CASE STUDY 2 (Suicidal Ideation)

CASE STUDY 2 (Suicidal Ideation)

Student’s Name: Doneva Lyn B. Medina Date: 06-08-2022 Score: ____ /15

CASE: Zeus

Case: A roommate found Zeus in his apartment after an overdose of aspirin. He was taken to the
emergency department and then admitted to the psychiatric unit. Zeus is 35 years old. He recently lost
his job. When his roommate was asked about the overdose. He took approximately 30 pills and assumed
that his roommate knew that he would be home within the hour. The nurse’s physical assessment
revealed that he was quiet and responded slowly to questions. He denied wanting to kill his self and
stated that he just wanted some peace. He said that he had only slept a maximum of four hours per
night in the last month or two and had lost 15 pounds. When Zeus was told he would receive one-to-one
supervision, he became angry and shouted, “I am not a prisoner”
1. Based on these data, what is the level of risk for Zeus’ suicidal act? Provide your rationale (3 pts)
Answer:
Moderate risk. Suicidal ideation with plan, but not intent or behavior. Hospital admission may be
necessary, develop crisi plan and suicide precautions, give emergency/ crisis numbers.
2. What impact might the job loss have had on Zeus? (3 pts)
Answer:
Job loss can be a profound psychological shock that leads to develop depressive mental illness and then
to commit suicide. As stated by the patient, he had only slept a maximum of four hours per night in the
last month or two and had lost 15 pounds and these are signs that the patient is suffering from
depression.
3. What data provided indicates that Zeus is depressed? (3 pts)
Answer:
He recently lost his job and had only slept a maximum of four hours per night in the last month or two
and had lost 15 pounds.
4. How would you respond to Zeus outburst about one-to-one supervision? (3 pts)
Answer:
 Zeus should be in direct sight of no more than 2 to 3 ft away from the staff member for all
activities.
 Maintain an eye contact with him and listen as he shares his thoughts and feelings.
 Try to understand the situations that triggers his outburst.
 Zeus should be under constant staff observation with no exceptions.
 Explain the purpose of such supervision more than once.
5. What other intervention is often used with suicidal clients to focus on their responsibility for their
own action? Describe the intervention. (3 pts)
Answer:
 Using an Authoritative role

- The nurse assumes the authoritative role to help clients stay safe. The nurse lets the clients
know their safety is the primary concern and it takes precedence over other needs and
wishes.
 Providing a Safe Environment
- Staff members remove any item they can use to commit suicide, such as sharp objects,
shoelaces, belts, lighters, matches, pencils, pens and even clothing with drawstrings.
 Creating a Support System List
- The nurse assesses support systems and the type of help each person or group can give a
client.
- The nurse makes a list of specific names and agencies that clients can call for support; he or
she obtains client consent to avoid breach of confidentiality.
CASE STUDY 3 (Major Depressive Disorder)

Student’s Name: Doneva Lyn B. Medina Date: 06-08-2022 Score: ____ /13
Case: Michaela
Case: A 52-year-old female, Micaela, is bookkeeper for a large company. For the past month, Michaela’s
husband has noticed that his wife is irritable, tearful, does not seek out any friends, and has insomnia.
He suggests that she should seek mental health care and accompanies her to the appointment. Michaela
tells the psychiatrist that she has been working long hours, is often alone because her husband travels,
and her only daughter is getting married in three months. Her request for vacation time prior to the
wedding was denied. She expresses feelings of “wanting an end to it all”
The psychiatric nurse documents the following assessment: Michaela has a SAD affect, insomnia, weight
loss, psychomotor retardation, and possible suicidal ideation. The psychiatrist diagnosis Michaela with
depressive disorder and recommends partial hospitalization (day treatment admission) for further
assessment and initial treatment. Michaela agrees and is admitted voluntarily to the partial hospital
program. Admission orders include sertraline (Zoloft) 50 mg. every morning.
1. Identify the client’s priority problems requiring immediate nursing intervention. (5 pts)
Answer:
 Weight loss
 Does not seek out any friends
 Suicidal ideation
 Insomnia
 Anxiety
2. Provide the rationale for the priority problems. (5 pts)
Answer:
Weight loss Nutrients we ingest through food should

be in adequate amounts to essentially
meet our body’s metabolic demands.
Does not seek out any friends Interaction with other people diverts the
patient’s attention from their negative
thoughts.
Suicidal ideation Provide a safe environment, free from
things that may harm the client.
Insomnia Sleep patterns may vary for each
individual. Evaluating these patterns will
provide general information and details
on certain areas of sleep that need to be
addressed or improved.
Anxiety Discussion of these feelings can provide a
role model for the client and show a
different way of dealing with them.
3. Upon admission to the partial hospital program unit, the client tells the nurse “I don’t really need to
be here” Write a response to the client’s statement. (3 pts)
Answer:
 “I understand what you are feeling, but this will help you recover. If you would need anything or
if you would like to talk, please tell me.”

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CASE STUDY 2 (Suicidal Ideation)

3. What data provided indicates that Zeus is depressed? (3 pts)

 Using an Authoritative role

CASE STUDY 3 (Major Depressive Disorder)

2. Provide the rationale for the priority problems. (5 pts)

Weight loss Nutrients we ingest through food should

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