This presentation gives a complete brief about stress adaptation and management of stress.This describes the definition of stress, pathophysiology of stress adaptation, clinical signs of stress, phases of stress , common type of stressors and the nursing interventions for stress management.

1. STRESS ADAPTATION AND ITS
MANAGEMENT
Ms. Shivnetri Chauhan
Nursing tutor
Faculty of nursing, Rama university

2. DEFINITION
Stress is body’s response to demands which can be overcome by one’s ability to adapt, therefore stress usually
results due to an imbalance between person’s demands and his or her ability to adapt.
PATHOPHYSIOLOGY OF STRESS(STRESS ADAPTATION)
The physiological response to stressor are protective and adaptive , involves three inter related systems that is
nervous system, endocrine system, immune system.
1. Nervous System
• Hypothalamus a neuro endocrine center situated in the center of the brain integrates the activity of ANS and
maintains the internal environment of body.It is surrounded by limbic system and contains vital centers for
respiration, temperature, blood pressure and emotion.
• Hypothalamus takes part in both emotional and physiological response to stressors.
• The important function of hypothalamus are:
• It controls and coordinates the autonomic nervous system, temperature regulation, food intake, water balance
and cardiovascular functions.
• It regulated the secretion of anterior pituitary hormones.
• It controls emotions and behavior.
• The limbic system is concerned with emotions and behaviour. When this system is stimulated, emotions, feelings
and behavior changes occur.

3. 2. ENDOCRINE SYSTEM
• Stimulation of hypothalamus by stressors releases pituitary hormones(ACTH) which subsequently results in stimulation
of adrenal system leading to release of adrenal cortex and catecholamines (epinephrine, nor-epinephrine) by adrenal
medulla. These hormones prepare the body for Fight response.
• The glucocorticoids produces number of physiological effects such as it increases blood glucose levels, inhibits
inflammatory response.
• The mineralocorticoids like aldosterone retains sodium and maintains extracellular fluid compartment.
• The stimulation of ADH by posterior pituitary promotes water reabsorption and maintains water balance.
• The stimulation of adrenal medulla and secretion of epinephrine and nor epinephrine increases blood sugar levels
which acts as a fuel in response to stress. There is an increase in heart rate and blood pressure.
3. IMMUNE SYSTEM
There is a suppression of immune system by corticosteroids and catecholamines secreted in response to stress.
There is reduction in inflammatory response to injury and infection initiated by inflammatory cytokines as a result the
ability of the person to resist infection is suppressed.

4. CLINICAL RESPONSE TO STRESS
1. Behaviour response
In response to stress, there may be a change in the behavior of a person that is decreased thinking and indecisiveness,
increased use od tobacco and alcohol, and disrupted sleep pattern.
2. Emotional response
• Anger
• Apathy
• Loss of self-esteem
• Loss of patience
• Depression
3. Body’s response
• Palpitations
• Sweating
• Fatigue
• Tightness in chest and head
• GI Upset
• Increase B.P
• Increase Heart rate and respiratory rate

5. PHASES OF BODY IN RESPONSE TO STRESS
Phase 1
Stressor
(Physical, psychological,social)
ALARM REACTION
(Fight or Flight response)
Stimulation of sympathetic nervous
system and CNS

6. STRESS RESISTANCE
The body responds to stress and
attempts to maintain homeostasis.
Coping and adaptive mechanisms come
into play to resist stress
RECOVERY Or EXHAUSTION
Recovery occurs if stress ceases.
If STRESS continues , adaptation is exhausted and
organ damage starts.
PHASE-II
PHASE-III

7. COMMON STRESSORS
1. Physical stressors
• Noise
• Burn
• Injury
• Infectious di9sease
• Pain
• Overwork
2. Emotional stressors
• Diagnosis of cancer
• Death of any loved one
• Problem at work
• Marital problems
• Business and financial problems
• Personal or social problems

8. NURSING INTERVENTIONS
1. Stress resistance and relaxation therapy
• Stress resistance means to overcome or resist stress by adopting healthy lifestyle such as healthy eating pattern,
engaging in physical work, adopting stress relaxation techniques.
• Physical activity is stressor as well as stress reliever when performed properly results in physical changes that counter
the negative effects if stress.
• Healthy eating resists stress while unhealthy eating aids to stress. Complex carbohydrates, fruits, vegetables provide
sustained release of energy hence have relaxing effect.
• Sleep and rest relieves mental health and physical stress by way of relaxation.
• Inadequate rest leads to mental dysfunction and can worsen stress.
• Meditation is also considered as a way for relaxation results in physiological changes such as lowering blood pressure
and blood sugar to prevent heart disease risks.
2. Changing the stress perception
Stress is an individual perception or experience to an event hence by changing the perception one can overcome stress.
The techniques to change perception are
Thought interruption
Substitution of irrational ideas with rational ideas
Imagination guidance

9. 3. Effectiver Coping
• It is defined as the recognition of the problems causing stress and solving them through skill
development.
• Effective coping skills include- assertiveness, problem solving therapy and development of support
system.
• Effective coping begins with identification of the problem and to study it thoroughly before
addressing it with the problem solving skills.