Question 1

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

Accepted Answer

Severe osteoporosis,acute and chronic pulmonary disorders,and a recent history of cardiovascular accident (CVA)can render clients at high risk for injury during electroconvulsive therapy.

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?

Accepted Answer

The most common side effect of ECT is temporary amnesia following the ECT procedure.

Question 3

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

Accepted Answer

The nurse administers 100% oxygen during and after electroconvulsive therapy to prevent anoxia due to medication-induced paralysis of respiratory muscles.Electroconvulsive therapy is the induction of a grand mal seizure through the application of electrical current to the brain.

Question 4

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

Accepted Answer

Electroconvulsive therapy is the induction of a grand mal seizure through the application of electrical current to the brain for the purpose of decreasing depression.

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?

Accepted Answer

ECT is an intervention for major depression that often includes suicidal ideations as a symptom.Continued suicide assessment is needed because mood improvement due to ECT may cause the client to act on suicidal ideations.

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?

Accepted Answer

Immediately after electroconvulsive therapy a nurse should monitor pulse,respirations,and blood pressure every 15 minutes for the first hour,during which time the client should remain in bed.

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?

Accepted Answer

Vagal stimulation induced by ECT may cause a client to experience bradycardia.Adequate tissue perfusion would be a realistic expectation when normal cardiac output is restored.

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?

Accepted Answer

A client who is experiencing cognitive deficits cannot give informed consent,which is required prior to ECT.A court proceeding could determine the client's level of competency and,if necessary,the judge would appoint a guardian.

Question 9

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

Accepted Answer

A client who is experiencing suicidal ideations is in need of an immediate intervention to prevent self-harm and must be prioritized when the nurse schedules ECT.

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?

Accepted Answer

In order to render a client unconscious during the ECT procedure,an anesthesiologist administers intravenously a short-acting anesthetic such as thiopental sodium (Pentothal).

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?

Accepted Answer

Glycopyrrolate (Robinul)is the standard preoperative medication given prior to ECT procedures to decrease secretions and prevent aspiration.

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.

Accepted Answer

ECT has been shown to be effective in the treatment of severe depression,acute mania,and acute schizophrenia,particularly if it is accompanied by catatonic or affective (depression or mania)symptomatology.ECT has also been tried with other disorders,such as obsessive-compulsive disorder (OCD)and anxiety disorders,but little evidence exists to support its efficacy in the treatment of these conditions.

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?

Accepted Answer

A client who is scheduled for ECT procedures is given nothing by mouth (NPO)for a minimum of 6 to 8 hours before treatment.

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.

Accepted Answer

A nurse should evaluate electrocardiographic records,pulmonary function study results,complete blood count,and urinalysis results and report any abnormalities to the client's physician.The client must be medically cleared prior to ECT.

Question 15

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

Accepted Answer

The nurse should place a client who has received electroconvulsive therapy on his or her side to prevent aspiration.After the treatment,most clients will awaken within 10 to 15 minutes and will be confused and disoriented.Some clients will sleep for 1 to 2 hours.All clients require close observation following treatment.

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?

Accepted Answer

Most clients require an average of 6 to 12 ECT procedures,but some may require up to 20 procedures.Treatments are usually administered every other day,three times per week.Treatments are performed on either an inpatient or outpatient basis,depending on the need for client monitoring.

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?

Accepted Answer

A blood pressure cuff is placed on the lower leg and inflated above systolic pressure before injection of succinylcholine.This is to ensure that seizure activity can be observed and timed in this one limb that is unaffected by the paralytic agent.

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?

Accepted Answer

Clients are given medical clearance for ECT.This decreases the risk of injury from the treatment.

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.

Accepted Answer

Because of the post-ECT thought alterations of confusion and memory loss,the client is anxious,is accident prone,and has socially isolated self.Altered sensory perception is related to psychotic thoughts of a sensory nature such as hallucinations,and because this client is diagnosed with major depression,not schizophrenia,altered sensory perception would not be anticipated.

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?

Accepted Answer

The client has the right to terminate treatment.This nursing reply acknowledges this right but focuses on the client's concerns so that the nurse can provide needed information.

Quiz 20: Electroconvulsive Therapy

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

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

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

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?

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 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 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?

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

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 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 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 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?

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

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

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

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?