1. The client/caregiver can define stress.
   1. It is a pressure or a strain caused by a real or perceived threat.
   2. It can cause mental, physical, intellectual, emotional, and/or spiritual consequences.
   3. It creates a physical reaction in which hormones are released, causing symptoms such as tense muscles, pounding heart, increase in blood pressure, cold clammy hands, and tense stomach.
   4. Prolonged or chronic stress can be particularly harmful.
2. The client/caregiver can list the benefits of stress.
   1. Increases concentration
   2. Increases alertness
   3. Improves performance
   4. Increases strength
   5. Provides incentive for accomplishment
3. The client/caregiver can list the bad effects of stress.
   1. Chronic fatigue and sleep disturbances
   2. Increased pulse, blood pressure, and respirations
   3. Constipation, diarrhea, or ulcers
   4. Chronic back pain, headache, and stiff neck
   5. Increased susceptibility to disease
   6. Loss of appetite, nausea, and weight loss
4. The client/caregiver can list methods to cope with stress.
   1. Identify stressors.
   2. Attend support groups.
   3. Have psychotherapy.
   4. Simplify life.
   5. Do not self-medicate with alcohol or drugs.
   6. Promote better organizational skills.
      1. Delegate jobs to others.
      2. Use time management.
      3. Establish priorities.
      4. Learn to say “no.”
   7. Take care of the body.
      1. Eat a well-balanced diet.
      2. Avoid caffeine, alcohol, and tobacco.
      3. Take vitamin and mineral supplements.
      4. Obtain adequate rest.
      5. Exercise regularly.
   8. Develop positive thinking.
      1. Learn and practice assertiveness.
      2. Use good posture.
   9. Keep your expectations realistic.
   10. Keep a sense of humor.
5. The client/caregiver can list techniques and activities that may decrease stress.
   1. Mental imagery/visualization
   2. Progressive muscle relaxation
   3. Meditation
   4. Biofeedback
   5. Aromatherapy
   6. Deep breathing exercises
   7. Massage
   8. Therapeutic touch
   9. Stretching
   10. Walking
   11. Gardening
   12. Spending time with a pet
   13. Hot baths
   14. Listening to music
   15. Reading
   16. Physical activities such as swimming
6. The client/caregiver can list stress management techniques that have been used in other countries many years ago and are now becoming popular in our society.
   1. Acupuncture uses needles at certain points on the body to promote the flow of energy.
   2. Acupressure uses the application of pressure on certain points in the body to promote the flow of energy.
   3. Reflexology is the use of pressure on specific areas of the foot or hand that correspond to body organs.
   4. Shiatsu is a form of manipulation to correct internal malfunctioning.
   5. Aroma therapy is the use of essential oils to promote healing.
   6. Massage has been used in many countries to reduce stress and pain.

Resources

National Center for Complementary and Alternative Medicine
http://nccam.nih.gov

Counseling/clergy

Support groups

Health clubs

YMCA

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Elsevier.
Canobbio, M. M. (2006). Mosby’s handbook of patient teaching . St. Louis: Mosby Inc.
Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY: Thomson Delmar Learning.
Lutz, C., & Przytulski, K. (2001).Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Nutrition made incredibly easy. (2003). Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K. (2005). Fundamental nursing skills and concepts. Philadelphia: J. B. Lippincott Williams & Wilkins.