NURS 301 MEDSURG TEST 1 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITY
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NURS 301 (NURS301)
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Liberty University
NURS 301 MEDSURG TEST 1 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITYNURS 301 MEDSURG TEST 1 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITYNURS 301 MEDSURG TEST 1 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITY
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NURS 301 Test 1 Study Guide
Ch. 8 Stress
The Mind-Body Link
What goes on in the mind influences every part of the body
Because stress affects the mind, it can have a powerful effect on your body and your health
1/3 Americans are living with chronic (extreme) stress and so are 100% of nursing students!
Two kinds of stress:
o Eustress- Good stress (ex. New job, planning wedding)
o Distress- Bad stress (ex. Terminal diagnosis, car wreck)
Hans Selye: Stress Theorist
Began early research on stress circa 1940 at McGill University
Applied physiological stressors to animals in the lab and studied responses.
He found their responses to be a patterned, predictable chain of reaction, regardless of the type of
stress he put on them
Selye formulated the “stress as a response” theory and later named it the GAS Theory (General
Adaptation Syndrome)
Theories of Stress
Selye’s Theory of Stress
o Definitions
“Stress”- A non-specific response of the body to any demand made on it
“Stressors”- Any demand that induces stress: physical or emotional, pleasant or
unpleasant
Perception influences how a person responds to a stressor. For example, one
patient can be diagnosed with diabetes and think their life is over while
another patient can receive the same diagnosis and be relieved because she
thought she had terminal cancer!
o Three Stages of GAS Theory (For test, be able to identify a patient in each stage)
1. Alarm Reaction
Initial response to stressor
Activation of SNS- “Fight or Flight” (ex. Bear in the woods)
Ideally the alarm reaction phase is short! (1 min-24 hours)
Physical exam would show:
o Vasodilation of skeletal muscles, vasoconstriction of reservoirs (skin,
kidneys, viscera) inc HR, inc RR, inc CO, inc SV, inc BP, dec GI, dec
Digestive enzymes (Know chart on page 102!)
o Blood shunted to core organs (brain, lungs, heart)
o increase in stress hormones (cortisol, Epi, NorEpi)
o Hyperglycemia! It is important to check glucose every 6 hours to
see how patient is adapting to stress. The Liver mobilizes stored
glucose (glycogenolysis) to fuel the muscles. Hyperglycemia then
leads to increased infections such as hospital acquired pneumonia,
slowed wound healing, and immunocompromise (Always expect a
hospital patient to have increased blood glucose and poor wound
healing!)
o Terms:
, 2
Stroke Volume- amt blood ejected per beat in mL
, 3
Cardiac Output- Amt blood pumped out per minute in L
Stress stimulates the Limbic Lobe which stimulates the Adrenal
Cortex (KNOW!)
o Cerebral Cortex- processes stress stimuli
o Limbic System- relays information to hypothalamus
o Hypothalamus- Releases CRH which activates SNS
o Anterior Pituitary- Releases beta-endorphins and ACTH
o Adrenal Cortex- Releases cortisol (STRESS HORMONE!)
o Adrenal Medulla- Releases catecholamines (Epi, Norepi)
2. Stage of Resistance
The amount of resistance is determined by the:
o Physical state of the person
o Number of stressors they have
o Coping abilities (strategies they have)
Goal=Adaptation! If no adaptation/coping, person moves to stage 3
(Exhaustion!)
3. Stage of Exhaustion
“Terminal Phase”
All energy for adaptation is exhausted
May see return of alarm phase
Can be terminal. Death can occur here if we don’t adapt
Later Theorists
o Holmes, Rahe and Masuda “stress as a stimulus”
o Richard Lazarus- “stress as a transaction”
Four Mediators of Stress-All four play huge roll in adaptation! (Know difference in hardiness, SOC, and
resilience)
1. Hardiness (how well someone deals with stress)
o A hardy patient has a clear sense of personal goals and values. They know what they’re
in for.
▪ Ex. Patient going in for elective surgery has a plan
o Has a strong tendency toward interaction with the environment
o Sense of meaningfulness is important
o An internal rather than an external locus of control. (Internal is more powerful!)
▪ Internal locus of control- Means the patient is in control and is the “captain of the
ship”
▪ External locus of control- Patient lets environment control him; ex. Eeyore
2. Sense of Coherence (SOC)
o Developed by Antonovsky
o Seen as more powerful than hardiness- refers to how the person sees the world and
their place in it
o Three terms related to SOC:
1. Comprehensibility- The sense that internal and external stimuli are ordered
and make sense
2. Manageability- that there are resources available as needed
3. Meaningfulness- the sense that the demands that one faces are worthy of
taking on
3. Resilience (ability to “bounce back” and do better next time)
o Means that one is resourceful, flexible, and a good problem solver
o Ex. Student goes to remediation when she realizes she needs extra help
4. Attitude (Hassles vs. Uplifts)
o The balance of the two within one’s life and how the stressor(s) is/are viewed
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