A nurse is caring for a client in the shock or alarm phase of the GAS. Which response by the patient would be expected?

Appeared in: SGPGI Nursing Officer-2023

Explanation

The alarm stage of GAS is the body's immediate 'fight-or-flight' response to a perceived threat.
This response is driven by the sympathetic nervous system, which triggers the adrenal medulla to release epinephrine and norepinephrine.
These hormones cause the liver to convert glycogen to glucose and release it into the bloodstream, providing a rapid source of energy.
This mobilization of energy results in increased physical energy levels and heightened mental alertness to confront or escape the stressor.

Option A: During the alarm phase, the sympathetic nervous system stimulates the heart, causing an increase in heart rate (pulse), not a decrease.
Option B: The release of catecholamines like epinephrine and norepinephrine leads to a state of hyper-alertness and wakefulness, not sleepiness.
Option D: The body's demand for oxygen increases to fuel the muscles and brain for the fight-or-flight response, leading to an increased respiratory rate.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Physiological responses during the alarm stage of the General Adaptation Syndrome (GAS) in acute care settings.
Nurses must be able to recognize the signs of the acute stress response in patients, as it can indicate pain, anxiety, fear, or a deteriorating physiological condition like shock or hypoxia.
Understanding GAS helps nurses anticipate patient needs. A patient in the alarm phase may require reassurance, a calm environment, and clear communication to manage their anxiety.
What if? If a patient is on a beta-blocker medication (e.g., metoprolol), the classic tachycardia (increased pulse) of the alarm response may be blunted or absent. The nurse would need to assess for other signs of stress, such as increased respiratory rate, diaphoresis (sweating), or agitation.

How to Approach the Question

First, identify the core concept in the question stem: 'shock or alarm phase of the GAS'.
Recall the key characteristics of the alarm phase. The most common association is the 'fight-or-flight' response.
Think about what 'fight-or-flight' means physiologically: the body prepares for intense physical exertion.
Evaluate each option based on this 'fight-or-flight' model.
Does the body need less pulse? No, it needs more. Does it need sleep? No, it needs to be alert. Does it need less air? No, it needs more oxygen.
Does it need more energy? Yes, absolutely. This aligns perfectly with the mobilization of resources for survival. Therefore, an increasing energy level is the expected response.

Concept Tested & Keywords

Concept Tested: Physiological responses during the alarm stage of the General Adaptation Syndrome (GAS)
Stem keywords: shock, alarm phase, GAS, General Adaptation Syndrome
Lead-in keywords: expected response
Negative lead-in flag: false

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E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 59-61

E6 Psychology Applied Sreevani 6e Sem1 p. 227-229

E6 Psychology Applied Sreevani 5e p. 226-228

Practise the full SGPGI Nursing Officer-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.