Question 1

Immediately after electroconvulsive therapy, in which position should a nurse place the client?

Accepted Answer

Placing the client on his or her side will help prevent aspiration in the event of vomiting, which can be a side effect of electroconvulsive therapy.

Question 2

A nursing student is observing an electroconvulsive therapy (ECT) treatment. The student notices a blood pressure cuff on the client's lower leg. The student questions the instructor about the cuff placement. Which is the most accurate instructor reply?

Accepted Answer

The blood pressure cuff is placed on the lower leg to prevent the muscle relaxant succinylcholine from reaching the foot, which could cause muscle damage. This is a necessary precaution during ECT treatment. The other options given are not accurate reasons for the placement of the cuff.

Question 3

A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering electroconvulsive therapy (ECT). What client information would determine the feasibility of this treatment option?

Accepted Answer

Informed consent is required for ECT, and the client's cognitive deficits may make it difficult for them to understand and provide informed consent.

Question 4

A client is scheduled for an initial treatment of electroconvulsive therapy (ECT). Which information should a nurse include when teaching about the potential side effects of this procedure?

Accepted Answer

The potential side effects of ECT include memory loss, particularly surrounding the ECT procedure. Option A is incorrect because "transient tangential thinking" is not a common side effect of ECT. Option C is incorrect because "avolution" is not a recognized term. Option D is incorrect because ECT is actually used to treat seizures, so it would not increase the risk for subsequent seizures.

Question 5

A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred?

Accepted Answer

ECT does induce a grand mal seizure as a therapeutic effect to relieve symptoms of certain mental illnesses such as depression, bipolar disorder, and schizophrenia. A and C are incorrect as they refer to incorrect states induced by ECT. D is incorrect as ECT induces a grand mal seizure, not a petit mal seizure.

Question 6

A client experienced bradycardia during electroconvulsive therapy (ECT) treatment. A nurse assigns a nursing diagnosis of decreased cardiac output R/T vagal stimulation occurring during ECT. Which outcome would the nurse expect the client to achieve?

Accepted Answer

Decreased cardiac output can lead to inadequate tissue perfusion. Therefore, the expected outcome would be for the client to maintain adequate tissue perfusion 1 hour after treatment. Verbalizing understanding of the need for moving slowly, maintaining oxygen saturation levels, or understanding common side effects of ECT do not specifically address the issue of decreased cardiac output and tissue perfusion.

Question 7

A client who is learning about electroconvulsive therapy (ECT) treatment asks a nurse "Isn't this treatment dangerous?" Which is the most appropriate nursing reply?

Accepted Answer

ECT does carry some risks, such as confusion, memory loss, and complications from anesthesia. However, a thorough medical examination and evaluation will determine if ECT is a safe and appropriate treatment option for the client. It is important for the nurse to provide accurate information while also emphasizing that steps will be taken to minimize risks and ensure safety. Options A and D are untrue, while option B is not entirely accurate as the effects of the treatment may last longer than 3 hours for some individuals.

Question 8

A nurse administers pure oxygen to a client during and after electroconvulsive therapy treatment. What is the nurse's rationale for this procedure?

Accepted Answer

During electroconvulsive therapy, a client is given medication that paralyzes their respiratory muscles, which can lead to anoxia (lack of oxygen). Therefore, administration of pure oxygen helps prevent anoxia.

Question 9

During a course of 12 electroconvulsive therapy (ECT) treatments, an anxious client diagnosed with major depression refuses to bathe or attend group therapy. At this time, which of the following nursing diagnoses should be assigned to this client? (Select all that apply.)

Accepted Answer

The answer of During a course of 12 electroconvulsive therapy...

Question 10

A client states, "My doctor has told me I am a candidate for electroconvulsive therapy (ECT). Where will the treatment take place and how much time would this entail?" Which is the most accurate nursing reply?

Accepted Answer

The most common practice for ECT is to receive 6 to 12 treatments, three times per week in an outpatient setting. It is not typically done daily for a month in a hospital room, nor is an unlimited number of treatments given. Two to three treatments can be done in either an outpatient or inpatient setting, but this is not the typical protocol.

Question 11

A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT treatments, a nurse should recognize the continued need for which critical intervention?

Accepted Answer

Suicide assessment must continue throughout the ECT course of treatment as ECT can temporarily increase suicidal thoughts and ideation. Therefore, it is critical to monitor the client's mental state and maintain a safe environment. Options B, C, and D are not the most critical interventions during ECT treatment. Antidepressant medications might be continued along with ECT; encourage positive expression of feelings can be more beneficial to the client, and a high-caloric diet may not be a priority concern during ECT.

Question 12

A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client's electroconvulsive therapy (ECT) treatment. What is the rationale for administering this medication?

Accepted Answer

Glycopyrrolate (Robinul) is an anticholinergic medication that decreases secretions in the respiratory, gastrointestinal, and sweat glands. It is administered prior to ECT to decrease salivation and prevent aspiration during the procedure.

Question 13

A nurse should recognize that electroconvulsive therapy (ECT) would potentially improve the symptoms of clients with which of the following Axis I diagnoses? (Select all that apply.)

Accepted Answer

Electroconvulsive therapy (ECT) has been shown to be effective in treating major depressive disorder, bipolar disorder (manic phase), and schizoaffective disorder. It is not typically used to treat obsessive-compulsive anxiety disorder or body dysmorphic disorder.

Question 14

After receiving two of nine electroconvulsive therapy (ECT) treatments, a client states, "I can't even remember eating breakfast, so I want to stop the ECT treatments." Which is the most appropriate nursing reply?

Accepted Answer

The most appropriate nursing reply acknowledges the client's concerns while providing information that supports the client's independence and autonomy. Option A is incorrect because the decision to discontinue treatments ultimately lies with the client. Option B is incorrect because the nurse can provide guidance and support but it is ultimately the client's decision to discuss their concerns with their doctor. Option D is incorrect because the client has expressed a concern about memory loss and dismissing their concern as rare is not helpful.

Question 15

Immediately after an initial electroconvulsive therapy (ECT) treatment a client states, "I'm not hungry and just want to stay in bed and sleep." Based on this information, which is the most appropriate nursing intervention?

Accepted Answer

It is common for clients to experience lethargy, confusion, and disorientation immediately after ECT treatment. Allowing the client to remain in bed and rest can help them recover and reduce the risk of falls or injury. It is also important to monitor the client's vital signs and neurological status during this time. Encouraging socialization or physical activities may be too stimulating for the client and could exacerbate these symptoms. Parenteral nutrition may be considered if the client is unable to eat or drink for an extended period or if they have significant weight loss or malnutrition, but this intervention is not necessary based on the client's current statement.

Question 16

Which of the following conditions would place a client at risk for injury during electroconvulsive therapy (ECT) treatments? (Select all that apply.)

Accepted Answer

A client with severe osteoporosis is at risk for bone fractures during ECT treatments. Acute and chronic pulmonary disorders can cause respiratory distress during ECT, and recent cardiovascular accidents can increase the risk of cardiac complications. Hypothyroidism and prostatic hypertrophy are not conditions that would place a client at risk for injury during ECT treatments.

Question 17

Which assessment test results should a nurse evaluate and report in the process of clearing a client for electroconvulsive therapy (ECT)? (Select all that apply.)

Accepted Answer

The answer of Which assessment test results should a nurse...

Question 18

A client scheduled for electroconvulsive therapy (ECT) at 9:00 a.m. is discovered eating breakfast at 8:00 a.m. Based on this observation, which is the most appropriate nursing action?

Accepted Answer

ECT requires the client to be NPO (nothing by mouth) for a certain period before the procedure to prevent aspiration. Eating breakfast an hour before ECT violates this protocol, so the nurse should notify the physician and cancel the ECT.

Question 19

A nursing instructor is teaching about the medications given prior to and during electroconvulsive therapy (ECT) treatments. Which student statement indicates that learning has occurred?

Accepted Answer

Thiopental sodium (Pentothal) is used as a short-acting anesthetic to render the client unconscious during ECT.

Question 20

When scheduling electroconvulsive therapy (ECT), which client should the nurse prioritize?

Accepted Answer

The client in active suicidal ideation is a high priority for ECT as it can be effective in reducing suicidal thoughts and behaviors. The other options may benefit from ECT but are not experiencing the same level of immediate danger.

Quiz 21: Electroconvolusive Therapy

Immediately after electroconvulsive therapy, in which position should a nurse place the client?

A nursing student is observing an electroconvulsive therapy (ECT) treatment. The student notices a blood pressure cuff on the client's lower leg. The student questions the instructor about the cuff placement. Which is the most accurate instructor reply?

A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering electroconvulsive therapy (ECT) . What client information would determine the feasibility of this treatment option?

A client is scheduled for an initial treatment of electroconvulsive therapy (ECT) . Which information should a nurse include when teaching about the potential side effects of this procedure?

A nursing instructor is teaching about electroconvulsive therapy (ECT) . Which student statement indicates that learning has occurred?