Unit 7 Suicide and Non Suicidal Behavior Chapter 25 Flashcards
What is Suicide?
Suicide is death caused by self-directed inju- rious behavior with the intent to die as a result of the behavior
Suicide is the intentional act of end- ing one’s life by any means.
What is suicidal ideation?
Suicidal ideation is thinking about death, including the wish to be dead, considering methods of accomplishing death, and formulating plans to carry the act out.
What is a suicidal attempt?
A suicide attempt, also referred to as a suicidal act, is engaging in potentially self-injurious behavior with the intention of death. These attempts may result in death, injuries, or no injuries. Suicide is the intentional act of end- ing one’s life by any means.
Which of the following members of society is at #1 risk for suicide?
A. Military personels
B. Nurses
C. Fire fighters
D. Police men
A. Military personels
Military is increasingly concerned about suicide rates
Veterans are at high risk for suicide
What is a risk factor for suicide?
Previous suicide attempt
* Hx of suicide in the family
* Substance use
* Mood disorders – Depression, Bipolar
* Access to lethal means
* History of Trauma or Abuse
* Professionals are considered a higher
risk for suicide. Law enforcement, sales
personnel, mechanics, insurance agents
and lawyers
* Losses and other events
* Breakup(a breakup can feel like the end of the world)
* Death
* Bullying
* Legal difficulties(fraud or bankruptcy)
* Financial difficulties(job layoff , losing all of your money in the stock market, tripling debt)
* Academic failures
* Chronic Physical illness including chronic
pain
- Exposure to the suicidal behavior of
others
What is an example of a patient who is Exposed to the suicidal behavior of
others?
their favorite celebrity committing suicide, which induces them to commit suicide as well
What is the number one nursing intervention when a patient expresses suicidal ideation?
A. verbal deescalation
B. initiate restraints
C. initiate Seclusions
D. 1-to-1 watch
D. 1-to-1 watch
S/S of a possible suicidal attempt ?
WARNING FACTORS
- Talking or writing about death, dying or suicide
- Comments about being hopeless, helpless or worthless
- Expressions of having no reason for living
- Increase alcohol and/or drug misuse
- Withdrawal from friends, family and community
- Dramatic mood changes
- Talking about feeling trapped or being a burden to others
Who is at greatest risk for suicide?
A. 26 year old female who has a suicide attemptted at 25 years old
B. 12 yer child who’s dog has past
C. wife who lost her husband
D. 26 year old who just got fired from his job
A. 26 year old female who has a suicide attemptted at 25 years old
Attempted suicide in the past (especially past 12 months)
HIGHEST PREDICTOR OF SUICIDE
Your patient has been selling all of his possessions following the start of antidepressants. what is the priority nursing intervention?
A. assess for suicidal ideation
B. initiate 1 to 1 observation
C.
like giving away possessions, sudden mood brightening, just starting antidepressants, organizing affairs, etc..
What is cheeking?
not taking medication , nonahderance to medication
Suicidal Precautions
1:1 observation
Remove any object that could be potentially harmful
Hands always in view
Monitor swallowing medications Etc.
Assessing the suicidal plan
Do you have a plan? (Even if no plan, take the threat SERIOUSLY
they can always get another plan)
establish rapport
Ask about the plan
do they have a plan, is it detailed
how lethal is the plan
do they have access to do it
Which of the following patient at the GREATEST risk of committing suicide?
A. a 12 year old child who has been bullied at school about her appearance.
B. A women who has lost her keys.
C. A police men who has lost his family due to a tsunami and his home
D. A foster child
C. A police men who has lost his family due to a tsunami and his home
Assessing Lethality
- cutting is less lethal than having a gun
-do thy have car to drive off a mountain but they live in Florida not California
What are some protective factors for suicide?
- Effective mental healthcare; easy access
- Strong connections to individuals, family, community, and social institutions
- Problem-solving and conflict resolution skills
- Contact with providers
- Some religions
Assessment for suicial ideation and suicide attempt
If there is a history of suicide attempt:
* Assess intent
* Lethality
* Injury
* Medical conditions(Cystic fibrosis - poor prognosis)
* Psychiatric diagnosis
* Current meds(TCA’s -cardio toxic , amtriptiline) weekly rx
Assessment for Suicadal patient
Assess risk factors
* Assess protective factors that may be
built upon
*A change from sad or depressed to
happy ad peaceful may be a red flag.
Especially if recently beginning an
antidepressant
* Always assess social supports and
helpfulness of significant others
Which of the following behaviors is a red flag in a depressed client?
A. Reports feeling depressed ever since his dog died
B. Telling you that he’s been giving away his valuables away after starting antidepressants.
C. Becomes traumatized every time he hears fireworks
D. Complains of insomnia after taking methylphenidate
B. Telling you that he’s been giving away his valuables away after starting antidepressants.
*A change from sad or depressed to
happy ad peaceful may be a red flag.
Especially if recently beginning an
antidepressant
What is an example of a verbal cue of suicidal ideation?
Direct vs Indirect
Verbal and nonverbal clues
* *Direct verbal statement – “I am going to blow my brains out”**
* “I can’t take it anymore.”
* “Life isn’t worth living anymore.”
* “I wish I were dead.”
* “Everyone would be better off if I died.”
- *Indirect verbal statement – “My family would be better off if I weren’t around”**
- “It’s okay now. Soon everything will be fine.”
- “Things will never work out.”
- “I won’t be a problem much longer.”
- “Nothing feels good to me anymore and probably never
will.” - “How can I give my body to medical science?”
What is an example of a nonverbal cue of suicide?
- Nonverbal –
sudden brightening of mood and increased energy. THEY HAVE A PLAN
Giving away prized possessions
, getting affairs in order
What do you do when you suspect someone is suicidal?
Open or closed ended question?
CLOSED ENDED
Yes or NO
What do you do when you suspect someone is suicidal?
* ASK – Directly – “Are you having thoughts of ending your life?” “Are you thinking
about killing yourself?”
Should ALL threats of suicide be taken seriously ?
A. Yes
B. Yes
A. Yes
- All threats of suicide are taken seriously
Lethality , SOFT VS HARD METHOD
Lethality – How quickly the person would die from that mode
* Hard method: using a gun, jumping from high place, car crash
* Using a gun
* Jumping off a high place
* Hanging
* Poisoning with carbon monoxide * *Staging a car crash
- Soft method: cutting self, ingesting pills