220 non suicidal self injury

What is the key factor that differentiates suicide from other forms of self-harm?

Intent. Suicide is a deliberate act with the intent to die.

Define Suicidal Ideation.

Thoughts about engaging in suicidal behavior, ranging from passive (wishing not to wake up) to active (planning/intent).

Why is a "prior suicide attempt" a critical assessment finding?

It is one of the strongest predictors of future suicide risk.

Differentiate gender trends in suicide.

Men: Die by suicide more often (~4x).

Women: Attempt suicide more frequently.

Which age group has the second leading cause of death as suicide?

Youth and young adults (ages 10–34).

Which age group has the highest overall suicide rates?

Middle-aged adults (ages 45–64).

What is the primary concern for older adults (65+) regarding suicide?

They make fewer attempts, but their attempts are more lethal (isolation, medical issues, lethal means).

What are three major psychiatric risk factors?

Depression, Bipolar disorder, and Substance use disorders.

List three key protective factors.

Strong social/family connections, effective clinical care, and restricted access to lethal means.

What is the purpose of the Columbia Suicide Severity Rating Scale (C-SSRS)?

A structured tool to assess the presence and severity of suicidal ideation and behavior.

How is the PHQ-9 used in suicide prevention?

It screens for depression and includes a specific item (Item 9) regarding thoughts of death or self-harm.

True or False: A validated screening tool replaces clinical judgment.

False. Tools provide a framework, but nursing clinical judgment is always primary.

What is "Means Restriction"?

Limiting access to lethal tools (firearms, meds, toxic substances) during a crisis.

List 3 nursing actions for a "Suicide Watch" environment.

1. Use plastic, counted utensils.

2. Keep doors open/no private rooms.

3. Search patient belongings in their presence.

What is "Ligature-Resistant" design?

Creating a environment that is "jump-proof" and "hang-proof" (e.g., breakaway shower rods).

Define NSSI

Intentional direct injury to body tissue without the intent to die (e.g., cutting/burning).

What is the primary motivation for NSSI?

To regulate intense emotions or relieve psychological distress.

What is the nurse’s first step in assessing a patient with NSSI?

Self-assessment to recognize personal reactions (countertransference) and maintain objectivity.

How should a nurse provide physical care for NSSI injuries?

Provide appropriate wound care without reinforcing the behavior (staying neutral/professional).

In the "Planning" phase for NSSI, what is the first of the six structured steps?

Safety: Addressing the immediate risk through limit-setting.

What are the later stages of the NSSI recovery plan?

Developing Self-Esteem, gaining Insight (understanding motivation), and the Maintenance Phase (reinforcing adaptive behaviors).

During "Evaluation" of a suicidal patient, what specifically is the nurse assessing?

The patient's communication, insight, and perception of their behavior/urges.

Why is "Continuity of Care" emphasized after discharge?

The period immediately following hospitalization carries the highest risk for suicide.

Why are Veterans considered a high-risk group?

Due to trauma exposure, PTSD, and frequent access to firearms.

Suicide is the ____ leading cause of death for ages 10–34.

Second

What clinical factors increase suicide risk in patients with chronic medical conditions?

Chronic pain, neurologic conditions, and terminal illness (due to loss of autonomy and hopelessness).

Why is NSSI often under-reported?

Due to shame, fear of judgment, or fear of involuntary hospitalization.

Does the absence of suicidal intent in NSSI mean the patient is safe?

No. NSSI increases the risk for future suicidal behavior even if intent isn't present now.

What are common nursing diagnoses for NSSI?

Risk for self-mutilation or Self-mutilation.