A nurse is caring for a client who has a mental illness.
Which of the following actions by the nurse demonstrates the ethical concept of autonomy?

Choice B rationale:

Schizophrenia is a severe mental illness that is characterized by disturbances in thought, perception, emotion, and behavior. It is associated with an increased risk of suicide, with estimates suggesting that up to 10% of individuals with schizophrenia will die by suicide.

Several factors contribute to the increased risk of suicide in individuals with schizophrenia, including:

Hopelessness and despair: Individuals with schizophrenia often experience profound feelings of hopelessness and despair, which can lead to suicidal thoughts and behaviors.

Psychotic symptoms: Psychotic symptoms, such as delusions and hallucinations, can also contribute to suicide risk. For example, an individual with schizophrenia may experience auditory hallucinations that command them to harm themselves.

Impaired judgment: Schizophrenia can impair an individual's judgment and decision-making abilities, which can make it more difficult for them to resist suicidal urges.

Social isolation: Individuals with schizophrenia often experience social isolation, which can further increase their risk of suicide.

Comorbidity with other mental disorders: Schizophrenia is often comorbid with other mental disorders, such as depression and anxiety, which can also increase suicide risk.

Substance abuse: Substance abuse is a common problem among individuals with schizophrenia, and it can further increase suicide risk.

Choice C rationale:

Alcohol use disorder is a chronic, relapsing brain disease characterized by compulsive alcohol use, despite harmful consequences. It is a significant risk factor for suicide, with studies suggesting that individuals with alcohol use disorder are 10-14 times more likely to die by suicide than the general population.

Several factors contribute to the increased risk of suicide in individuals with alcohol use disorder, including: Depression: Alcohol use disorder is often comorbid with depression, which is a major risk factor for suicide. Impulsivity: Alcohol can impair judgment and increase impulsivity, which can lead to suicidal behaviors.

Social isolation: Alcohol use disorder can lead to social isolation, which can increase suicide risk.

Access to lethal means: Individuals with alcohol use disorder may have access to lethal means, such as firearms, which can increase the risk of suicide completion.

Choice D rationale:

Substance use disorder is a chronic, relapsing brain disease characterized by compulsive drug use, despite harmful consequences. It is a significant risk factor for suicide, with studies suggesting that individuals with substance use disorder are 6-12 times more likely to die by suicide than the general population.

Several factors contribute to the increased risk of suicide in individuals with substance use disorder, including: Depression: Substance use disorder is often comorbid with depression, which is a major risk factor for suicide. Impulsivity: Substance use can impair judgment and increase impulsivity, which can lead to suicidal behaviors.

Hopelessness: Individuals with substance use disorder may experience feelings of hopelessness and despair, which can increase suicide risk.

Social isolation: Substance use disorder can lead to social isolation, which can increase suicide risk.

Access to lethal means: Individuals with substance use disorder may have access to lethal means, such as firearms, which can increase the risk of suicide completion.

Choice F rationale:

Age greater than 65 years old is a risk factor for suicide. Suicide rates are highest among older adults, particularly white men over the age of 85.

Several factors contribute to the increased risk of suicide in older adults, including:

Chronic health conditions: Older adults are more likely to experience chronic health conditions, such as pain, disability, and cognitive decline, which can increase suicide risk.

Social isolation: Older adults are more likely to experience social isolation due to factors such as retirement, loss of loved ones, and decreased mobility.

Loss of independence: Older adults may experience a loss of independence due to physical and cognitive decline, which can contribute to suicide risk.

Access to lethal means: Older adults may have access to lethal means, such as firearms or medications, which can increase the risk of suicide completion.

Choice A rationale: Fluoxetine, also known as Prozac, is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. One of the common side effects of fluoxetine is a decreased interest in sexual intercourse. This can manifest as a decreased sex drive, difficulty in achieving an orgasm, or inability to have or keep an erection. It’s important for patients to be aware of this potential side effect so they can discuss it with their healthcare provider if it becomes a concern.

Choice B rationale: While fluoxetine is an effective treatment for depressive disorders, it does not typically cause an improvement in depressive symptoms in 2 to 3 days. In fact, it may take several weeks before patients begin to feel the full benefits of fluoxetine. Some people may even feel worse before they start to feel better. This is because it takes some time for fluoxetine to adjust the chemical balance in the brain.

Choice C rationale: Drooling is not typically associated with the use of fluoxetine. While fluoxetine can have many side effects, drooling is not commonly reported. If a patient experiences this side effect, it may be due to another medication or a different medical condition. It’s always important to discuss any new or unusual symptoms with a healthcare provider.

Choice D rationale: Loss of appetite is another potential side effect of fluoxetine. This can lead to weight loss in some patients. While this may be desirable for some, it can also lead to malnutrition and other health problems if not properly managed. Patients should be advised to monitor their weight and dietary intake while taking fluoxetine, and to discuss any concerns with their healthcare provider.