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NUR 181 Chapter 12 Summary
Chapter 12: Stress and Adaptation - Physical Examination & Health Assessment. *Essential Study Material!!
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Chapter 12: Stress and AdaptationI. WHAT IS STRESS
A. Stress: disturbance in a person’s normal balanced state
B. Stressor: a stimulus that the person perceives as a challenge or threat; initiates physical or
emotional response
C. Coping responses: voluntary/involuntary responses aimed at restoring equilibrium
D. Adaptations: changes that take place as a result of stress or coping
E. Homeostasis: maintained external and internal equilibrium
F. *stress is not always bad, can keep you motivated
G. TYPES OF STRESSORS
1. Distress/Eustress
a) Distress:threatens health
b) Eustress: protective
2. External/Internal
a) External: death of a family member, excessive heat
b) Internal: anxiety, diseases
3. Developmental/Situational
a) Developmental: can be predicted to occur; easier to cope with
(1) Ex. leaving home, starting new job
b) Situational: unpredictable
(1) Ex. car crash, illness
4. Physiological/Psychosocial
a) Physiological stressors: affect body structure or function
b) Psychosocial stressors: external stressors that arise from work, family
dynamics, living situation, etc
II. HOW DO COPING AND ADAPTATION RELATE TO STRESS?
A. Coping strategies: thinking processes and behaviots a person uses to manage stressors
1. I.e problem solving, daydreaming, making lifestyle changes
B. Adaptive coping (effective): making healthy choices that reduce the negative effects of
stress
C. Maladaptive coping (ineffective): does not promote adaption
1. Overeating, overworking, oversleeping, substance abuse
D. THREE APPROACHES TO COPING
1. Altering the Stressor: person takes actions to remove or change the stressor
2. Adapting to Stressor: changing thoughts/behaviors on stressor
3. Avoiding the Stressor: can be both toxic and healthy
a) Toxic: avoiding to get a lump checked out
b) Healthy: leaving a person that causes too much stress
E. OUTCOME OF STRESS
1. Stress results in adaption or disease
2. Outcome depends on balance btwn strength of stressors and effectivemess of the
coping method
F. PERSONAL FACTORS INFLUENCE ADAPTATION
1. Adaptation occurs when a person has supports and coping abilities adequeate to
, enable him to deal with the stessor
2. Perception of the Stressor
a) Realistic or exaggerated
b) I.e having a mastectomy: woman a “i am more than just a breast” vs
woman b “ i will be so ugly, i wont be a woman”
3. Overall Health Status
a) Being an already healthy person helps you cope with new health issues
4. Support System
a) May include freinds, family, counseling groups, church grous or other
like minded people who share common interests
5. Hardiness
a) People who thrive despite overwhelming stressors -> “hardiness”
6. Other Personal Factors
a) Age, developmental level, life experiences
III. HOW DO PEOPLE RESPOND TO STRESSORS
A. General Adaptation Syndrome (GAS) (initiated by pituitary gland)
1. Alarm stage “Fight or Flight”
a) Shock phase: cerebral cortex first perceives a stressor and sends out
messages to activate endocrine and sympathetic nervous systems.
Epinephrine (adrenaline) and various other hormones prepare the body
for fight or flight.
b) Countershock phase: all the changes produced by the shock phase are
reversed and the person becomes less able to deal with immediate threat
c) Increased blood volume, blood glucose, epinephrine/norepinephrine
amounts, heart rate, blood flow to muscles, oxygen intake and mental
alertness
d) Pupils of the eyes dilate to produce greater visual field
2. Resistance Stage
a) the body stabilizes and responds in an opposite manner to the alarm
reaction. Hormone levels, heart rate, blood pressure, and cardiac output
return to normal, and the body repairs any damage that may have
occurred. However, if the stressor remains, and there is no adaptation, the
person enters the third stage, exhaustion.
3. Exhaustion Stage
a) occurs when the body can no longer resist the effects of the stressor and
when the energy necessary to maintain adaptation is depleted. The
physiological response is intensified, but the person's energy level is
compromised, and adaptation to the stressor diminishes. The body is
unable to defend itself against the impact of the event, physiological
regulation diminishes, and, if the stress continues, death may result
B. Local Adaptation Syndrome (LAS)
1. Localized body response; involves only a specific body part, tissue or organ.
2. Reflex Pain Response
a) Withdrawing from source of pain (i.e hot stove)
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