March 26, 2015
1. What other information should you ask J.B. regarding his thoughts of suicide?
The nurse would first assume an authoritative role to help the patient stay safe. Explain to the patient that his safety is your primary concern and will have to take precedence over other needs or wishes. Other questions that J.B. would need to answer are:
Do you have a plan? Is so, what is it and is the plan specific?
Do you have the means to carry out this plan? (access to a gun or items needed to accomplish plan)
When and where were the last times you intended on carrying out this plan?
Have you made death preparations?
Have you given away ay important items?
Have you attempted suicide in the past?
Any relatives recently commit suicide?
Any new medications added recently?
2. What characteristics of J.B put him at high risk for suicide?
a. His wife recently passed away
b. Poor support system
c. Secluded: Not participating in his normal activities
d. Gender: Men account for 72% of suicides (Videbeck, 2001).
e. Age: People over 65 are at higher risk of suicide (account for 25% of suicides but are only 10% of total population) (Videbeck, 2001).
3. Which psychiatric disorders can results in SI or gestures?
a. Depression, Bipolar, substance abuse, PTSD, borderline personality disorder, and schizophrenia (Videbeck, 2001).
4. What questions would you ask J.B. to determine whether he is clinically depressed?
a. I would use the Hamilton Rating Scale for Depression as a reference to guide my questions.
i. Do you have any feelings of guilt? ii. Do you have trouble falling asleep? iii. Do you frequently wake up at night? iv. Do you have feelings that life is not worth living?
v. Have you noticed slowness of thought and speech, impaired ability to concentrate, or decreased motor activity? vi. Have you noticed any increased anxiety or increased worry? vii. Have you experienced any agitation? Any new habits such as nail biting, hand wringing?
References: Alexopoulos, G. (2005, June). Depression in the Elderly. Science Direct , 365(9475), 1961-1970. Retrieved from http://www.sciencedirect.com.contentproxy.phoenix.edu/science/article/pii/S0140673605666652 Deckx, L., Van Den Akker, M., & Daniels, L. (2015, March ). Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study. BMC Family Practice , 16(30), . Retrieved from http://www.biomedcentral.com.contentproxy.phoenix.edu/1471-2296/16/30 Videbeck, S. L. (2001). Psychiatric Mental Health Nursing (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.