You use the sadPeRsONsscale to assess J.B.'s potential for ...

[tichca]

You use the sadPeRsONsscale to assess J.B.'s potential for suicide and find that he is at a 4 on the 10-point scale. J.B. tells you that he has just had general thoughts of suicide
 
  but has not really thought about how he would do it. you recall that there are two types of suicide methods based on lethality:
  higher-risk or hard methods, and lower-risk or soft methods.
 
  Which of these would be considered soft methods of suicide? Select all that apply.
  a. Using a gun
  b. Slashing one's wrist
  c. Hanging
  d. Poisoning with carbon monoxide
  e. Ingesting pills
  f. Inhaling natural gas
 
  What immediate interventions would you carry out for J.B.?

Question 2

You are working the day shift on a medical inpatient unit. you are discussing discharge instructions with J.B., an 86-year-old man who was admitted for mitral valve repair
 
  His serum blood glucose had been
  averaging 250 mg/dL or higher for the past several months. during this admission, his dosage of insulin
  was adjusted and he was given additional education in managing his diet. While you are giving these
  instructions, J.B. tells you his wife died 9 months ago. He becomes tearful when telling you about that loss
  and the loneliness he has been feeling. He tells you he just doesn't feel good lately, feels sad much of the
  time, and hasn't been involved in his normal activities. He has few friends left in the community because
  most of them have passed away. He has a daughter in town, but she is busy with her work and grandchil-dren. He tells you that he has been feeling so down the past few months that he has had thoughts about
  suicide.
 
  What other information should you ask J.B. regarding his thoughts of suicide?
 
  What characteristics of J.B. put him at high risk for suicide?
 
  Which psychiatric disorders can result in suicidal ideations or gestures? Name at least three
 
  What questions would you ask J.B. to determine whether he is clinically depressed? Name at
  least six.
 
  Ill people often have trouble sleeping, experience a change in appetite, reduce their level of
  activity, and have thoughts of death. How can you tell the difference between old age with
  illness and depression?
 
  List five of the most common signs of depression in the older adult.

[chinwesucks]

Answer to Question 1

Answer: b, e, f
These lower-risk methods, also called soft methods, are less lethal than the higher-risk methods
such as using a gun, hanging, or inhaling carbon monoxide.

 Conduct an immediate assessment of his safety. This will need to be done by a mental health
professional.
 Contact the physician and alert him or her to your findings.
 Facilitate the referral to community mental health services.
 Ensure that J.B. is not left alone. Monitor him closely.

Answer to Question 2

 Does he have a specific plan for suicide?
 Has he ever attempted suicide in the past?
 Does he have any weapons at home?
 Does he drink alcohol, and, if so, how much and how often? Does he use any drugs?
 Will he be alone once he goes home?

 The highest suicide rate among males is in those aged 75 years or older.
 Depression often occurs with chronic illnesses, such as diabetes mellitus, cardiovascular disease,
stroke, and cancer.
 Loneliness or social isolation are risk factors, and he has had a recent loss.

 Major depressive disorder
 Bipolar disorder, which is characterized by episodes of major depression accompanied by episodes
of mania
 Dysthymic disorder, which is a less severe but more chronic type of depression
 Schizophrenia
 History of alcohol or substance abuse

 Tell me about your sleep. Do you have difficulty falling asleep, staying asleep, or waking up early?
 How would you describe your appetite?
 Have you had any recent unintentional change in your weight?
 Tell me about your concentration. Are you able to read the newspaper or watch a TV show from
beginning to end?
 How is your energy level?
 How would you describe your mood or your spirits?
 Have you had any thoughts of death recently?
 Are there activities that you enjoy or give you pleasure?
 Have you lost interest in activities that you used to enjoy?

Depression includes feelings of worthlessness, hopelessness, indecisiveness, and guilt. Ill people
might still express a sense of satisfaction as they think back over their lives, their connection with
family members, and their participation in a spiritual life. Ill people may still have the ability to
concentrate on positive things.

 Persistent sad mood
 Loss of interest in activities that were once pleasurable
 Insomnia or hypersomnia
 A significant change in appetite with weight loss or weight gain
 Loss of energy
 Difficulty with concentration
 Feelings of worthlessness or guilt
 Thoughts of death or suicide
 Isolating oneself from others

[tichca]

TYSM

[cdmart10]

Gracias!