stress ms1

7/31/2019 Stress Ms1

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S T R E S S


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Possible signs of stress

High blood pressure

Insomnia ; hypersomnia

Shortness of breathStiff neck

Upset stomach

Weight gain or lossChanges in menstrual pattern


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Possible signs of stress

Problems with relationships

Nightmares

Smoking

Alcohol drinking

Drug addiction


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THEORIES OF DISEASE CAUSATION

GERM THEORY

Pasteur proposed that a specific microorganismwas capable of causing infectious disease

Antibiotics, vaccinations, and other treatment

were developed as a result of this theory.


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Multi- Causal Theory

A. Selyes theory ( GAS)

a framework to describe how people respondto stress

B. Local Adaptations Syndrome (LAS)

single organ or specific section of the body


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Both syndromes develop in 3 distinct stages

(GAS and LAS)

A)alarm reaction ( fight/flight )

B) resistancec) exhaustion


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Stages of GAS

1. Stage of ALARM (SA)

- the person becomes aware of the presence of threat or

danger

- adaptive mechanisms are mobilized ( fight or flight

reaction)


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Stages of GAS

2. Stage of RESISTANCE (SR)

characterized by adaptationlevels of resistance are increased

the person moves back to homeostasis


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Stages of GAS

3. Stage of EXHAUSTION (SE)

results from prolonged exposure to stress andadaptive mechanisms can no longer persist

unless other adaptive mechanisms will be

mobilized, death may ensue


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B. Lazarus Theory response

The brain, thru ones perception of the

stressor, appears to be the mediating

influence on how the body respond to stress

The degree of resistance to infection depends

on how well a person copes with stress &general life situation


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Stress

is a state produced by a change in the

environment that is perceived as challenging,

threatening or damaging to the persons dynamic

balance or equilibrium


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actual or perceived imbalance in the

persons ability to meet the demands of

new situation

Stress


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Adaptation

Constant

on going process

requires a change in structure, function

and behavior so that the person is better

suited to the environment


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Types of Stressor

Physical

Physiologic

psychosocial

1. day to day daily hassles

2. major complex occurrences

3. involve few people


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According To duration :

Acute stress

Stressor sequence

Chronic intermittent

Chronic enduring


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Homeostasis a state of dynamic equilibrium; stability;balance; uniformity

1. Systemic Physiologic Response to Stress

A. Sympatho-Adreno-Medullary Response

(SAM) or Fight or Flight Response

Stressors : a. physical injury

b. elevated body temp

c. dehydration


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Hypothalamus

Pituitary Gland

Adrenal Medulla

Norepinephrine Epinephrine


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Brain : increased alertness ; restlessness

Eyes : dilated pupils; increased visual perception

Mouth : decreased salivary secretion; thirst and

dryness of mouth

Heart : tachycardia; coronary vasodilation

Increased force of cardiac contractilityIncreased cardiac output

Lungs: hyperventilation; bronchodilation

Blood vessels: peripheral vasoconstriction;increased Blood Pressure


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Skin : pallor; diaphoresis

Liver : Increased blood glucose levels

Muscles : increased glycogenolysis

increased muscle tension

GIT : decreased gastric motilitydecreased peristalsis

constipation, Flatulence

Urinary bladder: relaxation of detrusor musclescontraction of the sphincter


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Local Physiologic Response :

inflammation involves mobilization of specific

and nonspecific defense mechanism in response

to tissue injury or infection

Purpose of inflammation :

to localize tissue injury


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Inflammatory Response

Inflammants : physical ( thermal, radiation)

mechanical

chemical

Microbial

Tissue Injury


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Vascular response

transitory vasoconstriction followed by

vasodilation due to release of

histamine

bradykinin

prostaglandin


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Increase capillary permeability

1. Rubor ( redness)

2. Dolor ( pain )

3. Calor ( heat )

4. Tumor ( tumor )

5. Impaired function


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Healing Process ( Reparative Phase )

Regeneration involves replacement of damaged

tissue cells by new cells which are identical in

structure or function

Scar formation involves replacement ofdamaged tissue cells by fibrous tissue formation


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Secondary Intention

occurs when the wound is extensive

great amount of tissue loss

repair time is longer

scarring is greater

Tertiary Intention

delayed surgical closure of infected wound.


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The systemic Manifestation of Inflammation :

a.Fever

Endogenous pyrogens

(prostaglandins, leukotrienes, interleukin 1)

Hypothalamus

Resetting of the body temp set-point at a higherlevel


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Increasing heat production/decreasing heat loss

(shivering, sweating is inhibited, vasoconstriction)

Increased phagocytic activity

LeukocytosisAnorexiaElevated ESRHeadache

LymphadenopathyFatigue/ malaise


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Nursing Interventions for Clients withInflammation :

Promote rest

Reduce swelling

Position : elevate the affected body part to

promote venous return

Heat and cold application

Relieve pain

Adequate hydration


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Nursing Interventions for Clients with Inflammation :

Provide adequate Nutrition

Pharmacotherapy

Analgesic/Antipyretic Aspirin, Paracetamol,

Mefenamic Acid

NSAIDS

Antimicrobials

Surgery

Incision and drainage


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Physiologic Effects of Heat Application

Vasodilation

increases blood flow to an area

Promotes muscle relaxation and sedative effect

Relieves edema because fluid is easily

absorbed in the area


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Physiologic Effects of Cold Application

Vasoconstriction

controls bleeding

Numbs nerve endings

has local anesthetic effect

relieves pain


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Cold application is done during the 1st 72

hours, heat application follows after

During heat and cold application, check the

area every 15 minutes.


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Methods of Dry Heat Application :

Hot Water Bags/Bottles

Heat Cradle

Disposable hot packs

Heat lamp/ portable lamp

Methods of Moist Heat Application :

Warm moist compressWarm soakSitz bath


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Methods of Dry Cold Application :

Ice collar

Ice cap

Disposable cold pack


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