suicide

Question 1

peak age of suicide males and females

Answer 1

men- after 45
women- after 55

Question 2

genetic risk factor for suicide

Answer 2

low serotonin levels in CSF

Question 3

psychosocial risk factors: Marital status

Answer 3

-Single never married = increased risk
-Marriage decreases risk
-Divorce increases risk

Question 4

psychological risk factors: mental illness

Answer 4

-Previous suicidal behavior: strongest, consistent indicator of risk
-95% of persons who commit suicide have a dx of mental illness
-80% depression
-10% schizophrenia (risk 50 x greater; males 60% attempt rate, esp. 1st few years of illness)
-5% dementia or delirium
-25% have co-morbid alcohol dependence

Question 5

protective factors of suicide

Answer 5

-treatment
-Restricted access to lethal means
-Family and community support
-Cultural and religious beliefs
-marriage
-employment

Question 6

risk factors of suicide

Answer 6

-Previous suicide attempt
-Mental illness, recent hospitalization
-Comorbid substance abuse
-Family hx of suicide/genetics
-hopelessness
-impulsive/aggressive behaviors
-Barriers to accessing mental health care
-Relational, social, work, financial loss
-Physical illness
-Access to lethal means
-contagion
-isolation

Question 7

meninger 3 parts to suicidal hostility

Answer 7

-wish to kill
-wish to be killed
-wish to die

Question 8

sociocultural factors

Answer 8

-rates highest with whites
- African American males complete suicide more than women. Peak rate in young adulthood and middle age

Question 9

warning signs of suicide

Answer 9

-Talking or writing about death, dying, or suicide
-Verbalizing feelings of helplessness, hopelessness, or worthless
-No sense of purpose in life, no reason for living
-Increased alcohol/drug use
-Withdrawal from family, friends, community
-Reckless behavior
-Dramatic mood changes
-Feeling trapped or like a burden

Question 10

Assessment: risk factors

Answer 10

-Previous SA
-Suicide in family
-Substance use
-Mood D/O (depression, BPD)
-Access to lethal weapons
-Life events
-Hx of trauma or abuse
-Chronic illness
-Exposure to suicidal behavior of others

Question 11

Assessment: protective factors

Answer 11

-Resilience
-Easy access to effective mental health assistance
-Strong connections to others (family, community, social interactions)
-Contact with providers

Question 12

Assessment: suicide

Answer 12

-Ideation
-Intent
-Plan (lethality, gestures, research, rehearsals, disclosure?)
-Means
-Previous suicide attempts
-Substance abuse/use
-Verbal clues: overt & covert statements
-Behavioral clues

Question 13

SAD PERSONS scale

Answer 13

-Sex (male)
-Age (25-44 or 65+ years of age)
-Depression

-Previous SI attempt
-Ethanol use
-Rational thinking loss
-Social supports lacking or recent loss
-Organized plan
-No spouse
-Sickness

Question 14

nursing diagnoses for suicide

Answer 14

-Risk for suicide (highest priority)
-Ineffective Coping
-Hopelessness
-Chronic low self-esteem
-Self care deficit
-Sleep pattern disturbance
-Altered nutrition
-Anxiety

Question 15

nursing interventions

Answer 15

-Create a safe environment
-Determine level of supervision needed for safety
-Assess for suicidal ideation/behavior
-Develop a safety plan with client; no contracts for safety
-Develop and maintain a collaborative therapeutic relationship with the patient

Question 16

environmental guidelines for risk reduction in a suicidal patient

Answer 16

-1:1 constant observation, arm’s length
-Removal of personal items for safekeeping
-Plastic utensils, utensil count
-Door remains open at all times
-Breakaway shower rods and recessed shower nozzle
-Absent or shortened wires; caution with telemetry cords
-Unbreakable glass in observation windows, covering television
-Patient and room search as indicated
-Monitor visitors, restrict if necessary

Question 17

Deliberate, direct attempt to cause bodily harm that does not cause death

Answer 17

non-suicidal self-injury (NSSI)

Question 18

prevalence of non-suicidal self-injury

Answer 18

Lifetime estimated at 13-23% adolescents; global issue; onset b/w 10-15 years old, peaks at late teens, declines b/w 25-29 y/o

Question 19

comorbidity of non suicidal self injury

Answer 19

-Personality disorders (Borderline PD)
-Depression
-Anxiety
-SUDs

Question 20

Assessment of non suicidal self injury

Answer 20

-Previous NSSI
-Types of self-injury
-Triggers for the behavior
-What has worked in the past to stop the behavior
-Physical assessment to evaluate wounds

Question 21

nursing diagnoses for NSSI

Answer 21

-Self Mutilation
-Risk for self mutilation
-Consider any appropriate dx for underlying conditions,i.e.,anxiety

Question 22

planning for NSSI

Answer 22

-Caring for wounds/injuries
-Establish a therapeutic alliance
-Teach coping skills
-Provide support
-CBT, DBT, Group Therapy
-Psychopharm for underlying conditions