suicide

Question 1

suicidal ideation

Answer 1

thinking about death, wish to be dead, consider methods, formulate plans
all encompassing term

Question 2

suicidal behavior

Answer 2

acts associated with suicidal intent, get means

Question 3

suicide attempt

Answer 3

engage in potentially injurious behavior with intent of death

Question 4

interrupted self directed

Answer 4

by other: take steps to injure self, stopped prior to fatal injury, during behavior or thought
by self: teak steps to injure self, stopped by self prior to fatal injury

Question 5

suicide/death by suicide

Answer 5

death by self directed injurious behavior with intent to die as result

Question 6

suicide survivor

Answer 6

survivors of person that died by suicide

Question 7

postvention

Answer 7

mental hc and support to survivors, resoruces, referrals

Question 8

cluster suicides

Answer 8

contagion, copycat
closer in time and space
inc when: stories inc, story reported at length, front page or beginning of broadcast, person broadly known, story spreads, dramatic headline

Question 9

unacceptable terms

Answer 9

completed/committed suicide -> suicide/death by suicide
wrongdoing
successful (+ connotation), failed (cant do anything right), non fatal, suicidal gesture, suicidality (broad) -> suicide attempt

Question 10

attempts

Answer 10

hx of attempt inc r/o death

Question 11

general info

Answer 11

active duty higher, 11th leading COD, vets rising rate, mental health cinditon higher, middle aged white men, F more attempts, firearms
national pt safety goal, sentinel event -> screening, doc, training, monitor and assess

Question 12

dx

Answer 12

not ideation or prep acts
w/n last 24 mo -> attempt, not just thoughts, plans, etc
not non suicidal self injury
not initiated in altered mental state -> delirium, confusion
not undertaken for religious or political objectives

Question 13

prevent

Answer 13

know rf and warning s
screen by directly asking
identify protective factors, dev safety plan (recognize it can help keep safe), dec lethal access
provide individuals with resources and hot line
create com based systems to respond to risk

Question 14

rf

Answer 14

multiple causes, not exhaustive, mod and non mod

Question 15

rf - individuals

Answer 15

hx atempt, dep or MI, OH or substance use disorder (major R), phys health, chronic illness, criminal/legal problem, job/financial problem/loss, hx adverse childhood experiences, hopelessness

Question 16

rf - relationships

Answer 16

bullying, fam/friend hx suicide, loss of relationship, high conflict/violent relationship, social isolation

Question 17

rf - comm

Answer 17

dec access to healthcare/tm, suicide cluster, stress of acculturation, comm violence, hx trauma, discrimination

Question 18

rf - societal

Answer 18

culture and env
stigma of help seeking and MI, easy access to lethal means

Question 19

warning signs

Answer 19

trust instincts, not crisis, just something to pay attention to
hopeless/worthless, burden, preoccupation with death/lack of concern for personal safety, reckless, trapped, unbearable pain, inc substance use (esp OH), anger, irritable, resentment, isolated withdrawing from fam/friends
extreme mood swings, inc anx, sudden uplift in mood w/o reason, sleep too little too much, giving away possessions, look for way to access lethal means, make plans

Question 20

protective factors

Answer 20

better coping skills
dec R, want to inc these factors -> resiliency

Question 21

protective factors - individual

Answer 21

effective coping and problem solving skills
reasons to live
strong cultural identity

Question 22

protective factors - relationships

Answer 22

strong connection and support from individuals, friends, fam
feel connected to others

Question 23

protective factors - comm

Answer 23

connected to school, comm, social institutions
avail of and contact with consistent and high quality of phys and behavioral health care

Question 24

protective factors - societal

Answer 24

dec access to lethal means
strong cultural identity; cultural, religious, moral objections, to suicide

Question 25

assess

Answer 25

with C-SSRS screen -> w/o action = no change rf and protective factors, reassess most share when asked directly everyone screened = no stigma for asking doesnt put thought in head plan = high risk

Question 26

starly brown safety plan

Answer 26

recognize and manage suicidal thoughts dont use no suicide contract

Question 27

recognizing cues

Answer 27

verbal and non verbal, body lang overt statements: wish I were dead, cant take it covert statements: soon everything will be fine, wont be a problem anymore, nothing feels good anymore do verbal match nonverbal? assess lethality of plan -> ask directly, time , plance self assess -> our own suicidal ideation, grief, anger, countertransference

Question 28

care plan

Answer 28

priority: suicide, coping, anx, social support, self care, sleep pattern outcome: self restraint, coping, hope planning: based on risk and protective factors involve SO

Question 29

treatment and management

Answer 29

reassess -> esp if change in conditoin safety planning for all env safety concerns -> search pt, mitigate ligature risks, plastic utensils, disposable tray, tubing, dispose outside ob sitter hand off comm reg safety rounding -> even with sitter means management -> no supplies in pt, discuss outpt no private room (sitter), door open, jump and hang proof, lock other doors, inform and monitor sitter of risk -> observe even in bathroom monitor and remove things from visitors monitor med ingestion identify means to self harm prior to d/c comm resources involve social throughout stay take care of self: exercise, nutrition, sleep, relax, outside, mindful, connect with others communities: dec stigma, learn rf and warning s, QPR, know resources

Question 30

treatment and management - support

Answer 30

direct Q, discuss current crisis, tc strategies, no judgement, trust, coping strategies, protective factors, educate about safety plan, comm resources

Question 31

treatment and management - obs

Answer 31

level determined by provider, only dec with order but can inc or be initiated by RN location: locked in pt -> based on acuity, higher at beginning; acute care -> 1:1