PERSONAL BACKGROUND

Name: Dan Drazen Lagmay

Age: 18
Birthdate: July 19, 1995
Civil Status: Single
Address: Brgy. 6, San Julian, Batac City, Ilocos Norte
Religion: Aglipayan
Educational Attainment: College level
Occupation: N/A

For most persons, everyday life includes its share of stressors and life demands, ranging
from family, work, school, responsibilities, pressure and whatnot. The client, Mr. Lagmay was
chosen for the reason that he is currently a Level IV student of BS Nursing in Mariano Marcos
State University College of Health Sciences and since it is only the beginning of the semester,
the subjects are, if not new, harder than the previous correlated subject. Mr. Lagmay is also an
active student in their class and the pressure to remain in his position is high. The previous
semester was, as stated by the client, was very hard on him, which took away his college
scholarship, which he plans to regain this semester which means that he has to double his efforts
and might lead to a higher level of stress.
The primary stressor identified by Mr. Lagmay is school, which he rated as 10 and stated
that he has been dealing with this stressor since his first year in secondary until today, which can
be calculated to 8 years. The client is subjected to the stressor since studying and stress always
come hand in hand, especially if the coping and adaptation is ineffective. Also, as stated by the
client, the pressure from his parents, mentors and the subjects are quite overwhelming.
The client is in the Stage of Resistance as evidenced by his efforts to cope with the
stressors as manifested by his efforts to control the stressors or adapt to it through talking to
people such as his parents about the things that are bothering him. He also mentioned that he
usually tries to structure the situation such as when he thinks that he is not well-versed with the
topics that are going to be in the examination, he tries to work really hard to comprehend the
topics in order for him to avoid threatening events, such as failing the examination. The client
stated that as much and as soon as possible, he tries to arrive to a solution regarding the problems
and stressors that he encounters in order to prevent the situation from getting worse. He also
asserted that he never fails to pray to God for wisdom, guidance and patience for him to resolve
any conflicts that he is currently experiencing or might encounter in the future. He also pointed
out that his most effective and most often relaxation technique that he uses is by relaxation, and
he does this by surfing the Internet and watching the television, especially those shows that are

for children to divert his senses for a while for him to come up with a better solution to his
problems.
These coping strategies that the client uses are, if not totally eradicate, results to a feeling
of relief from the stressors that he encounters.
The stress situation of the client can be supported by the Stress as a Response theory,
which states that stress is a response to the disruption caused by a noxious stimuli or a stressor.
The pressure caused by academics is the stressor that is highly being felt by the client and he
underwent stages to cope with the stress brought about by this stressor. The first stage is the
Alarm reaction, wherein the body is being alerted to act against the stressor, and its main goal is
to protect the individual from this stress. This can be seen when the client stated that he assesses
himself if he is well-versed with the lessons that are going to be a part of their examination,
which makes way for the second stage, which is the Stage of Resistance wherein the body
attempts to cope with the stressor, which can be observed in the client as he asserted that he
makes sure that he works really hard to read, study and comprehend the lesson in order to avoid
getting a failing grade in the exam. The third stage, which is the Stage of Exhaustion is where the
body can no longer resist the effects of the stressors, which has not been reached by the client
yet, since he affirmed that his coping mechanisms are effective enough to adapt to the stressors
he encounters.

Nurse-Patient Interaction
N: Hello kuya, good evening. Im Danielle Quigao, currently a Level 3 Student of BS Nursing at
Mariano Marcos State University. I am here to ask for your cooperation for me to gather
information regarding our current concept in NCM103, which is stress. And since it is only
the start of the semester and you are already in your level IV, I thought that maybe you are
currently being bombarded by a lot of stressors. Can I please interview you about this?
P: Sure ading, ma-is-stress nak talaga so go lang.
N: First kuya may I just ask some personal data such as your whole name, age, birthdate, civil
status, address and religion.
P: Dan Drazen Lagmay, 18 years old, born on July 19, 1995, currently single, living at Brgy. 6,
San Julian, Batac City and Aglipayan nak ngem mapmapanak makimismisa jay Romano.
N: Apay met jay Romano ka nga makimismisa kuya?
P: Agkasabali ngamin religion ni parents ko ket sursurutek latta nukwa ni mamak.
N: Ay sige kuya. Irugik ngarod ti agdamagen. First question, ana met dagitay pakais-stressam ita
nga panawen?
P: School ti pinaka-paka-is-stressak. Ayna.
N: Apay met mais-stress ka ti school kuya?
P: Nagrigat agbalin nga level IV, ket agadadapt kami paylang ti new subjects ken
responsibilities. Tapos jay research nga subject mi, nag rigat grabe. Tapos ag review kam to pay
para boarden. Tapos jay pressure nga dapat haan nga bumaba ti grades ko or haan nak nga
mabagsak kasi jak kayat nga madisappoint ni parents ko ken dagijay mentors ko nga
mangsupsupporta kanyak. Ken jak ngamin naka scholar idi last sem kasi nagrigat dagijay
subjects ket kayat ko kuma nga isubli, saying met tay stipend.
N: Kaanum pay nga narikna ti panagadda daytoy nga stressor kuya? Ken kasanu nga nag-arise
detoy nga stressor?
P: Idi payla first year high school, kasi idi elem, jak pulos agrevreview. Ket idi highschool,
ammom met nu kasano karigat nu periodical exam ta MMSU diba, ket kaslang na culture shock
nak. Although mais-stress nak since idi paylang about school, jak met pay ketdi nag-give-giveup. Kayak met paylang.
N: Ana pay dagijay sabali nga paka-is-stressam kuya?
P: Nu dadduma ket agproblema ak met ti kwarta, nagadut paggastwak ta nu dadduma ket
nalaingak nga mangan, stress-eating kumbaga. Tapos nu dadduma ket dagijay responsibilidad ko
jay balay, kaspagarigan dagijay ubra nga dapat ko kuma ubraen ket jak maaramid kasi nagadut
araramidek nga academics, kasjay. Tapos dagijay friends ko idi highschool ken dagijay best
friends ko ket jak unay makasarsaritan kasi busy busy met ditoy school Isu, mais-stress nak nga
mangpanpanunut nukwa.
N: Ana met ngarud nukwa dagitay marikriknam kuya nu mais-stress ka?

P: Adu, stress eating ti kanayun, naglaing nak nga mangan nukwa, nu dadduma agsakit bagbagik,
jak makatalna, agkalkaling-etan nak, marigatan nak umanges, jak makasau nga nasayaat ken
mabulbulol nak, ag palpitate nak, aglamlamiis ti imimak, ken marigatanak ag concentrate.
N: Ana met nukwa dagijay ububraem kuya tapno ma-alleviate mo dagitoy nga manifestations
ken tapnu maka-adapt ka kadagijay marikriknam nga stressors ?
P: Ti nangnangruna nga ububraek ket ag relax paylang nukwa. Agbuya ak TV, kasjay, tay
Spongebob, Chowder, kakasjay. Dagitay pang-ubing, kasi kasla makapaawan nukwat problema.
Tapos nu dadduma ket ag-Internet nak, agkita ti latest ken makidamag kadagijay friends ko. Idivert ko payla nukwa ti atensyon ko sa kun to sublyanan tay stressor tapnu mas fresh to tay
mind kon nga maki-deal with it. Tapos nu dadduma kasarsaritak ni parents ko tapnu met makaala
ak ti moral support, nu dadduma ag walkwalking nak nga meymeysa tapnu agpanunut ti
solusyon kadagiti pakaprobproblemaak ti byag, tapos agkararag nak.. Dumawatak ti guidance
ken patience, kasjay. Dumawatak ti sign ken God nu kasanut pamay-ak tapno masolusyonak
wenno maiwasak jay stressor tapno madi unay dumakkel nga agbalin nga problema.
N: Adda kad met instances kuya nga mariknam nga madi mo masulbar ti stress mun? Ken ana
met nukwat ubraem nu mapasamak daytoy?
P: Adda met nu dadduma. Kumaru nukwa daguijay manifestations ti stress ko, jay kaslang
marigatanak umanges, ag palpitate nak, marigatanak agsao, kasjay. Nagrigat nukwa lalo nu tay
talaga agsasabay amin ti stress ti school, tapos financial, tapos addan to pay problema mi jay
balay, or friends, jakammot ubraek. Ngem eventually, masulsulbar ko met lata.
N: Ti panagkitam kuya, epektibo metlang dagitoy nga coping mechanisms mo? Ken kasanum
nga maibaga nga epektibo?
P: Ay ket most of the time, effective met. Ngem jak met pay ketdi napadasan nga haan nga
nasolusyonan dagita probproblemaek. Maka-aramid nak met nukwat way tapno ma-eradicate ko
jay stressor, or nu man madi maawan, kayak nga labanan habang adda paylang. Pumaspasa ak
met ti exams kaasi ni Apo, ken haan nak met pay ketdi nga ag-giveup kideta reseach juray
nakarigrigat. Nu haan kuma nga epektibon ah ket nabagsak nak payla idi first year.

NURSING CARE PLAN

Nursing Diagnosis:
Stress overload related to multiple coexisting stressors as evidenced by patient verbalizing,
nagrigat nukwa lalo nu tay talaga agsasabay amin ti stress ti school, tapos financial, tapos addan
to pay problema mi jay balay, or friends, jakammot ubraek and reports of physical symptoms of
stress such as difficulty of breathing, slurred speech, palpitations and eating too much.
Nursing Inference:
Stress is a non-specific response to any demand placed on a person to adapt or change, and can
come from physical, emotional, social, spiritual, cultural, chemical or environmental sources
(Stacy, 2013). Although just enough stress can be a good thing, stress overload is a different story
- too much stress isn't good for anyone. Pressures that are too intense or last too long, troubles
that are shouldered alone, and multiple stressors affecting the person at once can cause people to
feel stress. Stress overload does not occur because the patient or family members have coping
deficits or psychological disorders. Rather, the stressors are too numerous and severe that people
tend to become overwhelmed.
Nursing Goal:
After 4-5 hours of appropriate nursing interventions, the client will be able to categorize the
stressors according to modifiability, identify successful behavior change to cope with or
eliminate current multiple stressors as evidenced by verbalization or demonstration of reduced
stress reaction.
Nursing Interventions:
1. Identify the events that have occurred over remote or recent past that are perceived by the
client to be stressful.
Rationale: To determine the number, duration and intensity of events causing perception of
overwhelming stress.
2. Identify the clients level of stress in each of the stressors being identified.
Rationale: Stress is highly individualized, normal, physical, and psychological response to
internal and external life events. Knowing the level of stress will aid in the planning of
appropriate interventions to deal with the stressors.
3. Identify the clients locus of control: internal or external.
Rationale: Knowing clients locus of control will help in developing a plan of care reflecting
clients ability to realistically make changes that will help in the management of stress.
4. Evaluate resources and support systems available to patient.

Rationale: Resources may include significant others, health care providers such as home health
nurses, community resources, spiritual counseling, and the like.
5. Encourage client to identify his own strengths and abilities.
Rationale: Assisting the client to develop appropriate strategies for coping based on personal
strengths and previous experiences improves the clients self concept and sense of ability to
manage such stressors.
6. Assist the client to categorize stressors as modifiable or non-modifiable by listing the
stressors and pondering over them and recording the coping mechanisms that can be done
based on the clients strengths and abilities.
Rationale: Removing or minimizing some stressors, changing responses to stressors, and
modifying the long-term effects of stress are all actions that can assist those clients with stress
overload.
7. Assist the client to use his locus of control to develop his possible coping mechanisms to
deal with the stressors.
Rationale: To develop care plan that is individualized and is specific for the client to facilitate
faster intervention and to ensure compliance. For clients with internal control, encourage client
to take control of his own care; for those with external control, begin with small tasks as
tolerated.
Nursing Evaluation:
After 5 hours of appropriate nursing interventions, the client is be able to categorize the stressors
according to modifiability, identify successful behavior change to cope with current multiple
stressors as evidenced by verbalization of naikkak metlat solusyon na tay problemakon and
disappearance of manifestations such as difficulty of breathing and palpitation.

Republic of the Philippines

COLLEGE OF HEALTH SCIENCES
MARIANO MARCOS STATE UNIVERSITY
Batac, 2906 Ilocos Norte, Philippines

Stress
Presented by:
Danielle B. Quigao
Group IV, BSN III-A

Presented to:
Ms. Judith P. Valenzuela
Clinical Instructor

June 2014