Lewis et al: Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 7th edition Key Points Chapter 9: Stress

and Stress Management
• • • Stress occurs when individuals perceive that they cannot adequately cope with the demands being made on them or with the threats to their well-being. Key personal characteristics—such as hardiness, sense of coherence, resilience, and attitude—buffer the impact of stress. The physiologic response of the person to stress is reflected in the interrelationship of the nervous, endocrine, and immune systems. Stress activation of these systems affects other systems, such as the cardiovascular, respiratory, gastrointestinal, renal, and reproductive systems. Stress can have effects on cognitive function, including poor concentration, memory problems, distressing dreams, sleep disturbances, and impaired decision-making. Long-term stress may increase the risk of cardiovascular diseases such as atherosclerosis and hypertension. Other conditions either precipitated or aggravated by stress include migraine headaches, irritable bowel syndrome, and peptic ulcers. Coping is defined as a person’s cognitive and behavioral efforts to manage specific external or internal stressors that seem to exceed available resources. Coping can be either positive or negative. Positive coping includes activities such as exercise and use of social support. Negative coping may include substance abuse and denial. Coping strategies can also be divided into two broad categories: emotion-focused coping and problem-focused coping. Emotion-focused coping involves managing the emotions that an individual feels when a stressful event occurs. Problem-focused coping attempts to find solutions to resolve the problems causing the stress. Relaxation strategies can be used to cope with stressful circumstances and elicit the relaxation response. The relaxation response is the state of physiologic and psychologic deep rest. It is the opposite of the stress response and is characterized by decreased sympathetic nervous
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

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Key Points

9-2

system activity, which leads to decreased heart rate and respiratory rate, decreased blood pressure, decreased muscle tension, decreased brain activity, and increased skin temperature. • Regular elicitation of the relaxation response can be achieved through relaxation breathing, meditation, imagery, music, muscle relaxation, and massage.

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

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