3) Exhaustion - not always present if stressor goes away during resistance phase
Body cannot differentiate between positive and negative stressors, nor physical, Psychological or Social stressors
Describe the Stressors cycle that evolves to affect the immune system
1) Corticosteroids (generated by the adrenal cortex) in response to ACTH released in response to stress WILL inhibitreproduction, growth and immunity.
2) Stress also causes the release of cytokines by immune cells, which activate and recruit other immune cells, which activate immunity.
3) But the activation is limited since the cytokines also cause the further release of corticosteroids, which (from 1) inhibit immunity.
T/F: Elevated cytokines and immune activation are often seen during episodes of deep depression.
True
Stress causes serotonin synthesis to become more active, which would be consistent with antidepressive effects, i.e. more serotonin is "good". What mediates this and what is its effect?
Corticosteroids also released by stressors is "believed" to impair serotonin receptor sites. Researchers don't fully understand the relationship, but Stress can lead to Depression.
PMR (Progressive Muscle Relaxation) is used by...
Tensing groups of muscles, beginning with the feet and ending with the face, as tightly as possible for 8 seconds and suddenly releasing them.
Good for tension headaches and psychiatric disorders, especially those with an anxiety component.
Benson's Relaxation Technique is...
1) Relax all muscles starting at feet.
2) TM on a word, like peace, joy, love for 10-20 minutes
It quiets the sympathetic nervous system.
Breathing exercises
Use abdominal or diaphragmatic breathing
Hold breath for 3 seconds and continue for 2-5 minutes
Regular exercise helps with all psychiatric and comorbid conditions except...
Bipolar disorder
4 months of regular aerobic exercise produces a similar relief from depression as does the same period with...
a SSRI antidepressant
Cognitive reframing techniques
If I chose to study for this course, I will increase my chances of success.
What positive things came out of this situation?
What did I learn from this situation?
What would I do in a different way?
Journaling
Diary of daily events, noting which things put a strain on energy and time, which trigger anger or anxiety.
LONG-TERM (CHRONIC)EFFECTS of Stress via HYPAC (Hypothalamus-Pituitary-Adrenal Cortex)
Immune system compromise
Atherosclerosis
Depression
High blood pressure
Insulin insensitivity
Obesity
High blood lipids
Protein breakdown
• Blood
• Bones (osteoporosis)
• Muscle (heart, too)
• Immunoglobulin
LONG-TERM (CHRONIC)EFFECTS of Stress via SAM (Sympathetic-Adrenal-Medulla)
High resting heart rate
Heart disease
Platelet aggregation
Reactive high BP
High cholesterol
High triglycerides
Renal/hepatic problems
Glucose intolerance
Chronic muscle tension
Hyperventilation (chronic)
Digestive problems
Chronic anxiety/anger
Hopi of North America express depressive states through
feelings of guilt, shame, and sinfulness.
Puerto Ricans and other Hispanics describe XXX as indicators of a depressive affect.
irritability, rage, and "nervousness"
The overwhelming majority of Asians, Africans, and Central Americans
"not only express subjective distress in somatic terms, but actually experience this distress somatically, such that psychological interpretations of suffering may not be much use cross-culturally."
An effect of stress can attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex and result in a short term increase in:
B. gluconeogenesis
Increase of gluconeogenesis stimulated by release of cortisol ensures increased amounts of glucose are available to the individual. Increased glucose levels heighten and maintain energy levels to meet the demands of a crisis or stressor. Text page: 196
Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex and over the long term effect:
D. Insulin resistance
Insulin resistance and obesity are considered long-term sequalae of the high blood glucose levels incurred when the body responds to stress. Text page: 196
High-quality social support relationships have qualities that include
B. reciprocal closeness.
High-quality social support relationships are relatively conflict free, and are close, confiding, and reciprocal. Text page: 199
The relaxation response calls upon:
D. parasympathetic activation.
Sympathetic activation prepares the individual for fight or flight response. Parasympathetic activation has the opposite effect. Text page: 204
An effective stress-reduction technique a nurse might teach an individual with performance anxiety is
B. diaphragmatic breathing.
Changing breathing pattern can be highly effective in aborting or mitigating the high anxiety level associated with performance anxiety. Text page: 205
Which approach to reducing client stress is most effective in people with low to moderate hypnotic ability?
C. Biofeedback
Biofeedback is usually thought to be most effective in people with low to moderate hypnotic ability. For people with hypnotic ability, meditation, progressive muscle relaxation, and other cognitive-behavioral therapy techniques produce the most rapid reduction in clinical symptoms. Text page: 206
An advantage of the Miller and Rahe updated life event and social readjustment scale is that it
A. assesses stress threshold and potential for future illness.
The scoring of this scale gives nurses the capability of predicting a person's potential for future stress-related illness. Text pages: 200, 202 and 203
