Question

Mental Health Nursing Depression and Suicidal Ideation The client is a 60-year-old woman whose physician ordered home health nursing for her following a 5-day admission to the acute care hospital with a with her medical diagnosis of major depression and suicidal ideation. She lives 75-year-old partner. They have no children. This was her first admission for depression and her first referral for home care. The physician orders include 35 mg of fluoxetine hydrochloride per day and assessment of the client's adjustment to home. She has no other medical problems but has lost 35 Ibs in the last 6 months. The client does not greet the nurse when she arrives. When introduced by her partner, the client tells the nurse. "I don't need any help; I know what to do." The client's partner adds that his wife has taken the medication as the physician prescribed. The client appears to be older than her age of 60. She is neatly dressed but appears tired and eager to have the nurse leave. She answers some of the questions but supplies only short answers. She refuses to discuss suicidal thoughts, informing the nurse that it is none of her business. Her only complaints are of dry mouth and occasional dizziness. Her partner seems con- cerned. He tells the nurse at the door that his wife just does not seem right, but he is pleased that she dressed herself. She seems to have more energy even though she looks tired. The client is 5 ft, 6 in and weighs 107 lbs, which was her weight at the time of discharge from the hospital. Her blood pressure is 110/70, her heart rate is 88 beats per minute (bpm), her respirations are 20 breaths per minute, and her oral temperature is 98.7F Laboratory test results from hospitalization are within normal ranges. Her physician has not ordered any further tests.

Answer 1

Suicide is one of the most preventable kind of death. Researches are showing that there is an increased number of suicides are occurring in later life, and are mostly seen in women aged 50 and older. Suicidal thoughts are mostly seen in patients who are suffering from depression.

1. By the proper application of therapeutic communication and gain the patient confidence we have to assess for the suicidal ideation.she has planned.

Her suicidal plan is by the ingestion of narcotic drugs /pain relievers in the high amount at once

2. The patient data shows according to her symptoms she is high risk for suicide when she is showing non-compliance for all the management. She is irritated with the nurse activities and she is trying to avoid that. Her husband says that she does not seem right and having high levels of energy.

She is planning to end her life by ingestion of high amounts of narcotic pain reliever

3. The studies found that there is a strong correlation between the suicidal impulses as well as energy to act on them may increase that may result in the suicidal attempt

4.Imbalanced nutrition less than body requirements related to severe depression/lack of appetite/negative thoughts.

5.

*Depressant clients never feel good about themselves. They have a negative, self-deprecating view of the world.

*The nurse has to assess the patient frequently regarding their thoughts and ideations and her attitude towards the suicide and the suicidal thoughts.

*As a nurse she has to weekly correct her weights. The client's body weight is the most reliable and objective evaluation of success in treating the nursing diagnosis because her dry mouth and occasional dizziness may be due lack of diet,

6.

*The Family history of depression

*Reproductive History

*Marital and sexual history

Her partner is concerning regarding that the wife does not seem alright, but he is pleased that she dressed her self that means the client is not showing Psychomotor agitation.

She looks tired than also seems to have more energy even though because of suicidal ideations and having the urge to act on it

7. The major reason for hospitalization of the depressed client is suicidal ideation.

By using the Sad Person Scale that is useful for the nurse in rating suicide risk

We have to improve her sense of responsibility to her partner/family and its need and importance if not what is the future effects........

In case when working with the client, made a covert reference to suicide, ask directlyif she is thinking of attempting suicide

Warmth and consistency when interacting

8. The researchers show that the greater incidence of suicide is occurring in later life and is more seen especially in the woman with aged 50 and above.

Most of the attempts of the suicide by females in this age population by the choice of some lethal drugs.

The main reason for the suicidal attempt and depression in this age of women is due to lack of insecurity and hopelessness.

9.

*By tender and soft touch, that promotes the security (avoid insecure feeling)

*Improve the responsibility/family role

*Be calm and quiet

*Help to manage life stressors

*Manage a positive mental health status

*Help them to avoid the feeling of alone

*Improves the hope of life

10,

*Identify the reason for depression

*Identify the reason for feeling insecurity

*Identify the reason for hopelessness

*Identify the reason for irritability

*Understands the reasons for the disorder of thinking

*During the age of 60, the physical and mental health needs of the women will vary and leads to depression and suicidal attempts.

*Assess for the interpersonal stress for suicide.

*Sometimes the loss of personal control may lead to suicidal thinking Eg: there is no longer support of a child for her/to the partner