Crisis Intervention
A sudden event in one’s life that disturbs homeostasis, during which usual coping mechanisms cannot resolve the problem
What is Crisis?
A behavior that is defined as the act of taking one’s own life, and it derives from the Latin words for “one’s own killing.” An irrational act associated with mental illness and most commonly, but not exclusively, with depression.
What is suicide?
An alteration in mood that is expressed by feelings of sadness, despair, and pessimism. There is a loss of interest in usual activities, and somatic symptoms may be evident. Changes in appetite, sleep patterns, and cognition are common.
What is depression?
During this episode, the mood is elevated, expansive, or irritable. The disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others or to require hospitalization to prevent harm to self or others. Motor activity is excessive and frenzied. Psychotic features may be present.
What is Mania?
This has been approved by the FDA to treat depression in children and adolescents.
What is Fluoxetine (Prozac)?
The individual is exposed to a precipitating stressor.
When previous problem-solving techniques do not relieve the stressor, anxiety increases further.
All possible resources, both internal and external, are called on to resolve the problem and relieve the discomfort.
If resolution does not occur in previous phases, “the tension mounts beyond a further threshold or its burden increases over time to a breaking point. Major disorganization of the individual with drastic results often occurs”
What are phases of development of crisis?
factors that have statistically been correlated with a higher incidence of suicide.
Risk factors
This is characterized by a depressed mood or loss of interest or pleasure in usual activities. Characterized by impaired social and occupational functioning that has existed for at least 2 weeks, no history of manic behavior, and symptoms that cannot be attributed to the use of substances or a general medical condition.
What is Major Depressive Disorder?
During this episode, the mood is elevated, expansive, or irritable. The disturbance does not cause marked impairment in occupational functioning or in usual social activities or relationships with others or to require hospitalization to prevent harm to self or others. Motor activity is excessive and frenzied. Psychotic features are not present.
What is hypomania?
This anti-depressant medication is FDA-approved for adolescents experiencing Major Depressive Disorder.
What is Escitalopram (Lexapro)?
A quick, simple, and reliable checklist that can be used as a risk assessment for potential violence.
What is the Brøset Violence Checklist (BVC)?
factors suggesting a more immediate concern.
warning signs
Its general goals are to obtain symptom relief as quickly as possible, to assist the client in identifying dysfunctional patterns of thinking and behaving, and to guide the client to evidence and logic that effectively test the validity of the dysfunctional thinking.
What is cognitive therapy?
A chronic mood disturbance of at least 2 years’ duration, involving numerous periods of elevated mood that do not meet the criteria for a hypomanic episode and numerous periods of depressed mood of insufficient severity or duration to meet the criteria for major depressive episode. The individual is never without the symptoms for more than 2 months.
What is cyclothymic disorder?
A combination of lithium and FDA-approved mood stabilizers (combination of olanzapine and fluoxetine, quetiapine, and lurasidone) have demonstrated effect in managing this.
What is managing bipolar depression?
The vehicle by which nurses assist individuals in crisis with a short-term problem-solving approach to change.
What is the Nursing Process?
A patient-centered, collaborative process in the context of a therapeutic relationship and should chronologically explore presenting suicide events, recent events, past events, and immediate intentions.
A chronically depressed mood (or possibly an irritable mood in children or adolescents) for most of the day, more days than not, for at least 2 years (1 year for children and adolescents). "Down in the dumps."
What is Persistent Depressive Disorder (Dysthymia)?
Risk for injury
Risk for violence: Self-directed or other-directed
Imbalanced nutrition: Less than body requirements
Disturbed thought processes*
Disturbed sensory-perception*
Impaired social interaction
Insomnia
What are Nursing Diagnosis associated with Bipolar Manic episode?
The drug of choice for treatment and management of bipolar mania. Its therapeutic range (0.6–1.2 mEq/L) can have toxic side effects and is potentially fatal when exceeded. Patients must consume adequate dietary sodium, and avoid excess caffeine or diuretics.
What is Lithium carbonate?
Through this structured method of assistance, nurses help individuals in crisis to develop more adaptive coping strategies for dealing with stressful situations in the future.
What is the four-phase technique of crisis intervention?
1. Identify risk factors- Note those that can be modified to reduce risk.
2. Identify protective factors- Note those that can be enhanced.
3. Conduct suicide inquiry- Evaluate suicidal thoughts, plans, behavior, and intent.
4. Determine risk level and intervention- Choose appropriate intervention to address and reduce level of risk.
5. Document- Record assessment of risk, rationale, intervention, and follow-up.
What is SAFE-T or Suicide Assessment?
Risk for suicide
Complicated grieving
Low self-esteem
Powerlessness
Spiritual distress
Social isolation/Impaired social interaction
Disturbed thought processes*
Imbalanced nutrition: Less than body requirements
Insomnia
Self-care deficit (hygiene, grooming)
What are Nursing Diagnosis associated with Depression?
Personalizing: “I’m the only reason my husband is a successful businessman.”
All or nothing: “Everything I do is great.”
Mind reading: “She thinks I’m wonderful.”
Discounting negatives: “None of those mistakes are really important.”
What are automatic thoughts?
These carry an FDA black-box warning for increased risk of suicidality in children and adolescents.
What are all antidepressants?