Fundamentals of Nursing
Quiz 42 :
Stress and Coping
Mastectomy is the surgical removal of the breast completely or partially. It alters the body shape of the patient Ruby. Lumpectomy is the removal of lumps or tumor tissue only. It does not alter the body shape of a woman. Therefore, the surgery is generally preferred by the women. The primary reason of the stress in the patient was losing the shape of the body. This option would have altered the stress levels of Ruby. Therefore, the anxiety, fear, and other stress-related parameters would have been minimized. Ruby has shown her major concern over the body shape changes. So, it appears logical that the nursing diagnosis might have been changed. Many of the diagnosed stress-related changes would have been absent from the list. This would have automatically altered the nursing outcomes. The nursing outcomes are based on the nursing diagnosis. A nurse would not have checked or assessed so many outcomes, if the lumpectomy was opted instead of mastectomy. Therefore, to conclude the discussion, the changes in the stress levels in a lesser stressful option would have changed the nursing diagnosis and the nursing outcomes.
Stress is something that we all have experienced at one point. Be it as a young teenager, or as a parent or as an older adult like a bride getting ready for her marriage or any student preparing for graduation. Stress is a condition in which a person feels and experiences changes in their normal body conditions. Anything, which causes stress, is called a stressor and it can be anything. When a person realizes how to tackle it, it is called as coping strategies, coping mechanisms and coping responses. If the nurse keeps herself busy and does not think about it also falls under effective coping. Joining a group discussion also falls under effective coping. Hence, the options 1, 2 and 4 are incorrect. If the nurse is spending all of her time by working extra shift and is not talking to anyone about it. This is not normal. It is categorized as ineffective coping, as the nurse is not able to cope with the deaths of her client and can sink into depression. Hence, the correct answer is option .
Response-based models consider the stress as the response of an event. The event can cause non-specific response as the stress elevates in the body. Therefore, this stress is the response, which causes the physiological chain of events. This chain of events is called the general adaptation syndrome. So, the stressor is the stimulus or the factor causing stress and disturbs the body equilibrium. In this case, the stress is only due to the physiological changes. Some of the physiological changes are the release of certain hormones and the subsequent alterations in the body. The effects of the stress are the ulcers in the body, the enlargement of the adrenal gland, and the shrinkage of the lymph nodes. On the other hand, the stimulus-based models define the stress as the stimulus, the event, or the circumstances that create physiological and psychological changes, which might eventually lead to illness. Stressful events can be the recent event, which leads to all the harmful changes in the person. Therefore, the case of Ruby appears to be based on this model. Ruby has a stress related to a recent upcoming event in the form of mastectomy. The physiological and psychological changes are occurring in her, because of the stress stimulus. One clear indication is that in the former model, the stress is only a physiological or biological change. Here, her psychological changes have, also, been mentioned.