NSG 357 Psychiatric Health Exam 2 with Complete Solutions

NSG 357 Psychiatric Health Exam 2 with Complete Solutions what is acute stress? - Answer-the short-term physiological response to an immediate perceived threat what is chronic stress? - Answer-an ongoing state of physiological arousal in response to ongoing or numerous perceived threats what is the diathesis-stress model? - Answer-stress associated with development or exacerbation of mental illness what two factors determine if a person experiences a stress response? - Answer-person environment relationship and appraisal what is meant by person-environment relationship? - Answer-- values and goals - personality and behavior patterns - physical and social environment (social networks, social support, demands & constraints, sociocultural factors, life events) explain the different personality types - Answer-- type a: competitive, tense, lots of stress - type b: easygoing, laid-back - type c: introvert, wants to please others - type d: pessimistic, does not share emotions what is meant by 'appraisal'? - Answer-consideration of demands, constraints, resources, and personal goals and beliefs what is primary appraisal? - Answer-- evaluation of the event: is it a threat, harm, or challenge? - may have no significance to the person, can be a benign-positive encounter, or can be harmful, threatening, or challenging - concerns the relevance to our wellbeing what is secondary appraisal? - Answer-- evaluation of internal and external coping options as well as resources to create a more positive environment - concerns an appraisal of coping options what is the lazarus theory of emotions? - Answer-stressor -> primary appraisal (is this harmful, threatening, challenging; negative or positive emotions?) -> secondary appraisal (can I cope with the stress; what are the alternatives?) -> yes, I can cope OR no, I can't cope what are the three stages of general adaptation syndrome? - Answer-- stage 1: alarm! your body reacts to the stress, sympathetic nervous system is triggered, HPA axis - stage 2: resistance; adaptation to stress, sustained release if cortisol in an attempt to maintain arousal - stage 3: exhaustion; the body's resources have been depleted what are the four different emotional stress responses? - Answer-- negative emotions: conflict between goals (anger, fright, anxiety, guilt, etc) - positive emotions: movement towards achieving goals (happiness, pride, relief, love) - borderline emotions: ambiguous (hope, compassion, sympathy) - nonemotions: too ambiguous to fit into the above categories (confidence, awe, confusion) what are some assessments and interventions r/t the biologic domain of stress? - Answer-- assessment: gender differences, review of systems, physical functioning, pharmacologic assessment - interventions: activities of daily living, nutrition, exercise, relaxation techniques what are some assessments and interventions r/t to the psychological domain of stress? - Answer-- assessment: severity of emotions, reaction to emotions, coping - interventions: assist patients to develop appropriate problem-solving strategies, have the patient discuss the person-environment situation and develop alternative coping strategies what are some assessments and interventions r/t the social domain of stress? - Answer- - assessment: recent life changes, social networks - interventions: facilitation of family functioning, assistance in expanding social network, support of family unit functioning, parent education, family therapy what are the four phases of crisis? - Answer-- a problem arises that contributes to increase in anxiety levels. the anxiety initiates the usual problem-solving techniques of the person - the usual problem-solving techniques are ineffective. anxiety levels continue to rise. trial-and-error attempts are made to restore balance - the trial-and-error attempts fail. the anxiety escalates to severe or panic levels. the person adopts automatic relief behaviors. - when these measures do not reduce anxiety, anxiety can overwhelm the person and lead to serious personality disorganization, which signals the person is in crisis what are the different types of crisises? - Answer-- developmental (maturational) crisis - situational crisis - traumatic crisis what is a developmental (maturational) crisis? - Answer-describe significant maturational events, accepting new responsibilities as you move through life what is a situational crisis? - Answer-specific stressful event threatens a persons biopsychosocial integrity and results in some degree of psychological dis-equilibrium what is a traumatic crisis? - Answer-a crisis that is precipitated by an unexpected, external stressor over which the individual has little or no control and from which he or she feels emotionally overwhelmed and defeated what is grief? - Answer-intense, emotional reaction to the loss of a loved one what is bereavement? - Answer-the process of mourning and coping with the loss of a loved one beginning immediately after the loss but possibly lasting months or years what are the five stages of grief? - Answer-denial, anger, bargaining, depression, acceptance what are the different types of grief? - Answer-uncomplicated, traumatic, and complicated grief what is uncomplicated grief? - Answer-normal grief, natural response to a loss what is traumatic grief? - Answer-external factors, can be from... - suddenness and lack of anticipation - violence, mutilation, and destruction - degree of preventability or randomness - multiple deaths - mourner's personal encounter with death what is complicated grief? - Answer-frozen in chronic mourning