Suicide
What is suicide? What is a suicide attempt? What is suicidal ideation?
- wanting to kill self
- trying to kill self but failed
- constantly planning or thinking about suicide
What is depression?
- sad mood and loss of interest
- changes in neuro transmitters (norepinephrine, dopamine, serotonin)
What is bipolar disorders? What is the etiology? What are the two types?
- extreme mood swings from mania to depression
- genetics, stress, brain structure
- Bipolar 1 = mania
- Bipolar 2 = hypomania
What is postpartum depression?
- chemical, social, psychological changes w/ having a baby
- avoid fermented, pickled, ages, overly processed foods (foods high in tyramine)
- have to be off other antidepressants for 2wks before starting this med
What risk factors are associated with suicide?
- genetics
- chronic illness/pain
- gender
- age
- drugs/ alcohol
- social isolation
- unemployment
- loss of relationship
- hx of trauma/ abuse
What are the causes of depression?
- genetics
- traumatic events
- stress
- hormonal changes
- poor coping mechanisms
- unhealthy relationship
What are the risk factors for bipolar disorder?
- family hx
- drug abuse
- stress
- major life altering events
- age 15 to 30
What are the risk factors associated with postpartum depression?
- family hx
- primiparity
- infant w/ special needs
- lack of support
- body image issues
- financial/ employment issues
What are the different types of depression?
- Major Depression ~ lasts >14days
- Persistent Depression ~ lasts >2yrs, has less severe symptoms than MDD
- Seasonal Depression ~ sadness and low energy in winter, decreased serotonin and increased melatonin
How is suicide diagnosed?
Columbia suicide severity rating scale
What are the signs and symptoms of depression?
- lack of energy
- agitation
- sadness/ hopelessness/ guilt
- sleep disturbance
- abnormal eating patterns
- loss of interest
What are the extrapyramidal clinical manifestations a patient with bipolar might experience?
- dystonia > salvation, bent neck
- akathisia > restlessness
- pseudo parkinsonism > muscle tremors
- tardive dyskinesia > tongue bulging, chewing movements
What is the treatment for postpartum depression?
- therapy
- ECT
- SSRI > no breastfeeding
What is the therapeutic dose for lithium and how long does it take to work?
- 0.6 > 1.2 mEq/L
- takes 1-3 wks to work
What is the treatment for suicidal thoughts?
- antidepressants > SSRI (side effect are suicidal tendencies)
- mood stabilizers
- antipsychotics
- therapy
What are the risk factors of depression?
- female
- family hx
- hx of trauma or abuse
- unemployment/ poverty
- low education
- lack of support
What are the treatment options for Bipolar disorder?
- Lithium
- anti seizure meds
- antipsychotics
- medical emergency immediately hospitalization
- hallucinations, delusions
- treatment is lithium and antipsychotics
At what level dose lithium become toxic and what are the symptoms of toxicity?
- >1.5 mEq/L
- nausea, confusion, tremors, kidney failure, dehydration, syncope, coma, death
What are the NNTK for suicidal patients?
- promote safety immediately
- place into suicide precautions
- main goal is to remain free from injury
What are the treatment options for depression?
- SSRI (prozac, zoloft, lexapro)
- SNRI (effexor, cymbalta)
- TCAs (-ine)
- MAOs > used when other meds don't work
- therapy
- ECT
- wellbutrin
- ketamine
A patient is taking lithium for treatment of an acute manic episode. What tests should the nurse expect the doctor to order before giving this med?
- thyroid
- pregnancy
- sodium levels
- kidney
A first time mother is having hallucinations and delusions about killing her baby. What is the first thing that needs to be done?
REMOVE THE INFANT
What is the difference between mania and hypomania? What should are the NNTK for bipolar disorder?
- mania lasts most of the day, every day, for at least 1 wk
- hypomania is shorter and less severe than mania
- promote safety, promote reality, have calm environment, set limits, offer high calorie finger foods, promote improved self care