STRESS

Possible signs of stress Anxiety ; floating anxiety Back pain Constipation or diarrhea Depression ; urge to cry

Fatigue
Headaches

Possible signs of stress

High blood pressure Insomnia ; hypersomnia Shortness of breath

Stiff neck
Upset stomach Weight gain or loss

Changes in menstrual pattern

Possible signs of stress Problems with relationships Nightmares Smoking Alcohol drinking Drug addiction

THEORIES OF DISEASE CAUSATION

GERM THEORY
Pasteur proposed that a specific microorganism was capable of causing infectious disease Antibiotics, vaccinations, and other treatment were developed as a result of this theory.

Multi- Causal Theory A. Selyes theory ( GAS) a framework to describe how people respond to stress B. Local Adaptations Syndrome (LAS) single organ or specific section of the body

Both syndromes develop in 3 distinct stages (GAS and LAS) A)alarm reaction ( fight/flight ) B) resistance

c) exhaustion

Stages of GAS

1. Stage of ALARM (SA) - the person becomes aware of the presence of threat or
danger

- adaptive mechanisms are mobilized ( fight or flight

reaction)

Stages of GAS

2. Stage of RESISTANCE (SR)

characterized by adaptation

levels of resistance are increased

the person moves back to homeostasis

Stages of GAS

3. Stage of EXHAUSTION (SE)

results from prolonged exposure to stress and

adaptive mechanisms can no longer persist

unless other adaptive mechanisms will be mobilized, death may ensue

Psychosocial Theory A. Masons theory of specificity of the stress response The stress response is dependent on psychological factors We can modify the cortisol response by coping effectively with a stressor

B. Lazarus Theory response The brain, thru ones perception of the stressor, appears to be the mediating influence on how the body respond to stress

The degree of resistance to infection depends

on how well a person copes with stress & general life situation

C. Wolffs theory of stress Stressors are created by the need to be successful at work and w other people Some individual consistently respond to situations thru a response by a particular body system or organ Pathologic change that occur regularly and that are combine w/ other chemical, biologic or physical stressors can eventually lead to tissue damage.

Stress
is a state produced by a change in the environment that is perceived as challenging, threatening or damaging to the persons dynamic balance or equilibrium

Stress

actual or perceived imbalance in the persons ability to meet the demands of new situation

Adaptation

Constant
on going process requires a change in structure, function and behavior so that the person is better suited to the environment

Types of Stressor Physical Physiologic psychosocial 1. day to day daily hassles 2. major complex occurrences

3. involve few people

According To duration :

Acute stress
Stressor sequence

Chronic intermittent
Chronic enduring

Homeostasis a state of dynamic equilibrium; stability; balance; uniformity

1. Systemic Physiologic Response to Stress

A. Sympatho-Adreno-Medullary Response (SAM) or Fight or Flight Response Stressors : a. physical injury

b. elevated body temp c. dehydration

Hypothalamus

Pituitary Gland
Adrenal Medulla Norepinephrine Epinephrine

Brain :
Eyes : Mouth : Heart :

increased alertness ; restlessness

dilated pupils; increased visual perception decreased salivary secretion; thirst and

dryness of mouth
tachycardia; coronary vasodilation Increased force of cardiac contractility

Increased cardiac output

Lungs: hyperventilation; bronchodilation peripheral vasoconstriction; Blood vessels:

increased Blood Pressure

Skin : Liver :

pallor; diaphoresis Increased blood glucose levels

Muscles :
GIT :

increased glycogenolysis
increased muscle tension decreased gastric motility

decreased peristalsis
constipation, Flatulence Urinary bladder: relaxation of detrusor muscles

contraction of the sphincter

Local Physiologic Response : inflammation involves mobilization of specific and nonspecific defense mechanism in response

to tissue injury or infection

Purpose of inflammation : to localize tissue injury

Inflammatory Response

Inflammants : physical ( thermal, radiation)

mechanical chemical Microbial

Tissue Injury

Vascular response
transitory vasoconstriction followed by vasodilation due to release of

histamine
bradykinin prostaglandin


Increase capillary permeability

1. Rubor ( redness) 2. Dolor ( pain ) 3. Calor ( heat ) 4. Tumor ( tumor ) 5. Impaired function

Healing Process ( Reparative Phase ) Regeneration involves replacement of damaged

tissue cells by new cells which are identical in

structure or function Scar formation involves replacement of damaged tissue cells by fibrous tissue formation

1st/Primary Intention

occurs in clean cut wound

The wound edges are approximated minimal or no tissue loss minimal granulation tissue formation.

Secondary Intention

occurs when the wound is extensive

great amount of tissue loss repair time is longer scarring is greater Tertiary Intention delayed surgical closure of infected wound.

The systemic Manifestation of Inflammation : a.Fever

Endogenous pyrogens (prostaglandins, leukotrienes, interleukin 1) Hypothalamus Resetting of the body temp set-point at a higher level

Increasing heat production/decreasing heat loss (shivering, sweating is inhibited, vasoconstriction)

Increased phagocytic activity Leukocytosis Anorexia Elevated ESR Headache Lymphadenopathy Fatigue/ malaise

Nursing Interventions for Clients with Inflammation : Promote rest Reduce swelling Position : elevate the affected body part to promote venous return

Heat and cold application

Relieve pain Adequate hydration

Nursing Interventions for Clients with Inflammation : Provide adequate Nutrition Pharmacotherapy Analgesic/Antipyretic Aspirin, Paracetamol, Mefenamic Acid NSAIDS Antimicrobials Surgery

Incision and drainage

Physiologic Effects of Heat Application Vasodilation increases blood flow to an area Promotes muscle relaxation and sedative effect Relieves edema because fluid is easily

absorbed in the area

Physiologic Effects of Cold Application Vasoconstriction controls bleeding Numbs nerve endings

has local anesthetic effect

relieves pain

Cold application is done during the 1st 72 hours, heat application follows after During heat and cold application, check the area every 15 minutes.

Methods of Dry Heat Application : Hot Water Bags/Bottles Heat Cradle Disposable hot packs

Heat lamp/ portable lamp

Methods of Moist Heat Application : Warm moist compress Warm soak Sitz bath

Methods of Dry Cold Application :

Ice collar
Ice cap Disposable cold pack

Thank you