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Risk Assessments
From ANCC Review
| Question | Answer |
|---|---|
| Suicide risk factors | divorced, single, separated, youth (15-24) >45 yo M, >55 yo F; elderly >65, white, M, lives alone, physical illness, Mood d/os (80% schiz., 10% dementia, 5% delirium), substance use, family hx of suicide, previous attempt, recent loss, various occupations |
| Occupations associated with suicide risk factors | law enforcement, dentists, artists, mechanics, lawyers, insurance agents, physicians |
| Life stressor risk factors for suicide | early loss/separation from parents, death of partner, loss of job/income, sudden fall of SES, LGBTQI, recent childbirth, sexual abuse, prior attempts or copycat, hallucinations, delusions, severe psych or chronic physical illness, severe family pathology |
| Copycat suicides are more common in | children |
| Suicide PROTECTIVE Factors | married, employed, stable family/work rxnshps, health, low substance use/social drinker, optimism, achievement (school/work/community), 1st suicide attempt, low lethality method w/ rescue inevitable, primary wish for change/good insight, social support |
| When assessing someone for suicide, one should look at both | risk and protective factors |
| When assessing suicidal thoughts | look at suicidal ideas or fantasizing |
| When assessing a suicide plan consider | lethality of method |
| These are associated with high lethality | guns, hanging, jumping, drowning, high ASA/tylenol overdose, carbon monoxide, car crash. Tricyclic and trazadone too |
| Speaking of trazadone, it is from what class? | Serotonin Antagonist & Reuptake Inhibitor (SARI) |
| Indicators for inpatient treatment for suicidal patient | history of impulsive behavior, suicidal plan with intent to act, absence of strong support system. |
| During inpatient treatment, it is important to determine the need for | close observation vs. constant observation |
| Close observation is | q15 min checks |
| Constant observation is | 1:1 arms length |
| This should always be considered | the least restrictive environment 24-72 hour crisis stabilization in community respite care Patient Aligned Care Team (PACT) |
| According to the reviewer, this is the strongest predictor of suicide | hopelessness, but through my own google search, previous attempts and severity of depression were cited as well. |
| Homicide Risk Factors | past hx of threats/acts of violence, direct threats to others, substance use/tx noncomp., young, male, low SES, culture of violence, access to weapons, psychotic symptoms, manic symptoms, hx of head injury/epilepsy/neuro impairment, hx of psych dx |
| Psych hx associated with homicide risk factors | impulsive, explosive, suspicous, persecutory manner |
| Intimate Partner Violence - victim is at highest risk when | leaving abuser |
| the number of female victims killed by an intimate | 1/3, 3% male murder victims by intimate. Female rate dropped and rose and male rate dropped. |
| Risk factors for intimate partner violence homicide | abuser threats use of weapon, prior attempts, hx of jealousy, rape, increase in violence, illicit drug use, violence outside home, beating while pregnant, prior reports of child abuse, killed/harmed pet, recently discussed separation, victim belief |
Created by:
jonquil
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