Psychiatric Medications Q 60
Nurse Krina recognizes that the suicidal risk for depressed client is greatest:
A. As their depression begins to improve.
B. When their depression is most severe.
C. Before any type of treatment is started.
D. As they lose interest in the environment.
Correct Answer: A. As their depression begins to improve
At this point, the client may have enough energy to plan and execute an attempt. All patients with depression should be evaluated for suicidal risk. Any suicide risk must be given prompt attention which could include hospitalization or close and frequent monitoring. Major depression has very high morbidity and mortality contributing to high rates of suicide. Even though effective drug treatment is available, nearly 50% may not initially respond. Complete remission is not common but at least 40% achieve partial remission in 12 months. Depression accounts for nearly 40,000 cases of suicide each year in the US. The highest rate of suicides is in older men.
Option B: Depression is a very common disorder encountered by the nurse practitioner, primary care provider, psychiatrist, and mental health worker, coordinating as an interprofessional healthcare team. The disorder has extremely high morbidity including the risk of suicide. All healthcare workers should be knowledgeable about this disorder and refer the patient to a psychiatrist if there is a risk of self-harm.
Option C: The treatment of a suicidal patient involves a 2-phase process. First and foremost, the patient’s safety must be assured; this is the intervention. Intervention is based on the application of risk factors coupled with a clinical inquiry. The second step is treatment aimed at diagnosing and treating the underlying mental disorder.
Option D: Determine whether the person has any thoughts of hurting him or herself. Suicidal ideation is highly linked to completed suicide. Some inexperienced clinicians have difficulty asking this question. They fear the inquiry may be too intrusive or that they may provide the person with an idea of suicide. In reality, patients appreciate the question as evidence of the clinician’s concern. A positive response requires further inquiry.