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Psychosocial Ch9
Problems with affect and mood
| Question | Answer |
|---|---|
| Suicide attempt resulting in death | Completed Suicide |
| Willful self-inflicting of painful, injurious acts without intent to die. | Deliberate Self-Harm |
| The level of risk in suicide method chosen to cause death. | Lethality |
| Thoughts about harming one's self. | Suicidal Ideation |
| Self-inflicted death with evidence that person intended to die. | Suicide |
| Any act intended to end in suicide | Suicide Attempt |
| Any action that appears to be a suicide attempt but is actually contrived or manipulative and that results in only minimal harm such as superficial cuts on the wrist or a small overdose of sleeping pills. | Suicide Gesture |
| Verbal threat to commit suicide. | Suicide Threat |
| What % of suicides does the individual have one or more medical illness. | 70% |
| What % of suicide victims suffer from at least one psychiatric disorder | 90% |
| What type of psychiatric disorder is most common among suicide victims. | Major Depressive Disorder |
| Do Men or Women make more attempts at suicide and who is most likely to succeed. | Women make more attempts and men are more likely to succeed. |
| What are the 3 factor that need to be present for a completed suicide. | Specific Plan, Lethality, and Access to lethal method. |
| What is the rank of suicide as a leading cause of death in the U.S. | 11th |
| Myth: Asking people about their suicidal thoughts will make them more likely to act on them. | Truth: Most patients are not afraid to talk about their thought of committing suicide and are usually grateful that someone is available and cares. Talking can reduce the sense of isolation |
| Myth: All people who attempt suicide have a psychiatric disorder. | Truth: People can become overwhelmed with life circumstances without having a psychiatric disorder. |
| Myth: A person who attempts suicide won't try again. | Truth: Approximately 80% of individuals who attempt or complete suicide give some definite verbal or indirect clue. As may as 50% have seen their physician within the previous month, often with vague somatic complaints. |
| Myth: A person who attempts suicide won't try again. | Truth: Almost 75% of those individuals who complete suicide have attempted it at least once before. |
| Myth: People who attempt suicide are always determined to die. | Truth: Many individuals are ambivalent and are using the suicide as a cry for help. |
| Myth: People who attempt suicide just want attention. | Truth: Even if the suicide attempt is manipulative, the individual may go on to complete the suicide. |
| Myth: As the person becomes less depressed, the risk of suicide decreases. | Truth: As the depression lifts, the individual's energy level can increase before feelings of hopelessness are relieved. Once the individual makes the decision that suicide is an effective solution to the problems, his or her mood may even elevate. |
| What are the Biologic and Genetic theories related to the Etiology of suicide. | Closely tied to those causing depression, low levels of serotonin and noreprinphrine. |
| What are the Psychological Theories related to the Etiology of suicide. | Intense feelings of hopelessness, helplessness. |
| What are the Sociological Theories related to the Etiology of suicide. | No longer feels a part culture or social group or political reasons. |
| Medications that may be used for a suicide attempt. | Analgesics, Tranquilzer, or Sleeping pills. |
| Life span issues related to child suicide. | Rate is rising and is an attempt to gain power or punish a parent or escape stressful situation. |
| Life span issues related to adolescent suicide. | 2nd leading cause of death in teens and teens who are depressed, socially isolated, using drugs and alcohol at higher risk. |
| Life span issues related to older adult suicide. | Highest risk of suicide is in older adults. |
| Possible Nurse Reaction | May see patient as weak or bad. |
| Suicidal Behaviors and Appearance | Direct verbal statements. |
| Suicidal Mood and Emotions | Depression or despair. |
| Suicidal Thoughts, Beliefs, and Perceptions | Disorganized, chaotic, irrational thinking. |
| Suicidal Relationships and Interactions | Social isolation; withdrawn; feels alone and abandoned. |
| Suicidal Physical Responses | Chronic debilitating illness. |
| Suicidal Pertinent History | History suicide attempts. |
| Pharmacological Management of Suicidal Patient | Antianxiety: Lorazepam |
| Nursing Diagnosis: Risk for Violence to Self Patient Outcomes. | Remains free from injury. |
| Nursing Diagnosis: Risk for Violence to Self Nursing Interventions. | Determine if patient has a plan. |
| Nursing Diagnosis: Hopelessness Patient Outcomes. | Verbalizes more optimistic expectations for the future. |
| Nursing Diagnosis: Hopelessness Nursing Interventions. | Recognize that extreme hopelessness is a strong indicator of suicide. |
| Nursing Diagnosis: Ineffective Coping Patient Outcomes. | Decrease in self-destructive behaviors. |
| Nursing Diagnosis: Ineffective Coping Nursing Interventions. | Determine if self-destructive behavior is a pattern. |
| Suicide: When to call for help. | Self-mutilation. |
| Grief response before and in preparation for a significant actual or potential loss. | Anticipatory Grief |
| State of having suffered a loss. | Bereavement |
| The absence of grief behavior when it would be normally expected. | Delayed Grief |
| Grief reaction that does not follow usual pattern and may include delayed and/or distorted grief. | Dysfunctional or complicated grief. |
| Subjective, emotional response to a loss. | Grief |
| Situation, real or potential, in which a valued object is rendered inaccessible or is altered in such a way that it no longer has the valued qualities. | Loss |
| Variables that influence the sense of loss. | Meaning of the lost object to the person. |
| Rando's Stages of Adapting to Loss | Avoidance Phase. |
| Kubler-Ross's Stages of Adapting to a Loss of Self. | Denial. |
| What are the physical stresses of grief that increase health problems. | Lack of Sleep. |
| What is the clinical concern related to the loss of a spouse. | Loss of a spouse is associated with higher morbidity and mortality rates. |
| Possible Nursing Reactions to a Grieving Patient. | May feel guilty. |
| Grief: Behavior and Appearance | Crying, agitation. |
| Grief: Mood and Emotions | Shock, numbness. |
| Grief: Thoughts, Beliefs, and Perceptions | Self-blame. |
| Grief: Relationships and Interactions | Seeking support from others, may become more dependent. |
| Grief: Physical Responses | Initial symptoms that may include hyperventilating, sighing, sobbing, muscle tension, chest pain, fainting. |
| Grief: Pertinent History | Unresolved or multiple past losses. |
| Nursing Diagnosis: Grieving Patient Outcomes | Acknowledges loss. |
| Nursing Diagnosis: Grieving Nursing Interventions | Accept all grieving behavior. |
| Nursing Diagnosis: Grieving, Dysfunctional Patient Outcomes | Acknowledges the loss. |
| Nursing Diagnosis: Grieving, Dysfunctional Nursing Interventions | Recognize that the individual needs to confront the loss slowly and accept it into his or her reality at the individual's own pace. |
| Grief: When to call for help? | Disturbing behavior including hallucinating, delusions, obsessions. |
| A distinct period that is similar to a manic episode but with less severe symptoms. | Hypomania |
| Psychiatric disorder marked by shifts in mood, energy and ability to function. | Bipolar Disorder |
| A distinct period during which there is an abnormally and persistently elated, expansive, or irritable mood possibly accompanied by inflated self-esteem or grandiosity, decreased need for sleep, pressured speech, fight of ideas, or subjective experience t | Mania |
| A period during which the criteria for both a manic and a major depressive episode are met nearly every day. | Mixed Episode |
| At least four episodes of a mood disturbance in the previous 12 months that meet criteria for a major depressive episode or a manic, mixed, or hypomanic episode. | Rapid Cycling |
| An uninterrupted period of illness during which, at some time, there is a major depressive, manic or mixed episode concurrent with the characteristic symptoms of schizophrenia. | Schizoaffective Disorder |
| Bipolar I Disorder | Characterized by occurrence of one or more manic episodes or mixed episodes. |
| Bipolar II Disorder | Characterized by occurrence of one or more major depressive episodes with presence of at least one hypomanic episode. |
| Biological etiology of Bipolar disorder. | Predominate theory: Caused by imbalance in norepinephrine, dopamine and serotonin |
| Genetic etiology of Bipolar disorder. | Demonstrated though family studies. |
| Sociological etiology of Bipolar disorder. | Mania most often initial episode in men and depression in women. |
| Psychological etiology of Bipolar disorder. | Mania viewed as defensive flight from an underlying extreme depression. |
| Clinical concerns related to bipolar disorder. | Hyperactive symptoms caused by substance abuse, medication use or general medical conditions are not considered to be a bipolar disease. |
| Drugs and physical illnesses that can cause manic states. | Drugs: Steroids, Levodopa, Amphetamines Tricyclic antidepressants, Monoamine oxidase inhibitors, Methylphenidate, Cocaine, Thyroid hormone. |
| Bipolar life span issues in children. | 20-30% of people with bipolar have onset before age 20. |
| Bipolar life span issues in adolescents. | 10-15% of adolescents with recurrent major depressive episode will develop bipolar disorder. |
| Bipolar life span issues in Adults. | Majority of first manic episode occurs between ages 20-30, most commonly early 20’s. |
| Bipolar life span issues in Postpartum. | Term applied if occurs within 4 weeks of delivery. |
| Bipolar life span issues in Older Adults. | Decrease in bipolar I and increase in bipolar II. |
| Possible Nurse’s reactions. | May be entertained of amused |
| Behavior and Appearance of patient with Bipolar Disorder | Excessive in all areas: bizarre, garish, flamboyant, eccentric. |
| Mood and Emotions of patient with Bipolar Disorder | Elation;heightened sense of pleasure; unrealistic optimism. |
| Thoughts, Beliefs and Perceptions of patient with Bipolar Disorder | Distracted. |
| Relationships and Interactions of patient with Bipolar Disorder | Excessively gregarious; can be charming; lacks true concern for others. |
| Physical Responses of patient with Bipolar Disorder | Sometimes initial overeating, weight gain, food hoarding. |
| Pertinent History of patient with Bipolar Disorder | Earlier episodes or family history of depressive and manic episodes. |
| Collaborative Management of Bipolar Disorder: Anitconvulsants | Carbamazepine, which can cause agranulocytosis |
| Collaborative Management of Bipolar Disorder: Herbal Products | Valerian root. |
| Collaborative Management of Bipolar Disorder: Dietary | Finger Foods, high calorie diet |
| Collaborative Management of Bipolar Disorder: Psychotherapy | Important part of treatment program to prevent or reduce severity of relapse. |
| Nursing Diagnosis Anxiety: Patient Outcomes | Slower and more controlled speech and behavior. |
| Nursing Diagnosis Anxiety: Interventions | Provide firm, clear limits. |
Created by:
chhinmda
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