NUR 253
EXAM 2 STUDY GUIDE
Concepts of Mental Health Nursing
Galen College of Nursing
, lOMoARcPSD|51648332
UNIT 3
CH.10 stress response/management
Mediators of stress
• Physiological responses to stress: Environmental conditions- Trauma, extreme heat/cold,
physical conditions such as infection, hemorrhage, hunger, and pain.
• Psychological stressors: Divorce, unemployment, death, retirement, terrorist attack. Also
includes positive stress such as marriage, arrival of a new baby, unexpected success.
• Perception: The perception of the stress determines the emotional and psychological reactions.
Things that affect perception (Age, culture, Hx, lifestyle)
• Fight or Flight Response: is the body’s way of preparing for a situation an individual perceives as a
threat. Sympathetic nervous system kicks in focusing on increased: BP, RR, HR, Dilated pupils.
• General adaptation syndrome (GAS): Cannons fight-or-flight response into an expanded theory of
stress
Alarm or acute stress stage
- Activates sympathetic nervous system
- Activates HPA axis to stay on alert
Resistance or adaptation stage
- Sustained and optimal resistance to the stressor; recovery, repair, and renewal may occur.
Exhaustion stage
- Resources are depleted; the stress may become chronic
Immune system responses
• Interaction between nervous system and immune system during alarm phase of GAS
• Negatively affects body’s ability to produce protective factors
• Links exist among stress (biopsychosocial), the immune system, and disease
• Stress influences the immune system in several complex ways by preparing the body to initially
respond to the injury by fighting infections and healing wounds. Immune cells normally release
cytokines which are proteins and glycoproteins used for communication between cells when a
pathogen is detected. Cytokines activate and recruit other immune cells. During times of stress
theses cytokines are released in the immune system is activated. The activation is limited
because the cytokines stimulate further release of corticosteroids, which inhibits the immune
system. Research has found that high concentration of cytokines that cause systemic
inflammation in subjects with major depressive disorder.
Stress Management
- Relaxation
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
- Biofeedback
- Deep Breathing
- Guided Imagery
- Progressive relaxation
- Meditation
- Physical exercise
- Cognitive reframing
- Journaling
- Humor
Mediators of the stress response
Stressors
- Physiological (Environmental)
- Psychological (stressful events)
Perception: perception is determined on how one person sees the stressor that determines the persons
emotional and psychological reaction to it.
Individual temperament: Part of the response to stressors is based on our own individual perceptions
Social support: Strong social support from significant others can enhance mental and physical health
and act as a substantial buffer against distress.
- Support groups: people going through similar life events.
Culture: interprets emotional problems differently. Asians, Africans, and central Americans express
distress in somatic terms and experience it physically.
Spirituality and religion: help people cope with stress and even enhance the immune system and sense
of well-being. Prayer can even elicit the relaxation response.
CH. 15 Anxiety & Obsessive-Compulsive Disorders
Anxiety: Basic emotion that everyone experiences. Body reacts to fear and anxiety similarly it provides
energy to carry out task, motivate to strive toward goals and prompt constructive behavior.
Anxiety Disorders
Levels of anxiety
Mild:
- Sharp focus
- More effective problem solving
- May have slight physical symptoms
Moderate:
- Sees hears and grasps less information
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, lOMoARcPSD|51648332
- Selective inattention
- Ability to think clearly hindered
- Problem solving can take place
- Tension, increased HR, BP, respirations, GI upset
Severe:
- Focused narrowed
- Doesn’t not notice the details of the environment
- Learning and problem-solving not possible
- HA, nausea, insomnia
- Hyperventilation may occur
Panic:
- Most intense
- Unable to process what is happening in the environment
- May lose touch with reality
- Physical may become erratic or impulsive
Anxiety Defense Mechanisms
• Automatic coping styles that protect people from anxiety and maintain self-image, by blocking
feelings, conflict, and memories
• The individual may not be aware they are utilizing a defense mechanism.
• Adaptive use of defense mechanisms helps the person to decrease anxiety
• Maladaptive use of defense mechanisms – used excessively and or used immaturely.
• Sublimation and Altruism – always healthy
Types and Symptomatology of Anxiety Disorders
Separation anxiety disorders
• Developmentally inappropriate levels of concern over being away from a significant
• other
• Often manifested as physical symptoms – GI disturbances, HA
• Can be brought on by environmental stressors
-Death, separation, Immigration, and physical or sexual assault
Specific phobias
• Persistent irrational fear of a specific object, activity, or situation that leads to a desire of
avoidance
• High levels of anxiety or fear, overwhelming and crippling
• Daily functioning is compromised
• Activities are restricted
Downloaded by Benjamin Luca ()
EXAM 2 STUDY GUIDE
Concepts of Mental Health Nursing
Galen College of Nursing
, lOMoARcPSD|51648332
UNIT 3
CH.10 stress response/management
Mediators of stress
• Physiological responses to stress: Environmental conditions- Trauma, extreme heat/cold,
physical conditions such as infection, hemorrhage, hunger, and pain.
• Psychological stressors: Divorce, unemployment, death, retirement, terrorist attack. Also
includes positive stress such as marriage, arrival of a new baby, unexpected success.
• Perception: The perception of the stress determines the emotional and psychological reactions.
Things that affect perception (Age, culture, Hx, lifestyle)
• Fight or Flight Response: is the body’s way of preparing for a situation an individual perceives as a
threat. Sympathetic nervous system kicks in focusing on increased: BP, RR, HR, Dilated pupils.
• General adaptation syndrome (GAS): Cannons fight-or-flight response into an expanded theory of
stress
Alarm or acute stress stage
- Activates sympathetic nervous system
- Activates HPA axis to stay on alert
Resistance or adaptation stage
- Sustained and optimal resistance to the stressor; recovery, repair, and renewal may occur.
Exhaustion stage
- Resources are depleted; the stress may become chronic
Immune system responses
• Interaction between nervous system and immune system during alarm phase of GAS
• Negatively affects body’s ability to produce protective factors
• Links exist among stress (biopsychosocial), the immune system, and disease
• Stress influences the immune system in several complex ways by preparing the body to initially
respond to the injury by fighting infections and healing wounds. Immune cells normally release
cytokines which are proteins and glycoproteins used for communication between cells when a
pathogen is detected. Cytokines activate and recruit other immune cells. During times of stress
theses cytokines are released in the immune system is activated. The activation is limited
because the cytokines stimulate further release of corticosteroids, which inhibits the immune
system. Research has found that high concentration of cytokines that cause systemic
inflammation in subjects with major depressive disorder.
Stress Management
- Relaxation
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
- Biofeedback
- Deep Breathing
- Guided Imagery
- Progressive relaxation
- Meditation
- Physical exercise
- Cognitive reframing
- Journaling
- Humor
Mediators of the stress response
Stressors
- Physiological (Environmental)
- Psychological (stressful events)
Perception: perception is determined on how one person sees the stressor that determines the persons
emotional and psychological reaction to it.
Individual temperament: Part of the response to stressors is based on our own individual perceptions
Social support: Strong social support from significant others can enhance mental and physical health
and act as a substantial buffer against distress.
- Support groups: people going through similar life events.
Culture: interprets emotional problems differently. Asians, Africans, and central Americans express
distress in somatic terms and experience it physically.
Spirituality and religion: help people cope with stress and even enhance the immune system and sense
of well-being. Prayer can even elicit the relaxation response.
CH. 15 Anxiety & Obsessive-Compulsive Disorders
Anxiety: Basic emotion that everyone experiences. Body reacts to fear and anxiety similarly it provides
energy to carry out task, motivate to strive toward goals and prompt constructive behavior.
Anxiety Disorders
Levels of anxiety
Mild:
- Sharp focus
- More effective problem solving
- May have slight physical symptoms
Moderate:
- Sees hears and grasps less information
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
- Selective inattention
- Ability to think clearly hindered
- Problem solving can take place
- Tension, increased HR, BP, respirations, GI upset
Severe:
- Focused narrowed
- Doesn’t not notice the details of the environment
- Learning and problem-solving not possible
- HA, nausea, insomnia
- Hyperventilation may occur
Panic:
- Most intense
- Unable to process what is happening in the environment
- May lose touch with reality
- Physical may become erratic or impulsive
Anxiety Defense Mechanisms
• Automatic coping styles that protect people from anxiety and maintain self-image, by blocking
feelings, conflict, and memories
• The individual may not be aware they are utilizing a defense mechanism.
• Adaptive use of defense mechanisms helps the person to decrease anxiety
• Maladaptive use of defense mechanisms – used excessively and or used immaturely.
• Sublimation and Altruism – always healthy
Types and Symptomatology of Anxiety Disorders
Separation anxiety disorders
• Developmentally inappropriate levels of concern over being away from a significant
• other
• Often manifested as physical symptoms – GI disturbances, HA
• Can be brought on by environmental stressors
-Death, separation, Immigration, and physical or sexual assault
Specific phobias
• Persistent irrational fear of a specific object, activity, or situation that leads to a desire of
avoidance
• High levels of anxiety or fear, overwhelming and crippling
• Daily functioning is compromised
• Activities are restricted
Downloaded by Benjamin Luca ()
