(Select all that apply): A nurse is providing care to a patient with MDD. Which of the following are components of nursing assessment for suicide risk in patients with MDD? (Select three).
Assessing the patient’s medical history.
Monitoring the patient’s response to treatment.
Asking direct questions about suicidal thoughts.
Providing a list of local crisis helplines.
Encouraging the patient to isolate themselves.
Correct Answer : A,B,C
Choice A rationale:
Assessing the patient's medical history is crucial in understanding potential risk factors for suicide in patients with Major Depressive Disorder (MDD). Various medical conditions and medications can contribute to depression and increase the risk of suicidal ideation. By gathering this information, the nurse can identify any factors that might exacerbate the patient's condition.
Choice B rationale:
Monitoring the patient's response to treatment is essential for assessing the effectiveness of interventions and identifying any signs of worsening depression or increased suicidal risk. Certain treatments, like antidepressant medications, might initially increase the risk of suicide in some patients. Therefore, close monitoring is needed to ensure patient safety.
Choice C rationale:
Asking direct questions about suicidal thoughts is a critical component of assessing suicide risk in patients with MDD. Openly addressing this topic allows the nurse to gauge the patient's current state of mind, explore the presence and severity of suicidal ideation, and take appropriate actions if the patient expresses active suicidal thoughts.
Choice D rationale:
Providing a list of local crisis helplines can be beneficial, but it is not a component of the nursing assessment for suicide risk in patients with MDD. While offering resources is important, the immediate focus should be on assessing the patient's condition and potential risk factors.
Choice E rationale:
Encouraging the patient to isolate themselves is not an appropriate action when assessing suicide risk in patients with MDD. Social isolation can exacerbate depressive symptoms and increase the risk of suicide. Therefore, promoting social connection and support is essential, rather than encouraging isolation.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Physical vital signs and body mass index (BMI) are important indicators of the patient's physical health. However, when assessing a patient with bipolar disorder, the focus should be on their psychosocial status rather than their physical health. Bipolar disorder primarily affects mood and emotions, so evaluating physical vital signs and BMI might not provide relevant information about the patient's psychosocial well-being.
Choice B rationale:
The patient's medication history and laboratory tests are crucial for understanding their medical treatment and potential physiological factors contributing to their bipolar disorder. However, this choice emphasizes the medical aspect rather than the psychosocial aspect of the patient's condition. While medication history and lab tests are important, they do not directly address the psychosocial evaluation that is required for understanding emotional expression in bipolar disorder.
Choice C rationale:
This is the correct choice. Bipolar disorder involves significant mood swings, from manic to depressive episodes. Assessing the quality, intensity, and range of emotional expression is essential to understand the patient's current emotional state, which is a fundamental aspect of their psychosocial well-being. It provides insight into potential mood fluctuations, which are characteristic of bipolar disorder.
Choice D rationale:
Social and emotional well-being is indeed crucial for individuals with bipolar disorder. However, this choice is too broad and general. The question specifically asks for an aspect related to psychosocial status that should be evaluated during the assessment. Choice C provides a more specific and relevant focus on emotional expression, which is directly tied to bipolar disorder symptoms.
Correct Answer is C
Explanation
Choice A rationale:
Dairy products, in general, do not have a significant interaction with TCAs (Tricyclic Antidepressants). The concern with dairy products is usually related to their interaction with certain antibiotics. Therefore, avoiding dairy products is not necessary for someone taking TCAs.
Choice B rationale:
Fresh fruits do not have a notable interaction with TCAs. In fact, a diet rich in fresh fruits can be beneficial for overall health. There is no need to advise avoiding fresh fruits due to TCA use.
Choice C rationale:
(Correct Choice) Aged cheese should be avoided when taking TCAs. Aged cheeses, such as cheddar, blue cheese, and parmesan, contain tyramine, which can lead to a hypertensive crisis when consumed along with TCAs. This interaction is a result of the monoamine oxidase inhibitory effects of TCAs, which can lead to elevated levels of tyramine in the bloodstream.
Choice D rationale:
Leafy vegetables do not have a significant interaction with TCAs. Leafy vegetables are generally considered healthy and are not contraindicated when taking these medications. Therefore, there is no need for the client to avoid leafy vegetables due to TCA use.
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