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A 52-year-old client presents to the emergency department following a car accident. The emergency department (ED) physician is concerned that the client may have intentionally crashed her car and requests a stat PMHNP consult. In speaking with the PMHNP, the client describes persistent feelings of sadness and hopelessness. She states that she often wonders if her husband would be happier if she wasn't around anymore since she's never happy and sometimes thinks about what it would be like to just take a handful of sleeping pills and go to sleep forever. The client reports a previous suicide attempt when she was 16 but denies that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
No action is necessary as the client is not currently considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST
Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat full safety and mental health evaluation, the client requires a brief suicide safety assessment to determine whether a full mental health evaluation in necessary. It is also important to notify the client's physician or the clinician responsible for the client's care.
Diagnostic Testing when diagnosing mental health disorders
-Diagnostic tests and labs are most used to rule out physical conditions that may cause psychiatric symptoms and to evaluate the effects of treatment
Basic Laboratory Interpretation
Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count
-measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that may present with symptoms that can be attributed to both medical and psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
RBCs: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
WBCs (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-3%
Basophils: 0.5%-1%
Lymphocytes: 20%-35%
Monocytes: 3%-8%
Platelets: 150,000-300,000/microliter
differential diagnosis
The provider's initial hypothesis
-a working list of potential problems that can be associated with the initial or chief complaint
-Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
• provides guidance for identifying psychiatric diagnoses
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