Question 1

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

Accepted Answer

The most appropriate nursing reply is to educate the client that they will undergo a thorough examination beforehand to ensure safe ECT treatment. This helps the client understand the importance of assessment and safety in the process. A is not correct as ECT does have side effects. B is partially correct but may sound alarming to the client. D is not the best choice as it may not provide clear information to the client.

Question 2

A client scheduled for 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

Electroconvulsive therapy (ECT) requires that the patient be fasted for several hours prior to the procedure to reduce the risk of aspiration during the treatment. If a patient eats before ECT, the procedure should be postponed and the physician notified to prevent potential complications.

Question 3

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

Accepted Answer

Option B states the most commonly used protocol for ECT, which involves 6 to 12 procedures done three times a week in an outpatient setting. This response provides the client with a clear and concise answer to their question. Option A is incorrect because ECT typically takes place in a dedicated treatment area, not in the client's hospital room. Option C is incorrect because ECT is not an unlimited procedure and is typically limited by the client's response to the treatment. Option D is incorrect because two to three treatments are not sufficient for most clients and the location of the treatment can vary depending on the client's needs.

Question 4

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

Accepted Answer

Suicide assessment should continue throughout the ECT course because ECT can cause transient confusion and disorientation, which may increase the risk of suicidal thoughts and behaviors. It is important to monitor the client closely and provide support to prevent self-harm. Antidepressant medications are not necessarily contraindicated during the ECT course, and discouraging expressions of hopelessness may be counterproductive to the therapeutic process. Encouraging a high-caloric diet is not a critical intervention during the ECT course.

Question 5

Which position should the nurse place the client in immediately after ECT?

Accepted Answer

The nurse should place the client on his or her side to prevent aspiration of any gastric contents that may have been present in the client's stomach during the procedure.

Question 6

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

Accepted Answer

During ECT, the client is given medication-induced paralysis of respiratory muscles, which can lead to anoxia. Administering pure oxygen helps prevent anoxia by ensuring adequate oxygenation.

Question 7

Which assessment results should the nurse evaluate and report to prepare a client for ECT? Select all that apply.

Accepted Answer

The answer of Which assessment results should the nurse evaluate...

Question 8

A client experienced bradycardia during 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?

Accepted Answer

The nursing diagnosis of decreased cardiac output indicates that there is an inadequate amount of blood being pumped by the heart, which can lead to decreased tissue perfusion. The desired outcome would be for the client to maintain adequate tissue perfusion, which is indicated by a normal blood pressure, heart rate, and oxygen saturation level. A and D are not directly related to the nursing diagnosis and B is not a relevant outcome for treating bradycardia.

Question 9

A nursing student is observing an 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?

Accepted Answer

The placement of the blood pressure cuff on the client's lower leg during an ECT procedure is to prevent the administration of succinylcholine from reaching the foot. Succinylcholine is a muscle relaxant that is administered during the procedure to prevent injury from convulsions, but it can cause temporary paralysis if it reaches the foot. By placing the cuff on the lower leg, the flow of succinylcholine is restricted to the upper part of the body during the procedure.

Question 10

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

Accepted Answer

Thiopental sodium is a short-acting anesthesia used to render the client unconscious during ECT. Atropine sulfate is used to increase heart rate and secretions, not to paralyze skeletal muscles. Succinylcholine chloride is a muscle relaxant used during ECT, but it is not used to decrease secretions. Glycopyrrolate is used to decrease secretions, not to prevent severe muscle contractions during seizure.

Question 11

A client with cognitive deficits is extremely suicidal.The client has not responded to antidepressants and the treatment team is considering ECT.Which client information would impact the feasibility of this treatment option?

Accepted Answer

Informed consent is required for ECT, and cognitive deficits could preclude this option. The client's ability to give meaningful consent is essential in determining the feasibility of ECT as a treatment option.

Question 12

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

Accepted Answer

Clients with severe osteoporosis have fragile bones and are at risk for fractures during ECT, clients with acute and chronic pulmonary disorders are at risk for respiratory complications during ECT, and clients who have recently had a cardiovascular accident are at risk for cardiovascular complications during ECT. Hypothyroidism and prostatic hypertrophy do not directly place the client at risk for injury during ECT.

Question 13

Immediately after an initial ECT procedure,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

Immediately after an ECT procedure, it is common for clients to feel groggy and disoriented. Allowing the client to rest in bed is appropriate until the effects of the procedure wear off. Encouraging socialization or involving the client in physical activities may increase anxiety and disorientation. Parenteral nutrition may not be necessary at this time as the client's lack of hunger may be due to the aftereffects of the procedure.

Question 14

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

Accepted Answer

Robinul (glycopyrrolate) is administered before procedures like ECT to decrease secretions, which helps prevent aspiration during the procedure.

Question 15

The nurse recognizes that ECT would potentially improve the symptoms of clients with which of the following diagnoses? Select all that apply.

Accepted Answer

ECT is typically used to treat severe depression, acute mania in bipolar disorder, and some cases of schizoaffective disorder. It is not typically used to treat OCD or body dysmorphic disorder.

Question 16

A client is scheduled for an initial ECT procedure.Which information will the nurse include when teaching about the potential side effects of ECT?

Accepted Answer

Memory loss is a common side effect of ECT, especially surrounding the time of the treatment. Options A and C are not commonly associated with ECT, while option D is not accurate. ECT does not increase the risk for subsequent seizures.

Question 17

After undergoing two of nine 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?

Accepted Answer

The client has expressed concerns about memory loss and a desire to stop the treatment. Option A is not appropriate as the client has the right to refuse treatment. Option B is partly appropriate, but the nurse should also address the client's concerns. Option D is not accurate as memory loss is a common side effect of ECT. Option C acknowledges the client's concerns and offers support while also informing them of their right to make decisions about their treatment.

Question 18

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

Accepted Answer

ECT (electroconvulsive therapy) induces a grand mal seizure, which is a brief but intense convulsion that affects the entire body. This is a desired effect of the therapy. A state of euphoria or catatonia is not the intended outcome of ECT. A petit mal seizure is a type of seizure that does not involve convulsions and is not induced by ECT.

Question 19

During a course of 12 ECT procedures,an anxious client diagnosed with MDD refuses to bathe or attend group therapy.The client reports some memory problems and says he has trouble figuring out what time of day it is.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 ECT procedures,an...

Question 20

When scheduling ECT,which client should the nurse prioritize?

Accepted Answer

The client in bed in a fetal position who is experiencing active suicidal ideations should be prioritized for ECT as they are at an immediate risk for harm to themselves. ECT can be an effective intervention for severe depression and suicidal thoughts. Clients with bipolar manic episodes, irritability, and delusions may benefit from ECT, but they do not pose an immediate risk of harm to themselves.

Quiz 20: Electroconvulsive Therapy