ResistanceGAS ExhaustionSlide 14Physiologic ResponseInterrelation of Body SystemsNervous SystemSlide 18Slide 19Slide 20Slide 21Hypothalamic-Pituitary-Adrenal AxisEndocrine SystemFight-or-Flight ReactionSlide 25Slide 26Slide 27Immune SystemSlide 29Slide 30Slide 31Slide 32Effects of Stress on HealthSlide 34Slide 35Slide 36Slide 37CopingSlide 39Slide 40Slide 41Slide 42Slide 43Relaxation StrategiesSlide 45Relaxation Strategies Relaxation BreathingSlide 47Relaxation Strategies MeditationRelaxation Strategies ImagerySlide 50Slide 51Relaxation Strategies Music for RelaxationSlide 53Relaxation Strategies Muscle RelaxationRelaxation Strategies MassageNursing AssessmentSlide 57Nursing DiagnosesSlide 59Nursing ImplementationSlide 61Slide 62Strategies for Clinical PracticeSlide 64Slide 65Stress-Busting Kit on Student CDCase StudySlide 68Slide 69Slide 70Slide 71Discussion QuestionsSlide 73Focus on StressFocus on Stress(Relates to Chapter 8, “Stress and Stress Management,” in the textbook)Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.2Why Study Stress?Why Study Stress?•Linked to leading causes of deathCancer AccidentsSuicideCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.3HistoryHistory•Hans Selye identified stress as a response of the body to any demand made on it.Research focused on physiologic stressors, or what Selye called “diverse nocuous agents.” Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.4StressStress•Response to demands•Perception that one cannot adequately cope with demands being made on person or well-being •Perception and personal meaning of how a potential stressor influences responseCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.5Types of StressTypes of Stress•Physiologic or emotional/psychologic stressors•Type, duration, and intensity of a stressor influence an individual’s adaptive response.Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.6Examples of StressorsExamples of StressorsPHYSIOLOGIC EMOTIONAL/PSYCHOLOGIC • Skin burn • Diagnosis of cancer • Chronic pain • Marital problems • Hypothermia • Failing an examination • Infectious disease •Inadequate financial resources to meet needs • Excessive noise • Grieving the loss of a family member • Starvation • Caring for a disabled child • Running a marathon • Winning or losing an athletic event • Birth of a baby • Winning the lottery Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.7Factors Affecting Response to Factors Affecting Response to StressorsStressors•Internal and external influences (Table 9-2 in the textbook)•Key personal characteristicsResilienceAttitudeCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.8Resilience and AttitudeResilience and Attitude• ResilienceResourceful, flexible, and having available source of problem-solving strategies •AttitudePositive emotional attitude can prevent disease and prolong life.Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.9 A 46-year-old patient is told by his doctor that he has type 2 diabetes and will require treatment and lifelong changes in his lifestyle. The patient is very distressed but asks for information about the illness, visits the local office of the American Diabetes Association, and elicits help and suggestions from his family in planning lifestyle changes. The nurse recognizes that this patient’s response to stress is mediated by the personal characteristic of: 1. Attitude.2. Optimism. 3. Hardiness.4. Sense of coherence.Audience Response QuestionCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.10General Adaptation General Adaptation Syndrome (GAS)Syndrome (GAS)•Physical response to stress•GAS has three stages:Alarm reactionStage of resistanceStage of exhaustion Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.11GAS GAS Alarm ReactionAlarm Reaction•Perception of a stressor physically or mentally•Fight-or-flight response is initiated.•Temporarily decreased resistance May result in disease or death if the stress is prolonged and severe Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.12GASGASResistanceResistance•Ideal transition from alarm to resistance is quick.•Few overt physical signs and symptoms occur compared with the alarm stage.•Adaptation occurs or person advances to exhaustion.Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.13GASGASExhaustionExhaustion•Final stage of GAS•Occurs when all energy for adaptation has been exhaustedCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.14GASGASExhaustionExhaustion•Physical symptoms of alarm reaction may briefly reappear in final effort by body to survive.•This stage can be reversed by external sources, such as medication.Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.15Physiologic ResponsePhysiologic Response•Stress affects three interrelated systems (nervous, endocrine, and immune).Activation of these systems affects other systems (cardiovascular, respiratory, gastrointestinal, renal, and reproductive). Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.16Interrelation of Body Interrelation of Body SystemsSystemsCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.Fig. 8-3. Neurochemical links among the nervous, endocrine, and immunesystems. The communication among these three systems is bidirectional.17Nervous SystemNervous System•Cerebral cortexPlans a course of action after evaluating stressor in light of past experiences and future consequencesCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.18Nervous SystemNervous System•Limbic systemMediator of emotions, feelings, and behavior that ensures survival and self-preservationCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.19Nervous SystemNervous SystemCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.20Nervous SystemNervous System•Reticular formationContains the reticular activating system to send alertness impulses to limbic system and