Mental Exam 2; Suicide & nonsuicidal self injury
Where is assisted suicide legal?
netherlands, belgium, switz, columbia, canada
diathesis stress model for suicide?
combination of suicidal fantasies and significant loss
suicide successfully resulting in death
completed suicide
A person with which psychiatric problem is most likely to complete suicide? A.Personality disorder B.Major depression C.Substance abuse D.Schizophrenia
d
Which method of suicide has the highest lethality? A.Ingesting pills B.Cutting one's wrists C.Inhaling natural gas D.Self-inflicted gunshot wound
d
example of overt statements?
I cant take it anymore, life isn't worth living anymore, I wish I were dead, everyone would be better off if I died
suicide bombing ?
a bomb attack carried out by a person, especially a terrorist, who intends or expects to kill themselves as well as other people
example of covert statements?
its okay now soon everything will be fine, things will never work out, I wont be a problem much longer, nothing feels good to me anymore and probably never will, how can I give my body to medical science?
does DSM-5 include religious and political suicides in its criteria?
no excludes it
Self-injury directed to the surface of the body to induce relief from a negative feeling/cognitive state or to achieve a positive mood state
nonsuicidal self injury
protective cultural factors of AA with suicide?
religion, role of the extended family
protective cultural factors of hispanic americans with suicide?
roman catholic religion and importance of extended family
thinking about killing oneself
suicidal ideation
intentional act of killing oneself by any means
suicide
SAFE-T tool?
suicide assessment five step evaluation and triage
freuds thoughts on suicide?
theorized that suicide resulted from unacceptable aggression toward another person that is turned inwards
treatment of the actual suicidal crisis
treatment
safety plan?
written 6 step plan that includes identification of warning signs, internal coping strategies, social settings, and people who provide distraction
what are some questions you could ask to assess for suicide ideation?
-Have you ever felt that life was not worth living? -Have you been thinking about death recently? -Did you ever think about suicide? -Have you ever attempted suicide? -Do you have a plan for completing suicide? -If so, what is your plan for suicide?
environment safety guidelines?
-Use (and count) plastic utensils. -No private room; keep door open at all times. -Jump-proof and hang-proof bathrooms: by installing breakaway shower rods & recessed shower nozzles -Keep electrical cords to a minimal length -Lock doors to non-patient areas. -Monitor for and remove potentially harmful gifts. -Install unbreakable glass in windows, tamper proof screens. Keep all windows locked -In patient's presence, assess belongings and search patient for harmful objects. -Ensure that patients do not bring or leave harmful objects.
mileu therapy for acute suicide precautions?
-continuously observe patients , one on one observation and interaction 24h a day never let patient out of staff sight -describtion of patients affect and bheavior (fearful, clam, hostile) -chart patients whereabouts and record mood, verbatim statements, and behavior every 15-30 min per protocol -Ensure that meal trays contain no glass or metal silverware -when patients is sleeping, hands should always be in view, not under the covers -observe patients swallow each dose of medication
what are the lower risk/soft methods for suicide?
-cutting writs -inhaling natural gas -ingesting pills
why do people do nonsuicidal self injury?
-desire To feel relief from negative thoughts or feelings such a sanxiety, anger, distress -Achieve a short but intense state of euphoria during or after the injurious act, release of endogenous opiods in response to tissue damange. -Outcomes for people who self injure can eventually become fatal
what are the higher risk/hard methods for suicide?
-using a gun -jumping off a high place -hanging -poisoning with carbon minoxide -staging a car crash
things to consider with lethality of patients suicide plan?
1. is there a specific plan with details? 2. how lethal is the proposed method? 3. is there access to the planned method? -when the patient confirms access to the propped method, the situation is more serious
copycat suicide?
A suicide that follows a highly publicized suicide of a public figure, idol, or peer in the community.
nursing interventions for nonsuicidal self injury?
Caring for the patients wounds and injuries, establishing a therapeutic alliance and teaching coping skils to replace the self injurious behaviors
C-SSRS ?
Columbia Suicide Severity Rating Scale
risk factors for suicide?
Sex (Male), Age (Teenager or Elderly), Depression, Previous Attempt, Ethanol or Drug Use, Loss of rational thinking, Sickness (medical illness), 3 or more prescription medications, Organized plan, No spouse (divorced, widowed, or single especially if childless). Social support lacking. Women try more often. Men succeed more often. -schizophrenia pt attempt suicide at least once related to the depressive negative symptoms rather than to command hallucinations or delusions -may run in families, genetic -low serotonin levels related to depressed mood -85-90% caucasians
suicide rates among who are increasing rapidly?
active duty service members & veterans
menningers thoughts on suicide?
added to freuds work by describing 3 aspects of suicidal hostility -the wish to kill (revenge) -the wish to be killed (guilt) -the wish to die (hopelessness)
protective cultural factors of asian americans with suicide?
adherence to religions that tend to emphasize interdependence between the individual and society
aaron beck thoughts on suicide?
central emotional factor underlying suicide intent is hopelessness
is assisted suicide allowed in US?
certain states can allow, regulate or prohibit assisted suicide
intentional damage to ones own body tissue without conscious suicidal intent and for purposes not socially or culturally sanctioned, deliberate and are direct attempts to inflict painful injuries to the surface of the body without intending to die; cutting, burning, scraping, scratching skin, biting, hitting, skin picking, interfering with wound heeling
nonsuicidal self injury
interventions with a circle of survivors left by individuals who completed suicide to reduce the traumatic aftereffects
postvention
activities that provide support, information and education to prevent suicide
prevention
6 step planning approach for nonsuicidal self injury?
•Limit setting for safety •Developing self-esteem •Discovery of motive and its role •Discovering self-control •Replacement with coping skills •Entering maintenance phase
diagnosis for at risk suicide pt?
•Risk for suicide •Self-care deficit •Sleep pattern disturbance •Altered nutrition •Anxiety