nr326 exam 2 review suicide precautions priority nursing intervention one to one observation suicidal client priority outcomegoal the client will remain safe during the hospital stay suicidal
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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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