Nursing Level I

• what a person thnks about themselves
• subjective
• un/conscious thoughts, attitudes, and perceptions about one's self
• directly affects self-esteem
• affects management of all situations and relationships

• ever-changing
• influenced by family, caregivers, culture
• low in adolescents/geriatrics
• high in childhood/adulthood
• physical appearance
• vocational performance
• intellectual functioning
• being liked by others
• ability to cope and resolve

• thoughts/feelings about lifestyle, health, and illness
• Awareness ie the effects of non-verbal communication
• personal values and expectations
• ability to convey non-judgmental attitude
• attitudes about cultural differences

• emotional assessment of self-concept that reflects the overall sense of being capable, worthwhile, & competent
• foundation for self-esteem is established during early life experiences
• dependent upon stress day to day, high to low

recognize: personal identity, body image, role performance

• individuality
• wholeness
• consistency over time and in different situations
• what makes a perosn different
• necessary for intimate relationships
• racial & cultural identity
• (vulnerable at adolescence)

• physical appearance
• structure/function
• sexuality
• youthfulness
• health/strength
• aging
• race/ethnicity
• culture

• cognitive growth
• devaluing others
• physical development

• Western Culture= Youth
• Eastern Culture= Age

• Reinforcement-extinction
• Inhibition
• Substitution
• Imitation
• Identification

Behavior becomes common or avoided depending on whether approved or punished

learn to refrain even when tempted

Replace one behaviorwith another, same gratification

Acquire knowledge, skill, etc. from other members

Internalize values, behavior of role models

• Stage of Development
• Family & Culture
• Resources
• -internal/external
• History of Success/Failure
• Illness
• Stressors

• loss of body part
• unrealistic body ideal

• conflict
• ambiguity
• strain
• development
• mastery
• overload

• caregiver
• or child
• or parent

no defining lines

feel inadequate to full fill the role

• under or over developed
• unevenly developed

• difficulty reaching mastery
• only master one role

unmanageable amount of responsibility

• lack of positive feedback from significant other
• repeated failures

• declining physical, mental or sensory abilities
• identity confusion-unrealistic ideal self

• multiple roles
• role ambiguity
• developmental tasks
• caring for others
• empty nest
• beginning physical decline

• Dependence
• Devaluation
• Depersonalization
• Functional Impairments
• Lack of Control
• Multiple Losses
• -finances, loved ones, health status

• Physical or behavioral response that preserves integrity and stability of a person
• protects from harm
• strengthens ability to deal with challenging situations
• mobilizing resources
• emowerment

• Physical or behavioral response that causes disruption of integrity or persistent instability
• overuse of soem mechanisms
• conflict continues on unresolved or intensifies
• self-destructive behaviors: alcohol/drugs, tobacco, indiscriminate sexual behaviors

• effort to manage psychological stress of daily living
• may differ from one time of stress to another
• may use combination of strategies
• goal to use strategies/mechanisms that decrease unnecessary stress

• emotional conflicts and stressors are dealt with by meeting the needs of others
• Dennis Quaid example

taking drives or impulses that are personally or socially unacceptable into activities that are constructive

voluntarily blocking awareness of unpleasant feelings and experiences

avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain

Transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute

attempting to avoid expressing emotions of a stressful situation by using logic, reasoning, and analysis

• seeing your own unwanted feelings in other people
• projecting one's feelings or impulses that one finds unacceptable to himself/herself onto another person

Taking on the beliefs and values of someone else

separating feelings or emotions from a thought or memory

making a behavior acceptable as a way of dealing with stressors

• overcompensation
• prevents unacceptable behaviros by exaggerating opposite thoughts or behaviors

returning to behaviors that were once acceptable but are no longer acceptable in the current stage of development

involuntary, unconscious blocking of unpleasant feelings/experiences

• somataziation
• changing the anxiety into a physical symptom

actions that psychologically undo wrongdoings for the wrongdoer

making up a real or imagined deficiency by emphasizing an asset

assuming another's qualities, actions, characteristics

focusing on the good things and ignoring the limitations or the reality of a thing or an issue

• subjective sense of numbing, and a reduced awareness of one's surroundings
• separating thoughts activities from conscious awareness

• Passive-aggressive behavior: defense of rights by expressing resistance to social/occuptational demands
• Acting-out behaviors: not coping-giving in to the pressure to misbehave

• decrease stress producing situations
• increase resistance to stress
• learn skills that reduce physiological response to stress

• exercise
• support systems
• time management
• guided imagery/visualization
• progressive muscle relaxation
• assertiveness training
• journal writing
• workplace stress management

State created by a change in the environment that is perceived as challenging, threatening, or damaging to one's well being

• alarm reaction
• resistance stage
• recovery or exhaustion stage

• perceived threat to body or psyche
• mild, moderate, severe, panic

• sympathetic nervous system: fight or flight
• Psych/Cognition: increased alertness, sharper observations, grasps increased sensory input
• Behavioral: irritable, restless, repeated questions

• physical: increased SNS response
• Psych: perceptual field constricted, focused on specific details
• Behavioral: increased movement, more intense irritability

• Pronounced Fight or Flight
• Processing scattered, disorganized, purposeless activity
• Hyperactive behavior

• can be a disorder
• s/s may mimic heart attack
• perceptions grossly distorted
• intense urge to escape or fight
• may be a danger to self or others
• speech difficulties
• inability to sleep, delusions, and hallucinations

• panic disorder
• generalized anxiety disorder
• post-traumatic stress disorder
• social phobia
• specific phobia
• obsessive-compulsive disorder

• sense of caring
• therapeutic self
• respect
• active listening

person is under stress only if he/she evaluates event/circumstance as personally significant (subjective)

stress that is deemed healthful or giving one the feeling of fulfillment; protects health

state of extreme necessity or misfortune; damaging stress

• increased pain perception
• decreased or abnormal immune response
• causes disease
• decreased compliance with treatment programs
• interferes with learning if severe and/or prolonged

• Permission to feel/validate emotion
• Spiritual Support
• Teaching
• Modify the Environment
• Empower the patient
• Medications

• old coping mechanisms
• aware of unrecognized strengths & resources or functioning deteriorates
• situation for danger or opportunity; decline or growth
• focus on problem; approach w/ problem solving
• mental connection between event and response is imperative
• awareness of feelings
• explore/identify coping mechanisms
• facilitate social interactions/contacts