N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide 4.2 Stress and Adaptation Stress was a word coined by Hans Selye in the 1920s to describe the pressures of injuryand disease. Since that time, various theories of stress have been described. These theories can generally be labeled as stimulus-based, response-based, or transaction-based. Stimulus-BasedModels Stimulus-based models of stress describe stress as a disruption in the environment, or a set of circumstances that cause physical or psychological reactions that may increase an individual's susceptibility to illness. • The life change theory (Holmes and Rahe): This theory quantifies stress based on major life changes. These stimuli may be either positive or negative events, such as marriage or divorce, birth or death, moving, going to college, or illness, and any of these life events may cause stress in an individual. • The daily hassles theory (Lazarus): This theory measures stress as the product of daily hassles rather than major life events. In this theory, "hassles" are those everyday occurrences that are distressing but not necessarily major life events. The daily hassles theory states that these hassles are balanced by positive experiences. This theory posits that hassles may cause disease and positive experiences may help prevent disease. Response-BasedModels Selye noted that patients with various ailments manifested many similar symptoms that placed demands on the person's body. In response-based models, the stressors may be positive or negative events, but it is the response of the patient that determines the level of adaptation required. Selye described the General Adaptation Syndrome (GAS) to explain the pattern of physiological events that occur in response to stress. This syndrome is divided into three stages: • Alarm stage: This is the initial stage in which the autonomic nervous system reacts by releasing adrenaline (epinephrine) and cortisone. This release produces what is called the "fight or flight response." This response causes the body to defend itself by preparing to fight or running away from the stressor. Physical changes in the body may include pale skin, sweaty palms, uncontrollable shaking, dilated pupils, pounding heart, nausea, andvomiting. • Resistance stage: The resistance or adaptation stage occurs when the body attempts to cope with and limit the stressor. • Exhaustion stage: The exhaustion stage occurs when attempts to adapt are not successful and cannot be maintained. During this stage, stress begins to affect the entire body and major body systems may be affected. Heart, renal, and immune system failure may result. If stress is not relieved through intervention, death may result. Transaction-BasedModels Transactional models of stress explain the effects of stress as an interaction between the person and the stressor. It is the individual's evaluation of events within the environment that either elicits a stress response or not. In the person's evaluation, if the change evokes feelings of threat or harm, the stress response will be evoked. If in the transaction the individual does not perceive any threat, the stress response will not be activated. This model explains why a threat to one individual will evoke the stress response, while the same threat may not evoke the same response in someone else.

©2017

Achieve Test Prep

Page 65

of 135