NCLEX RN Practice Question # 579

NCLEX Examination.

Practice Question # 579.


 

Nclex

ELECTROCONVULSIVE THERAPY (ECT)

Description

  • ECT is an effective treatment for depression that consists of inducing a tonic-clonic seizure by passing an electrical current through electrodes attached to the temples.
  • The administration of a muscle relaxant minimizes seizure activity, preventing damage to long bones and cervical vertebrae.
  • The usual course is 6 to 12 treatments given 2 to 3 times per week.
  • Maintenance ECT once a month may help decrease the relapse rate for a client with recurrent depression.
  • ECT is not a permanent cure.
  • ECT is not always effective in clients with dysthymic depression, depression and personality disorders, drug dependence, or depression secondary to situational or social difficulties.
  • At-risk clients include clients with recent myocardial infarction, brain attack (stroke), or intracranial mass lesions.

Uses

  • Clients with major depressive and bipolar depressive disorders, especially when psychotic symptoms are present, such as delusions of guilt, somatic delusions, and delusions of infidelity
  • Clients who have depression with marked psychomotor retardation and stupor
  • Manic clients whose conditions are resistant to lithium and antipsychotic medications and clients who are rapid cyclers (a client with a bipolar disorder who has many episodes of mood swings close together)
  • Clients with schizophrenia (especially catatonia), clients with schizoaffective syndromes,
  • and psychotic clients

Preprocedure

  • Explain the procedure to the client.
  • Encourage the client to discuss feelings, including myths regarding ECT.
  • Teach the client and family what to expect.
  • Informed consent must be obtained when voluntary clients are being treated.
  • For involuntary clients, when informed consent cannot be obtained, permission may be obtained from the next of kin, although in some states the permission for ECT must be obtained from the court.
  • Maintain NPO status after midnight or at least
  • 4 hours before treatment.
  • Baseline vital signs are taken.
  • The client is requested to void.
  • Hairpins, contact lenses, and dentures are removed.

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