General Adaptation Syndrome and Stress Phase Nursing Interpretation
Key Points
- General adaptation syndrome (GAS) explains whole-body stress progression through alarm, resistance, and exhaustion.
- Alarm phase reflects rapid sympathetic activation and emergency physiologic readiness.
- Resistance phase may resolve stress through effective coping or drift into maladaptive persistence.
- Exhaustion reflects depleted adaptive resources and high risk of clinical deterioration.
Pathophysiology
Selye’s GAS model describes a nonspecific biologic response to stressors. In alarm phase, sympathetic and endocrine systems mobilize resources for immediate threat response.
In resistance phase, the body attempts to counterbalance stress activation and restore function. Effective coping and relief of stressors support recovery; unresolved strain extends this phase and increases physiologic burden.
Exhaustion phase occurs when adaptation resources become depleted and compensatory capacity fails. At this point, system dysfunction, worsening chronic illness, and crisis states become more likely.
Classification
- Alarm phase: Acute activation, high vigilance, and immediate physiologic mobilization.
- Resistance phase: Ongoing adaptation with potential for recovery or maladaptive persistence.
- Exhaustion phase: Resource depletion, declining resilience, and high complication risk.
- Response scope: Generalized systemic response versus localized adaptation reactions.
Nursing Assessment
NCLEX Focus
Exam items often test whether findings reflect recovery-capable resistance or high-risk exhaustion.
- Assess stress timeline and whether symptoms are improving, stable, or worsening.
- Assess stage-linked physiologic patterns (autonomic arousal, sustained strain, or decompensation signs).
- Assess coping adequacy and support availability relative to stress burden.
- Assess for exhaustion indicators such as recurrent exacerbations, functional decline, and increasing crisis episodes.
Nursing Interventions
- In alarm stage, prioritize stabilization and immediate threat reduction.
- In resistance stage, strengthen effective coping and reduce stressor intensity where possible.
- In exhaustion stage, escalate interdisciplinary support and intensify monitoring/intervention.
- Use stage-based reassessment to confirm transition toward recovery.
Exhaustion Transition
Missing progression into exhaustion can delay intervention until preventable decompensation occurs.
Pharmacology
Pharmacologic management may support acute physiologic instability and symptom clusters, but persistent stage progression requires comprehensive nonpharmacologic stress-reduction and disease-management strategies.
Clinical Judgment Application
Clinical Scenario
A patient with chronic stress-related hypertension now shows fatigue, poor coping, repeated admissions, and worsening glycemic control.
Recognize Cues: Chronic activation with declining compensatory performance. Analyze Cues: Pattern suggests late resistance progressing toward exhaustion. Prioritize Hypotheses: Prevent further system breakdown and crisis-level deterioration. Generate Solutions: Intensify stress and chronic-disease management with multidisciplinary input. Take Action: Implement stage-based plan and close follow-up. Evaluate Outcomes: Reduced exacerbation frequency and improved function trend.
Related Concepts
- stress-response-homeostasis-and-allostasis - Baseline framework for stress physiology and recovery.
- chronic-stress-allostatic-load-and-system-breakdown - Long-term effects of unresolved GAS progression.
- stress-crisis-staging-and-type-specific-nursing-response - Crisis-level escalation logic.
- stress-and-anxiety - Behavioral and psychological manifestations across phases.
- clinical-judgment-measurement-model - Structured cue analysis and hypothesis prioritization.
Self-Check
- Which findings best distinguish resistance from exhaustion phase?
- How does ineffective coping extend GAS progression?
- Why is phase-based reassessment essential in chronic stress care?