N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide Types and Manifestations of Stressors Stressors can be characterized as physiological, psychological, or social/environmental. • Physiological: Physiological stressors may include trauma, fatigue, oxygen or sleep deprivation, pain, and infection. These physiological stressors may manifest as increased pulse rate, increased blood pressure and respiration, headache, dilated pupils, nausea, tension, twitching, uncontrollable shaking, and increased blood sugar. The body will attempt to adapt to physiological stressors by stimulating the sympathetic nervous system, the hypothalamus, the anterior pituitary gland, and the release of hormones. • Psychological: Psychological stressors may include anticipation of pain, feelings of helplessness or loneliness, and rejection by peers or family. These stressors may cause the individual to feel anxious, fearful, apprehensive, sad, depressed, or more sensitive than usual. The individual may not be able to concentrate or think clearly. The individual will attempt to adapt to psychological stressors by using defense mechanisms that may be either conscious or subconscious: o Repression is an unconscious mechanism that prevents stressful thought from entering awareness. o Suppression is a conscious attempt to keep threatening thoughts out of consciousness. o Sublimation is a redirection of unacceptable feelings into more acceptable feelings. o Rationalization is an intellectual justification of ideas or behaviors. o Reaction formation is expression of a feeling opposite of the individual's real feelings. o Projection is attributing one's own feelings to others. o Denial is avoiding the stressor by reinterpreting the event as something less threatening. o Regression is reverting to less mature behaviors. o Displacement is transferring a feeling or emotion from the actual threat to a less threatening one. • Social/environmental: Social and environmental stressors may include environmental pollution, family problems, and other factors. Manifestations of these stressors may be withdrawal from friends and families, anxiety, and feelings of emptiness. Anxiety Anxiety is a response that occurs to a real or perceived threat. It is one of the most common reactions to a stressful event and may result in additional stress. As the level of anxiety increases, the individual may experience decreased ability to function. Anxiety is typically experienced on a continuum from mild to panic levels and can be detected by the astute nurse. • Mild levels of anxiety will produce a slight increase in vital signs and increasedalertness. This level of anxiety provides an optimal time for patient teaching as the patient has heightened awareness. • With moderate levels of anxiety, the patient will report tension and will have adecreased attention span. The patient may have a tendency to complain or argue and may report headaches, nausea, and vomiting.

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