The nurse is caring for a client who just had a subclavian central venous catheter inserted. Which symptom should the nurse recognize as setting a priority for this client's care?

B. This statement aligns with the concept of allostatic load, which refers to the cumulative physiological toll that chronic stress places on the body over time. Initially, the body's stress response system (the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system) is designed to help individuals cope with acute stressors. However, when stress becomes chronic, these physiological responses can become dysregulated and maladaptive, leading to negative health outcomes such as cardiovascular disease, immune dysfunction, and mental health disorders.
A. Chronic stress has been associated with various changes in gene expression and epigenetic modifications. However, these changes typically occur over longer periods and are not the primary mechanism by which chronic stress leads to illness in most cases.
C. Chronic stress can lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, which are responsible for producing and regulating corticosteroids (such as cortisol) and catecholamines (such as adrenaline and noradrenaline). While acute stress typically results in increased production of these stress hormones, chronic stress can lead to desensitization and dysregulation of these systems, resulting in alterations in hormone levels and potential deficits in the availability of these stress mediators. However, deficits in corticosteroids and catecholamines are not the sole mechanism by which chronic stress leads to illness.
D. While chronic stress can certainly contribute to psychological fatigue and depletion of energy reserves, this is not the primary mechanism by which chronic stress leads to illness. The physiological responses to chronic stress, such as dysregulation of stress hormones, inflammation, and oxidative stress, are more directly linked to the development of various illnesses.

D. It is important to recognize and respect the client's natural sleep patterns, especially considering their age and current health status. Napping during the day can be a normal and beneficial behavior for older adults, helping to replenish energy levels and promote overall well-being. As long as the client's napping does not interfere with their ability to sleep at night or their daily activities, no intervention may be necessary.
A. Encouraging the client to stay awake during the day may not be appropriate, especially considering the client's age and natural sleep patterns. Older adults often experience changes in their sleep-wake cycle, including more frequent napping during the day.
B. Physical activity is important for maintaining mobility and overall health but substituting physical therapy for one of the client's usual nap times may not be feasible or beneficial. The client's need for rest and sleep should be respected, especially if they are experiencing fatigue or illness.
C. Prescribing a sleeping pill for the client may not be appropriate, especially if they are already napping during the day. Sleep medications can have side effects, including drowsiness, confusion, and increased risk of falls, particularly in older adults.