NRS Exam #3

• is a localized response of the body to stress.
• It involves only a specific body part (tissue, organ) instead of the whole body.
• The stress precipitating the LAS may be traumatic or pathologic.
• LAS is a primarily homeostatic short-term adaptive response.
• Although the body has many localized stress responses,
• Two most common responses that influence nursing care are
• the reflex pain response and the inflammatory response.

• The reflex pain response is a response of the central nervous system to pain.
• It is rapid and automatic, serving as a protective mechanism to prevent injury.
• The reflex depends on an intact, functioning neurologic reflex arc and
• involves both sensory and motor neurons. For example, if you step into a
• bathtub of dangerously hot water, your skin senses the heat and
• immediately sends a message to the spinal cord. A message is then sent
• to a motor nerve, which activates the muscles in your leg to pull back
• your foot. All of this happens before you consciously realize that the
• water is too hot to be safe.

• is a local response to injury or infection.
• It serves to localize and prevent the spread of infection and promote wound healing.
• When you cut your finger, for example, you often develop the symptoms of the inflammatory response—
• pain, swelling, heat, redness, and changes in function.

• The general adaptation syndrome (GAS) is a biochemical model of stress developed by Hans Selye (1976).
• The GAS describes the body's general response to stress, a concept essential in all areas of nursing care.
• The three stages in the GAS are:
• the alarm reaction, resistance, and exhaustion.

Anxiety is a vague, uneasy feeling of discomfort or dread accompanied by an autonomic response

• Mild anxiety is present in day-to-day living.
• It increases alertness and perceptual fields (eg, vision and hearing) and motivates learning and growth.
• Although mild anxiety may interfere with sleep, it also facilitates problem solving.
• Mild anxiety is often manifested by restlessness and increased questioning.

• Moderate anxiety: narrows a person's perceptual fields so
• that the focus is on immediate concerns, with inattention to other
• communications and details. (quavering voice, tremors, increased muscle tension, a complaint of
• “butterflies in the stomach,” and slight increases in respirations and
• pulse.)

• Anxiety often is managed without conscious thought by coping mechanisms, which are behaviors used to
• decrease stress and anxiety.

• Crying, laughing, sleeping, cursing
• Physical activity, exercise
• Smoking, drinking
• Lack of eye contact, withdrawal
• Limiting relationships to those with
• similar values and interests

• A person attempts to overcome a perceived weakness by emphasizing a more desirable trait or
• overachieving in a more comfortable area. Ex: A student who has difficulty
• with academics may excel in sports

• A person refuses to acknowledge the presence of a condition that is disturbing.
• Despite finding a lump in her breast, a woman does not seek medical treatment.

• A person transfers (displaces) an emotional reaction from one object or person to another object or
• person. An employee who is angry with a coworker kicks a chair.

• A person incorporates qualities or values of another person into his or her own ego structure.
• This mechanism is important in the formation of conscience during childhood.
• An older sibling tells his preschool sister not to talk to strangers, expressing his parents'
• values to his younger sister.

• A person's thoughts or impulses are attributed to someone else.
• A person who denies any sexual feelings for a coworker accuses him of sexual harassment.

• A person tries to give a logical or socially acceptable explanation for questionable behavior
• (“behavior justification”). A patient who forgot to keep a healthcare appointment says, “If patients didn't have to wait 3 months
• to get an appointment, they wouldn't forget them.”

• A person develops conscious attitudes and behavior patterns that are opposite to what he or she would really like to do.
• A married woman is attracted to her husband's best friend but is constantly rude to him.

• A person returns to an earlier method of behaving.
• Children often regress to soiling diapers or demanding a bottle when they are ill.

• A person voluntarily excludes an anxiety-producing event from conscious awareness.
• A father may not remember shaking his crying baby.

• A person substitutes a socially acceptable goal for one whose normal channel of expression is blocked.
• Ex: An individual who is aggressive toward others may become a star football player.

• An act or communication used to negate a previous act or communication
• A husband who was physically abusive to his wife may bring her an expensive present the next day.

is a developmental crisis, occurs as a person progresses through the normal stages of growth and development from birth to old age. Within each stage, certain tasks must be achieved to resolve the crisis and reduce the stress.

• The infant learning to trust others
• The toddler learning to control elimination
• The school-aged child socializing with peers
• The adolescent striving for independence
• The middle-aged adult accepting physical signs of aging

• is different from developmental stress. It does not occur in predictable patterns as one progresses
• through life. Rather, situational stress can occur at any time, although the person's ability to adapt may be strongly influenced
• by his or her developmental level.
• Examples of situational stress, which may be either positive or negative:
• Illness or accident
• Marriage or divorce
• Loss (belongings, relationships, family member)
• New job
• Role change

Psychosocial stressors include both real and perceived threats.

• Accidents: cause stress for the victim, the person who caused the accident, and the families of both
• Stressful or traumatic experiences of family members and friends
• Horrors of history, such as Nazi concentration camps, the dropping of the atomic bomb on Hiroshima, and
• the Sept. 11, 2001, terrorist attacks
• Fear of aggression or mutilation, such as muggings, rape, murder, and terrorism
• Events of history that are brought into our homes through television, such as wars, earthquakes, and violence in schools
• Rapid changes in our world and the way we live, including changes in economic and political structures and rapid advances in technology