Question

2. You are a general practice nurse caring for a husband and wife who made an appointment to see the health care provider regarding how stress is impacting their well-being. The 72-year-old husband is a caregiver for his wife, who is in the early-middle stage of Alzheimer’s disease. As a nurse for 40 years, the wife is very aware of what is going on (when she’s oriented) and is very concerned about the responsibility her husband feels quite deeply.

a. Which human dimensions are impacted by stress?

b. Why is adaptation necessary?

c. Which physiologic indicators of stress might you assess (or discover by interview) in the husband?

Answer 1

A. Stress is a emotional and mental strain in response to adverse situations. It affects an individual in following dimensions:

• Cognitive Dimension: The cognitive manifestations of stress have to do with our thinking and thought processes. If one’s stress level is elevated and remains unchecked, concentration, focus, organization, and clarity of thought can be compromised. Elevated stress levels can also affect one’s ability to remember important details, and to listen to others. Time management and organization can all suffer in the cognitive realm when stress increases.
• Affective Dimension: Likewise, at the affective level, one’s emotions can be effected by stress. Irritability, rapid mood swings, unpredictable anger, and sadness are all accentuated by increased stress levels.
• Behavioral Dimension: Increased levels of stress can also result in behavioral changes like alcohol and substance use and abuse, and absentee issues. It can also compromise our relationships with others. As stress increases, we become less capable of positive interactions with others.
• Physical Dimension: Physically, high levels of stress have been linked to changes in appetite and sleep patterns (either increases or decreases), weight gain or loss, and other health issues like high blood pressure and ulcers. Stress can also impact exercise regimens that in turn can have dramatic impacts on our behavior, our emotions, and our cognitive functioning.

B. adaptation is a process by which an individual becomes suitable to his situations so as to survive otherwise an individual will be physically, mentally, emotionally and cognitively sick. He will not be able to carry out his activities of daily living

C. I may assess physiological indicators like laxk of sleep, loss of apetite by interview and other indicators like heart rate, blood pressure, body temperature, serum levels of various stress hormones (e.g. cortisol) and immunological functions (e.g. suppression of lymphocyte activity)by various lab tests.