Nurs 5354 Exam 1 Questions And
Answers With Verified Solutions Already
Passed Latest Updated 2024/2025
Describe the physiologic response and clinical manifestations of pain and its
relation to the sympathetic-adrenal-medullary system stress response. -
ANSWER✔✔ If an individual is exposed to pain and they perceive this pain as
stressful, the adrenal medulla secretes adrenaline (hormone). Adrenaline leads to
the arousal of the sympathetic nervous system and reduced activity in the
parasympathetic nervous system. Once the painful threat is over, the
parasympathetic branch takes control and brings the body back to homeostasis.
Potential changes in the body r/t adrenaline: ↑HR, Pulse, and BP; ↓ digestion; and
↑ sweating (diaphoresis)
Biological Syndrome of Stress
What are the 3 structural changes? - ANSWER✔✔ 1. Adrenal Gland Cortex
enlargement
2. Atrophy of thymus gland and other lymphoid structures
3. Development of bleeding ulcers in stomach and duodenal lining
Homeostasis - ANSWER✔✔ Physiologic regulation around an unchanging set
point
Stable or Remaining the same
Allostasis - ANSWER✔✔ Long-term or chronic exaggerated responses to stress
,Proposes physiologic systems are dynamic & capable of changing set-points after
exposure to stress
Ability to successfully adjust to challenges
Allostatic Overload - ANSWER✔✔ Chronic over-activation of adaptive regulatory
physiologic systems that increases susceptibility to disease
Exaggerated pathophysiologic responses to stress
What is stress? - ANSWER✔✔ Transactional or interactional concept - it is not
necessarily the event but how we perceive and react to the event that produces
stress.
The state of affairs arising when a person relates to situations in a certain way.
A person experiences stress when a demand (real or imagined) exceeds a person's
coping abilities.
Allostatic load - ANSWER✔✔ The individualized cumulative effects of stressors
that exist in people's lives and influence their physiologic responses.
Under conditions of allostatic overload, the parasympathetic system may (increase,
decrease) its restraint of the sympathetic system resulting in (increased, decreased)
inflammatory responses. - ANSWER✔✔ decrease, increased
What are the 3 key mediators and biomarkers of allostatic overload? -
ANSWER✔✔ 1. glucocorticoid cortisol
,2. catecholamines (released from the sympathetic nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) - ANSWER✔✔ the sum of all nonspecific
reactions of the body to prolonged systemic stress, comprising of 3 successive
stages → Alarm Stage; The Stage of Resistance; and The Stage of Exhaustion
Alarm Stage - ANSWER✔✔ First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation - ANSWER✔✔ Second stage of the GAS,
during which the body adapts to and uses resources to cope with a stressor.
Mobilization contributes to "Fight or Flight"
When does the Stage of Resistance or Adaptation begin? - ANSWER✔✔ Begins
when the actions of Cortisol, norepinephrine and epinephrine all start to go to work
doing their respective jobs.
The Stage of Exhaustion (Allostatic Overload) - ANSWER✔✔ Third stage of the
general adaptation syndrome.
Stress continues; adaptation unsuccessful.
, Continuous stress causes the progressive breakdown of compensating mechanisms
(acquired adaptations) and homeostasis. Exhaustion marks the onset of certain
diseases.
The body's ability to resist stress becomes depleted; illness, disease, and even death
may occur.
Causing impairment of the immune response, heart failure, and kidney failure,
leading to death.
Hypothalamic-Pituitary-Adrenal (HPA) axis - ANSWER✔✔ Stress (+) →
Hypothalamus (+) [Release CRH] → Anterior Pituitary Gland [Releases ACTH]
→ Adrenal Gland [Releases Cortisol] → Via Negative Feedback Cortisol goes to
hypothalamus and Anterior Pituitary Gland to halt the release of hormones
The release of cortisol causes a number of changes that help the body deal with
stress.
When cortisol levels in the blood get high, this is sensed by receptors in areas of
the brain (like the hippocampus & hypothalamus) which leads to the shutting off of
the stress response via negative feedback mechanism.
Compare and Contrast the sympathetic-adrenal-medullary system activation to the
hypothalamic-pituitary-adrenal (HPA) axis response that is activated during the
stage of resistance (adaptation). - ANSWER✔✔ When a stress response is
triggered, it sends signals to two other structures: the pituitary gland and the
adrenal medulla. These short term responses are produced by the "fight or flight"
response via the sympathetic-adrenal-medullary system. Long term stress is
regulated by the hypothalamic pituitary-adrenal (HPA) system.
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