Deck 20: Electroconvulsive Therapy

Question 1

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

A) Severe osteoporosis
B) Acute and chronic pulmonary disorders
C) Hypothyroidism
D) Recent cardiovascular accident
E) Prostatic hypertrophy

Answer 1

Severe osteoporosis
Acute and chronic pulmonary disorders
Recent cardiovascular accident

Question 2

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

A) "You may experience transient tangential thinking."
B) "You may experience some memory deficit surrounding the ECT."
C) "You may experience avolution for the remainder of the day."
D) "You may experience a higher risk for subsequent seizures."

Answer 2

"You may experience some memory deficit surrounding the ECT."

Question 3

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

A) To prevent increased intracranial pressure resulting from anoxia
B) To prevent hypotension, bradycardia, and bradypnea due to electrical stimulation
C) To prevent anoxia due to medication-induced paralysis of respiratory muscles
D) To prevent blocked airway resulting from seizure activity

Answer 3

To prevent anoxia due to medication-induced paralysis of respiratory muscles

Question 4

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

A) "During ECT a state of euphoria is induced."
B) "ECT induces a grand mal seizure."
C) "During ECT a state of catatonia is induced."
D) "ECT induces a petit mal seizure."

Question 5

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,a nurse should recognize the continued need for which critical intervention?

A) Suicide assessment must continue throughout the ECT course.
B) Antidepressant medications are contraindicated throughout the ECT course.
C) Discourage expressions of hopelessness throughout the ECT course.
D) Encourage a high-caloric diet throughout the ECT course.

Question 6

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

A) Allow the client to remain in bed.
B) Encourage the client to join the milieu to promote socialization.
C) Obtain a physician's order for parenteral nutrition.
D) Involve the client in physical activities to stimulate circulation.

Question 7

A client experienced bradycardia during electroconvulsive therapy (ECT).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?

A) The client will verbalize an understanding of the need for moving slowly after treatment.
B) The client will maintain an oxygen saturation level of 88% 1 hour after treatment.
C) The client will continue adequate tissue perfusion 1 hour after treatment.
D) The client will verbalize an understanding of common side effects of ECT.

Question 8

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 impact the feasibility of this treatment option?

A) Because the client is extremely suicidal, ECT is an appropriate option.
B) Because antidepressant medications have been ineffective, ECT is a good alternative.
C) Because informed consent is required for ECT, cognitive deficits could preclude this option.
D) Because of the client's cognitive deficits, a signed consent is waived.

Question 9

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

A) A client in bed in a fetal position who is experiencing active suicidal ideations
B) A client with an irritable mood and exhibiting angry outbursts
C) A client experiencing command hallucinations and delusions of reference
D) A client experiencing manic episodes of bipolar disorder

Question 10

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

A) "Atropine (Atro-Pen) is administered to paralyze skeletal muscles during ECT."
B) "Succinylcholine chloride (Anectine) decreases secretions to prevent aspiration."
C) "Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious."
D) "Glycopyrrolate (Robinul) is given to prevent severe muscle contractions during seizure."

Question 11

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

A) Robinul decreases anxiety during the ECT procedure.
B) Robinul induces an unconscious state to prevent pain during the ECT procedure.
C) Robinul prevents severe muscle contractions during the ECT procedure.
D) Robinul decreases secretions to prevent aspiration during the ECT procedure.

Question 12

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

A) Major depressive disorder
B) Bipolar I disorder: manic episode
C) Schizoaffective disorder
D) Obsessive-compulsive disorder
E) Body dysmorphic disorder

Question 13

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

A) The nurse notifies the client's physician of the situation and cancels the ECT.
B) The nurse removes the breakfast tray and assists the client to the ECT procedure room.
C) The nurse allows the client to finish breakfast and reschedules ECT for 10:00 a.m.
D) The nurse increases the client's fluid intake to facilitate the digestive process.

Question 14

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

A) Electrocardiographic records
B) Pulmonary function study results
C) Electroencephalogram analysis
D) Complete blood count values
E) Urinalysis results

Question 15

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

A) On his or her side to prevent aspiration
B) In semi-Fowler's position to promote oxygenation
C) In Trendelenburg's position to promote blood flow to vital organs
D) In prone position to prevent airway blockage

Question 16

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?

A) "Clients typically receive ECT in their hospital room, daily for 1 month."
B) "Clients typically undergo 6 to 12 ECT procedures, three times a week in an outpatient setting."
C) "Clients typically receive an unlimited number of treatments, in the hospital procedure room."
D) "Clients typically receive two to three treatments, in either an outpatient or inpatient setting."

Question 17

A nursing student is observing an electroconvulsive therapy (ECT)procedure.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) "The cuff has to be placed on the leg because both arms are used for intravenous fluids."
B) "The cuff functions to prevent succinylcholine from reaching the foot."
C) "The cuff position gives a more accurate blood pressure reading during the treatment."
D) "The cuff is placed on the leg so that arms can easily be restrained during seizure."

Question 18

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

A) "No, this treatment is side-effect free."
B) "There can be temporary paralysis, but full functioning returns within 3 hours of treatment."
C) "There are some risks, but a thorough examination will determine your candidacy for ECT."
D) "Transient ischemic attacks (TIAs) can occur but are rare."

Question 19

During a course of 12 electroconvulsive therapy (ECT)procedures,an anxious client diagnosed with major depression refuses to bathe or attend group therapy.He reports some memory problems and says he has trouble figuring out what time of day it is.At this time,which of the following nursing diagnoses should be assigned to this client? Select all that apply.

A) Anxiety R/T post-ECT confusion and memory loss
B) Risk for injury R/T post-ECT confusion and memory loss
C) Risk for activity intolerance R/T post-ECT confusion and memory loss
D) Altered sensory perception R/T post-ECT confusion and memory loss
E) Social isolation R/T post-ECT confusion and memory loss

Question 20

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

A) "After you begin the course of treatments, you must complete all of them."
B) "You'll need to talk with your doctor about what you're thinking."
C) "It is within your right to discontinue the treatments, but let's talk about your concerns."
D) "Memory loss is a rare side effect of the treatment. I don't think it should be a concern."