Reference no: EM133894965

Question

You are working the day shift on a medical inpatient unit. You are discussing discharge instructions with J.B., an 86-year-old man who was admitted for mitral valve repair. His serum blood glucose is 250 mg/dL (13.9 mmol/L) and increasing for the past several months. During this admission, his dosage of insulin was adjusted and he was given additional education in managing his diet. While you are giving these instructions, J.B. tells you his wife died 9 months ago. He becomes tearful when telling you about his loss and the loneliness he has been feeling. J.B. states he just doesn't feel good lately, feels sad most of the time. J.B. also expresses his lack of involvement in his normal activities. He has few friends left in the community because most of them have passed away. He has a daughter in town, but she is busy with her work and grandchildren. He tells you he has been feeling "depressed" the last few months with thoughts of suicide.

1. What further assessment data is needed to determine the seriousness of J.B.'s thoughts of suicide?

2. What characteristics of J.B. put him at high risk for suicide?

3. Which psychiatric disorders can result in suicidal ideations or gestures? Name at least 3.

4. People with a physical illness, often have trouble sleeping, experience a change in appetite, reduce their level of activity, and have thoughts of death. How can you tell the difference between old age with illness and depression?

5. List 5 of the most common signs of depression in the older adult.

6. You use the SAD PERSONS scale (see below) to assess J.B.'s potential for suicide and find that he is at a 4 on the 10-point scale.

7. J.B. tells you he has general thoughts of suicide, but has not really thought about how he would do it. What important questions about suicide must the nurse ask J.B. at this time?