For which patient is the nurse most likely to need to schedule a ...

[appyboo]

For which patient is the nurse most likely to need to schedule a pre-ECT workup and teaching?
 
  a. Patient A, who is newly diagnosed with dysthymic disorder
  b. Patient B, who has melancholic depression that responded well to ECT 2 years ago
  c. Patient C, who was unresponsive to a 6-week trial of SSRI antidepressant therapy
  d. Patient D, who has depression associated with diagnosis of inoperable brain tu-mor

Question 2

Immediately after electroconvulsive therapy (ECT), nursing care of the patient is most similar to care of a patient:
 
  a. With severe dementia
  b. With delirium tremens
  c. Recovering from conscious sedation
  d. Recovering from general anesthesia

[Mochi]

Answer to Question 1

ANS: B
Indications for ECT include patients with major mood disorders; patients who have re-sponded to ECT in the past; patients who are unresponsive to antidepressants or unable to tolerate their side effects; and patients who are acutely suicidal or in danger of fluid and electrolyte imbalance related to inability to eat due to depression, severe mania, or severe catatonia. Patients with dysthymia are not candidates for ECT. The patient has not run out of medication options when prescribed only an SSRI. Patients with space-occupying lesions of the brain are not candidates for ECT.

Answer to Question 2

ANS: D
The patient who has ECT receives a short-acting IV anesthetic and a skeletal muscle relaxant. Thus care is most similar to the patient recovering from general anesthesia. The nurse will as-sess vital signs, quality of respirations, presence or absence of the gag reflex, level of con-sciousness, orientation, and motor abilities during the post-treatment period.