Student Name:
Course:
Clinical Section:
Date:
NSG3450 Simulation-Based Experience:
Suicidal Ideation in the ER
Prep Questions-CH 25
1. Identify risk factors associated with suicidal ideation.
a. Biological
Family history of suicide or mental illness
Genetic predisposition to mood disorders
Chronic medical conditions (cancer, chronic pain)
Hormonal imbalances (thyroid dysfunction)
b. Neurobiological
Altered neurotransmitter levels (especially low serotonin)
Brain abnormalities in regions regulating emotion (prefrontal cortex, amygdala)
Dysregulation of the hypothalamic pituitary adrenal axis (HPA) linked to stress
c. Cognitive
Hopeless and helplessness
Rigid thinking
Poor problem-solving skills
Cognitive distortions (“im a burden,” “nothing will ever get better”)
d. Environmental
Access to lethal means (firearms, medications)
Exposure to suicide (within family, media, community)
History of abuse, neglect, trauma
Major life stressors (job loss, relationships, divorce, finances)
e. Cultural
Stigma around mental health treatment
Cultural beliefs that may normalize suicide
Identity based stress (racial discrimination, gender, sexuality)
f. Social
Social isolation or lack of support
Bullying
Relationship breakdowns
, Loss of loved one (grief)
g. Other
Psychiatric conditions (depression, bipolar, schizophrenic)
Previous suicide attempts
Substance/ETOH use or abuse
Poor access to mental health care
2. Identify Warning Signs, Risk factors, and Protective Factors for a patient with
Suicidal Ideation.
oTalking about wanting to die or kill oneself
oExpressing hopelessness or no reason to live
oExtreme sudden mood swings (calm after agitation)
oIncreased substance/ETOH use
oWithdrawing from family and friends
oGiving away possessions or saying goodbye
oEngaging in risky behaviors
oSelf-destructive
oTalking or writing about death or suicide
oSleeping too much or too little
Protective factors
Strong personal relationships (family, friends, community)
Access to mental health care and support services
Problem solving and coping skills
Cultural or religious beliefs that discourage suicide
Sense of purpose/responsibility
Engagement in meaningful activities
Restricted acess to letal means
3. Identify verbal and nonverbal clues individuals considering suicide may say or
do to indicate intent for self-harm by suicide.
o“I want to die”, “Im going to kill myself”, “you have to worry about me much longer”
o “I cant go on anymore”, “life isn’t worth living”, “soon this wont matter”, “I just
want to sleep and never wake up.”
oWithdrawal
oGiving away personal belongings
oNeglecting personal hygiene
oVisiting/calling loved ones to say goodbye
oSelf-harming behaviors
oIncreased risk taking (reckless driving, substance abuse)
oSudden happiness after being depressed (may indicate a decision has been made)
4. Identify the top priorities when assessing a patient with suicidal ideation.
Course:
Clinical Section:
Date:
NSG3450 Simulation-Based Experience:
Suicidal Ideation in the ER
Prep Questions-CH 25
1. Identify risk factors associated with suicidal ideation.
a. Biological
Family history of suicide or mental illness
Genetic predisposition to mood disorders
Chronic medical conditions (cancer, chronic pain)
Hormonal imbalances (thyroid dysfunction)
b. Neurobiological
Altered neurotransmitter levels (especially low serotonin)
Brain abnormalities in regions regulating emotion (prefrontal cortex, amygdala)
Dysregulation of the hypothalamic pituitary adrenal axis (HPA) linked to stress
c. Cognitive
Hopeless and helplessness
Rigid thinking
Poor problem-solving skills
Cognitive distortions (“im a burden,” “nothing will ever get better”)
d. Environmental
Access to lethal means (firearms, medications)
Exposure to suicide (within family, media, community)
History of abuse, neglect, trauma
Major life stressors (job loss, relationships, divorce, finances)
e. Cultural
Stigma around mental health treatment
Cultural beliefs that may normalize suicide
Identity based stress (racial discrimination, gender, sexuality)
f. Social
Social isolation or lack of support
Bullying
Relationship breakdowns
, Loss of loved one (grief)
g. Other
Psychiatric conditions (depression, bipolar, schizophrenic)
Previous suicide attempts
Substance/ETOH use or abuse
Poor access to mental health care
2. Identify Warning Signs, Risk factors, and Protective Factors for a patient with
Suicidal Ideation.
oTalking about wanting to die or kill oneself
oExpressing hopelessness or no reason to live
oExtreme sudden mood swings (calm after agitation)
oIncreased substance/ETOH use
oWithdrawing from family and friends
oGiving away possessions or saying goodbye
oEngaging in risky behaviors
oSelf-destructive
oTalking or writing about death or suicide
oSleeping too much or too little
Protective factors
Strong personal relationships (family, friends, community)
Access to mental health care and support services
Problem solving and coping skills
Cultural or religious beliefs that discourage suicide
Sense of purpose/responsibility
Engagement in meaningful activities
Restricted acess to letal means
3. Identify verbal and nonverbal clues individuals considering suicide may say or
do to indicate intent for self-harm by suicide.
o“I want to die”, “Im going to kill myself”, “you have to worry about me much longer”
o “I cant go on anymore”, “life isn’t worth living”, “soon this wont matter”, “I just
want to sleep and never wake up.”
oWithdrawal
oGiving away personal belongings
oNeglecting personal hygiene
oVisiting/calling loved ones to say goodbye
oSelf-harming behaviors
oIncreased risk taking (reckless driving, substance abuse)
oSudden happiness after being depressed (may indicate a decision has been made)
4. Identify the top priorities when assessing a patient with suicidal ideation.
