Mental Health Chapter 13 Suicide PDF

Ch 13 Suicide Suicide: is a self inflicted death that the evidence showed the person intended to die - suicidal thought do not nessarly mean you have a psychiatric diagnosis - sucial attempt: is an y act with intention of taking ones own life that ther managed to survive that’s. Y it wa...

Ch 13 Suicide Suicide: is a self inflicted death that the evidence showed the person intended to die - suicidal thought do not nessarly mean you have a psychiatric diagnosis - sucial attempt: is an y act with intention of taking ones own life that ther managed to survive that’s. Y it was a attempts - so suicide is seen in a negative light that our society will lead to myths, suicidal facts : 12th leading cause of death in the US - 2nd leading cause of Death age 15-34 - more die from suicide than homicide - females attempt 3x more than males, but males are more successful - those who are in the high risk groups are : older adults, LGTBTQ+, native Americans and those with mood disorders and substances use disorders - take anyone serious who talks about it , threatens or makes a suicide attempt must be taken seriously causes : decrease in levels of serotonin , happy chemical in Brian, - depressive disorder and substance abuse disorder are the primary risk factors - other psychiatric disorder include anxiety, bipolar, psychosis - suicide pact common in teenagers, and copycat suicide are also popular in young people contributions to suicide : suicidal ideation—> - hopelessness; the relief of symptoms—shame -guilt - humiliation - isolation - impulsivity disorder - history of attempts methods ; most common ways to go about it is with firearms, hanging and overdose on various drugs. warning signs -: verbal threats, expression of hopelessness, prior suicide attempt , talking about suicide , access to lethal methods: saving the pills and weapons - researching, asking questions about suicide, risk taking behavior - personality changes, depression , lack of interest in future plans More signs —> noticeable improvement in mood, giving personal item away lasting with cleaning house and wanting a special friend to have a particular item all these are giant red flags - finally, talking about death or belong preoccupied with learning about it treatment for suicide : Prevention to it is to warning signs, and support - take people seriously about this - individual psychiatric care - emergency psychiatric care - thier is a number to call suicide hotline -988 - Pharmacololigal treatment :is depression and , psychosis , anxiety - being in inpatient for high risk of suicide  - outpatient with support for low to mod risk pt nursing interventions: take them/ pt seriously whe they talke about suicide or threatening to do it. - how to talk about it use honest , confrontational communication,. Are you planing to kill yourself? How? When? Etc,.,, - when waits to transfer in a place that isn’t safe keep them on 1;1 - monitor, typically 10-15 min in psychiatric facility - id those things that they might use to complete self harm and remove then if possible - maintian safety for all of those involved - in a facility, institute suicide precautions - by removing all potential weapons anything that might aid to suicide - medications, when giving them to pt ensure they are swallowing the meds not patching them in check and saving them for later family survivors: those who commit suspected they leave loved ones behind which are at high risk for long term distress due to guilt and anger about the suicide along with —- support groups Pic off Columbia severity rating scale Ch 14 Personality Disorders Personality : they are thoughts , feelings and attitudes that make up each Individual them ,…, theiorist believe personality is Delores and very young age, and other think it evolves at a very young age. Some belting it evolves and changes throughout life personality disorder : - maladaptive behavior leading to significant functional impairment or subjective distress - ineffective personality development and overuse of defense mechanisms - affects the way humans interpret and respond to the world. Poor boundaries - most major theorist agree that personality disorder originate in early childhood - may psychiatric pts have at least one personality disorder Categories of personality disorders—> 10 personality disorders the 10 are divided into o 3 clusters - odd behavior which is being paranoid, schizoid, schizotypal personality disorders - Dramatic behavior includes borderline. Antisocial, narcissistic, personality disorders - fearful include dependent, avoidant, obsessive compulsive common threads : one or more they display negative affect : frequent negative emotions detachment - withdraws from others antagonism - difficult to get along with disinhibiton - is impulsive inflexibility - clings to rigid or fixed ideas causes : personality disorders often have roots in difficult relationship with parental figures,.,., although each disorder has its own dynamics, this relationship is the thread that runs though them all ,.., genetics may be a factor in some of these disorder as well antisocial ‘sociopath’ : a pattern of irresponsible, exploitive, and guiltless behavior with tendency to fail to conform to the law and exploit and manipulate others for personal gain, popularly known a sociopathic ,.., difficulty folowing rules, high association with criminal behavior avoidant : indivuals with extreme sensitivity to rejection leading to avoidance of social contacts ,.., when may appear shy or socially awkward borderline personality : unstable behavior , exhibit both cliningng and distracting behaviors,., known to use manipulation to reduce thier anxiety to achieve goals ,., manipulative behavior can present as overlay intense attachment to staff Narcissistic : those who have this disorder tend to display and exaggerated impression of one’s self with an inflated sense of self importance,.., other chatheristics is limited ability to empathize with other problems because they see everything through thier own eyes (they are the center of the Universe) obsessive compulsive: they show obsession and compulsion that are severe enough to interfere with social and oupatinal function in a person ,.., preoccupied with rules , ordernessliness and control ,.., etramlu displined and appear ridged - this personality disorder differ rom OCD obsessive compulsive disorder that is characterized by recurrent obsessions and compulsions and has its own category in the DSM — Schizotypal: characterized by odd and eccentric behaviors but not t the degree of schizophrenia, aloof and isolated.,,. May use language and/or gestures that only have meaning to the individual medeicaiton treatment for personality disorders : Difficult to treat, it is really hospitalized ,.., unless for separate medical or surgical condition. People with personality disorder may not seek out mental health treatment of thier disorder until it drains thier coping resvers,., pt often do not perceive they have any problems meds to treat depression, anxiety, delusions may be helpful./. Group therapy its like a less invasive peer pressure to help modify behavior. Goal for medical and Nursing treatment : increase the motivation and socialization for them push them ,.., make the efforts to avoid stereotyping of judging this pt based on info that they have personality disorder ,…, pt with these disorders can present challenges for the HCP as maladaptive mechanisms are used to cope with the stresses of their illnesses Nursing interventions : as a nurse we should promote trust,.., set the limits that are clear expections and consequences ,.., use effective therapeutic communications, confronting behavior as necessary, model positive behaviors, maintain calm, an have a safe milieu Ch. 15 Schizophrenia Schizophrenia —> illness identified by Eugene bleuler ,.., it mean ‘split’ not to be confused with multiple personality disorder the split is between a patients thoughts and feelings ,., between a persons reality and society reality - psychotic thought disorder where hallucinations and delusions dominate pt thinking - It’s a very serious, debilitating , lifelong psychiatric disorder, seeming to strike people between ages of 16 and 35 most frequently first psychotic break really after the age of 40 its a young mans game ,..,, the way they are view on the gradient of psychopathology from least to most severe on spectrum disorder other types of psychotic disorders Delusional, schizoaffective, schizpreniform, psychotic depression or mania, substance or medication induced psychotic disorder,.., also postpartum psychosis common symptoms Delusions - they are fixed, false beliefs that cannot be changed with logic — grandeur, paranoia, reference, physcial sensations, thought insertions Hallucinations - false sensory perceptions,.., can be auditory, visual, tactile, gustatory, olfactory Illusions- mistaken perceptions of reality (it’s thier but looks different) Speech Disturbances- losse associations; lacking of connection between ideas - neologisms: made up words - perseveration: repetition of words or ideas - echolalia ; repetition of words - disorganized: speech Echopraxia: repeating action of other Magical thinking : believing ones thoughts can control others Catalonia : Impaired motor activity including stupor positive symtioms : these are found in people who have schizophrenia. But not in those who do not ,..,like example is delusions, thoughts, disordes, or hallucinations negative symptoms : these are found amount people who do not have the disorder but are missing or lacking amount indvualuals wit schizophrenia and reflect alessing or loss of normal functions ex are las of desire to for social relationships,also inappropriate social behavior ( pacing, rocking) causes : now referred to a as a brain disorder, theriores include disruption of neurotransmitters and or neuron function or cortisol abnormalities,.., along with a genetic predisposition ,.., family dysfunction is no longer believed to be primary cause. medical treatment : Medications include antipsychotics,., and anticholinegics,.., to counter act the extrapyrimidal symptoms EPS ,.., psychotherapy which in a group and family , ECT therapy, supportive milieu environment,.., ongoing support and education to learn to live with disease and comply with medication regimen antipsychotics : these med are the main focus of the treatment,.., the patient may need to be on these for the rest of the lie the side effects Management of these med is the key part treatment we treat the ide effects and they try to live,.., EPS are common with many of these drugs. nursign. Interventions : As nurses we shall never reinforce their hallucination, delusions, or illusions, Never ever ever - ‘I don’t see a snake lets walk to the dining room together now ‘ this an example of the few times when it is acceptable to change the subject in communications - Never whisper or laugh when the pt is not aware of the whole conversation - Keep pt out of competitive or embarrassing situations - develop trust,.., maintain calm, structured milieu - maintain clear, concise communication ,.., state what is acceptable and ex[ected behavior along with rationale and consequences at the same time ch20 Postpardum Post pardon blues : not a psychiatric disorder,.., its very common in first few days after delivery,.., can show up as crying spells, rapid mood shifts, sleep disturbances, forgetfulness, anxiety and feeling overwhelmed - etiology includes hormone shift and fatigue,.., generally, resolves a few days after delivery with ,.., TX emotional support, compassion and rest post pardon psychozala disorder : Post partum depression—> clinical depression that occurs to a mother shortly after the birth of the baby( usually within 3 mo, or less time) postpartum psychosis—> sudden onset of psychotic symptoms after the birth of the baby ,.., putting th baby at risk post pardon disorder : highest risk in pts, with previous hx of depression ,.., symptoms include those typical of depression that last at least 2 weeks within the first 6mo after delivery - symptoms being intense anxiety,., agitation,., feelings of inadquency,., overwhelm treatment for post pardon depression : Antidepressants,.., though these are tx of choice some are excreted in breast milk ,.., make sure to discuss with physician the risk and benefits of taking these meds also psychotherapy and family support postpardon psychosis this is the medical emergency as the bay could be at risk ,.., generally pt has hx of psychiatric disorder especially bipolar,.., the women take lithium may still meds during pregnancy due to risk to fetus for birth defects leading to exacerbations common psychosis symptoms —> - disorganized behavior , extreme mood shifts, insomnia - Delusions that often enter around the baby , bizarre behavior - risk of infanticide and /or suicide, symptoms my begin during pregnancy treatment for : emrgency psychiatric treatment that may include hospitalization ,., safety of patient and infant must be ensured ,.., mood stabilizer and antipsychotic medications,.., rapid tranquil action may be required when large doses of antipsychotics are needed to control behavior pharmacological TX : the risk the infant with breast feeding from mood stabilizers,…, and educate about the trick and benefits of breastfeeding must be part of prenatal teaching Nursing causing for postpartum pt ,.., as nurses we should be supportive, educate the patient and the family safety, monitoring of high-risk patients prenatally, appropriate medication management