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Exam (elaborations)

NR326 - EXAM 2 REVIEW

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NR326 - EXAM 2 REVIEW SUICIDE PRECAUTIONS - PRIORITY NURSING INTERVENTION one-to-one observation SUICIDAL CLIENT - PRIORITY OUTCOME/GOAL the client will remain safe during the hospital stay SUICIDAL CLIENT WITH SUDDEN MOOD IMPROVEMENT - PRIORITY NURSING INTERVENTION increase frequency of client observation increased energy may compel client to act on suicidal ideation CLIENT EXHIBITING COMMAND HALLUCINATIONS FOR SELF HARM - PRIORITY NURSING INTERVENTION place client on one-to-one observation while monitoring suicidal ideations TRICYCLIC ANTIDEPRESSANTS - NURSING CONSIDERATION Tricyclic antidepressants have a narrow therapeutic range can be used in overdose to commit suicide distributing limited amounts of the medication decreases this potential NURSING DX - HOPELESSNESS Client "Nothing will ever get better. Nobody can help me." Nursing Dx Hopelessness R/T altered mood AEB client statements SUICIDE - FAMILY TEACHING be available to actively listen, support and accept feelings increases potential that a client will confide suicidal ideations to family members WHEN CLIENT HAS MANY RISK FACTORS FOR SUICIDE - PRIORITY INTERVENTION client should have increased supervision to decrease likelihood of self-harm SUICIDE RATE - ELDERLY eldery comprise 13% of the population, but account for 15% of all suicides WHEN A CLIENT THREATENS SUICIDE - NURSING CONSIDERATION the more specific the plan is, the more likely the client will attempt suicide SUICIDE the act of taking one's own life NOT a diagnosis, or disorder the act is a BEHAVIOR SUICIDE - FIRST STEP IN DEVELOPING PLAN OF CARE assess suicide risk

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NR326 - EXAM 2 REVIEW
SUICIDE PRECAUTIONS - PRIORITY NURSING INTERVENTION
one-to-one observation
SUICIDAL CLIENT - PRIORITY OUTCOME/GOAL
the client will remain safe during the hospital stay
SUICIDAL CLIENT WITH SUDDEN MOOD IMPROVEMENT - PRIORITY NURSING
INTERVENTION
increase frequency of client observation

increased energy may compel client to act on suicidal ideation
CLIENT EXHIBITING COMMAND HALLUCINATIONS FOR SELF HARM - PRIORITY
NURSING INTERVENTION
place client on one-to-one observation while monitoring suicidal ideations
TRICYCLIC ANTIDEPRESSANTS - NURSING CONSIDERATION
Tricyclic antidepressants have a narrow therapeutic range

can be used in overdose to commit suicide

distributing limited amounts of the medication decreases this potential
NURSING DX - HOPELESSNESS
Client
"Nothing will ever get better. Nobody can help me."

Nursing Dx
Hopelessness R/T altered mood AEB client statements
SUICIDE - FAMILY TEACHING
be available to actively listen, support and accept feelings

increases potential that a client will confide suicidal ideations to family members
WHEN CLIENT HAS MANY RISK FACTORS FOR SUICIDE - PRIORITY
INTERVENTION
client should have increased supervision to decrease likelihood of self-harm
SUICIDE RATE - ELDERLY
eldery comprise 13% of the population, but account for 15% of all suicides
WHEN A CLIENT THREATENS SUICIDE - NURSING CONSIDERATION
the more specific the plan is, the more likely the client will attempt suicide
SUICIDE
the act of taking one's own life

NOT a diagnosis, or disorder

the act is a BEHAVIOR
SUICIDE - FIRST STEP IN DEVELOPING PLAN OF CARE
assess suicide risk

,ISOLATIVE BEHAVIORS BASED ON LOW SELF ESTEEM - OUTCOME/GOAL
client will be able to express three positive self attributes by a specified day
CLIENT GOALS
should be...

client centered

specific

realistic

measurable

contain a time frame
SUICIDE - NURSING CONSIDERATION
between 50-80% of all people who kill themselves have a history of a previous attempt

having a history of suicide places client at a higher risk for current suicide behaviors
SUICIDE RISK FACTORS - MARITAL STATUS
single-never married 2x more than married person

divorce increases risk
- men 3x more than women

divorced men 2x more than married men

widows/widowers have increased risk
SUICIDE RISK FACTORS - GENDER
women attempt suicide more often, but more men succeed

women tend to overdose, while men use more lethal means (i.e. firearms)
SUICIDE RISK FACTORS - AGE
risk increases with age, particularly with men

Highest Rate of Suicide
- 45 - 64 years old group
- those 85 and older
MOST COMMON METHOD OF SUICIDE IN ADOLESCENTS
Adolescent Males
firearms

Adolescent Females
suffocation
SUICIDE RISK FACTORS - RELIGION
affiliation with religious group DECREASES risk
SUICIDE RISK FACTORS - SOCIOECONOMIC STATUS

, high and low social classes have higher suicide rates than middle class

unemployed persons have higher rate of suicide than employed persons
OCCUPATIONS WITH HIGHER RATES OF SUICIDE
physicians

artists

dentists

law enforcement officers

lawyers

insurance agents
SUICIDE RISK FACTORS - ETHNICITY
Whites are at highest risk for suicide (14.7 percent)

American Indian and Alaska Natives (10.9 percent)

Hispanic Americans (6.3 percent)

Asian Americans (5.9 percent)

African Americans (5.5 percent)
ACTIVELY SUICIDAL CLIENT - NURSING INTERVENTION
observe client for the first hour after admission

after full assessment, the treatment team can determine the observation status of the
client

observation allows the nurse to interrupt any observed suicidal behaviors
SUICIDAL CLIENT - PLAN OF SAFETY
a degree of the responsibility for the suicidal clients safety is given to the client

when a client shares with staff a plan for suicide, the client is participating in a plan for
safety by communicating thoughts of self-harm that would initiate interventions to
prevent suicide
POTENTIAL GRIEF RESPONSES FOLLOWING SUICIDE OF A FAMILY MEMBER
shock

disbelief

guilt

remorse

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Written in
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