Unit 3: Pediatric Mental Health
What is the most common precursor to adolescent suicide? - Depression
Also drugs and alcohol use.
Signs and symptoms of depression - Boredom, restlessness, irritability, acting out,
bullying, sadness, extreme mood swings, feeling trapped, withdrawing from activities,
uninterested in school, anxious, talking about being a burden to others,
Girls: Body image, self esteem
Group therapy
No suicide contract
Communication - Can be effective. Involve the family
Just puts in writing that they will not attempt suicide.
Open lines of communication helps.
Risk Factors of Depression (NIH website) - Depression, substance abuse (especially
when in combination with other mental disorders), prior suicide attempt, firearms in the
home, prior mental, physical abuse, incarceration, exposure to others with other who
have suicidal ideation.
Nursing intervention - Teach parents how to identify normal/abnormals in behaviors,
stressors, sleep habits
Stressors - Schoolwork, trying to compete, trying to fit in
Antidepressants - Can be effective, but can also cause suicidal ideations.
Bath Salts (Mephedrone+ methylenedioxypyrovalerone (MDPV)
How are they taken? What can they do? - These are legal.
They are snorted, smoked, or injected.
Causes altered speech patterns, hallucinations, psychosis, and delusions so severe, the
person can take their own life.
Accepting - "Yes, mmhmm, nodding"
Does not mean you agree with what they said.
, Remember your facial expression (nurse face), posture, and tone of your voice. (This is
just as important as our words).
Giving recognition - Acknowledging. "I see you made a picture today".
It does not say whether the picture is good or bad.
Also recognize the person as an individual.
Give broad Openings - allow patients to take initiative in choosing topic
"Is there something you'd like to talk about?" "What are you thinking about?" "Would you
like to talk about yourself now?"
Allow patients to feel like he can take the initiative
After a question is asked wait silently until the patient takes over
Restating (This one is critical) - repeating the main idea expressed
Patient: "I can't sleep. I stay awake all night"
Nurse: "You have difficulty sleeping"
Reflecting - directing the patient's questions, feelings, and ideas back to him
Patient: "Do you think I should tell the doctor..."
Nurse: "You're worried about that"
Patient: "My mom never buys me any thing"
Nurse: "This cause you to feel angry"
Indicates that the patient's point of view has value and it is his right to have opinions,
make decisions and think for himself
Reflects emphasizes the pronoun "you"
It leads the patient to think of feelings he is expressing as part of own personality
Making observations - verbalized what is perceived
"You appear tense"
"Are you uncomfortable when you...?"
"You seem deep in thought"
"Oh I see you are pacing today"
Brings observations to awareness of the patient
Encourages mutual understanding of behavior or feeling
Offers patient something to which he may respond when ready
Presenting reality - - offers for consideration what which is real
"I see no one else in the room"
"Your mother is not here; I'm the nurse"
Presenting reality is not done by way of arguing with the patient to consider, don't
convince him he is in error
Never ask.... - "WHY"
What is the most common precursor to adolescent suicide? - Depression
Also drugs and alcohol use.
Signs and symptoms of depression - Boredom, restlessness, irritability, acting out,
bullying, sadness, extreme mood swings, feeling trapped, withdrawing from activities,
uninterested in school, anxious, talking about being a burden to others,
Girls: Body image, self esteem
Group therapy
No suicide contract
Communication - Can be effective. Involve the family
Just puts in writing that they will not attempt suicide.
Open lines of communication helps.
Risk Factors of Depression (NIH website) - Depression, substance abuse (especially
when in combination with other mental disorders), prior suicide attempt, firearms in the
home, prior mental, physical abuse, incarceration, exposure to others with other who
have suicidal ideation.
Nursing intervention - Teach parents how to identify normal/abnormals in behaviors,
stressors, sleep habits
Stressors - Schoolwork, trying to compete, trying to fit in
Antidepressants - Can be effective, but can also cause suicidal ideations.
Bath Salts (Mephedrone+ methylenedioxypyrovalerone (MDPV)
How are they taken? What can they do? - These are legal.
They are snorted, smoked, or injected.
Causes altered speech patterns, hallucinations, psychosis, and delusions so severe, the
person can take their own life.
Accepting - "Yes, mmhmm, nodding"
Does not mean you agree with what they said.
, Remember your facial expression (nurse face), posture, and tone of your voice. (This is
just as important as our words).
Giving recognition - Acknowledging. "I see you made a picture today".
It does not say whether the picture is good or bad.
Also recognize the person as an individual.
Give broad Openings - allow patients to take initiative in choosing topic
"Is there something you'd like to talk about?" "What are you thinking about?" "Would you
like to talk about yourself now?"
Allow patients to feel like he can take the initiative
After a question is asked wait silently until the patient takes over
Restating (This one is critical) - repeating the main idea expressed
Patient: "I can't sleep. I stay awake all night"
Nurse: "You have difficulty sleeping"
Reflecting - directing the patient's questions, feelings, and ideas back to him
Patient: "Do you think I should tell the doctor..."
Nurse: "You're worried about that"
Patient: "My mom never buys me any thing"
Nurse: "This cause you to feel angry"
Indicates that the patient's point of view has value and it is his right to have opinions,
make decisions and think for himself
Reflects emphasizes the pronoun "you"
It leads the patient to think of feelings he is expressing as part of own personality
Making observations - verbalized what is perceived
"You appear tense"
"Are you uncomfortable when you...?"
"You seem deep in thought"
"Oh I see you are pacing today"
Brings observations to awareness of the patient
Encourages mutual understanding of behavior or feeling
Offers patient something to which he may respond when ready
Presenting reality - - offers for consideration what which is real
"I see no one else in the room"
"Your mother is not here; I'm the nurse"
Presenting reality is not done by way of arguing with the patient to consider, don't
convince him he is in error
Never ask.... - "WHY"
