PSYCH - ECT

Question 1

is passing of an electric current through
electrodes applied to one or both temples to artificially induce a grand mal seizure for the safe and effective treatment of depression

For depressed patients, bipolar and schizo pt.

Answer 1

ELECTROCONVULSIVE THERAPY

Question 2

Last resort for a depressed patient who can no
longer wait for the effect of an antidepressant
medications or is no longer responsive to
medication

Answer 2

ECT

Question 3

ADVANTAGES OF ECT

Answer 3

• Quicker effects than antidepressants; 80 %
  improvement rate of major depressive episode
  with vegetative aspects
• Best therapy for major depression (last resort)
• Non-Invasive
• Induction of 70-150 volts of electricity in .5-
  2secs. Then, it is followed by a grand-mal seizure
  lasting 30-60 secs.
  o Prone to aspiration that is why atropine
  sulfate is given to decrease secretions and
  prevent aspiration
  o Should be in supine during ECT, then
  after place in a side-lying position to
  allow drainage of secretions

Question 4

Quicker effects than antidepressants; _____
improvement rate of major depressive episode
with vegetative aspects

Answer 4

80 %

Question 5

Best therapy for major depression (last resort)

Answer 5

ECT

Question 6

NON-INVASIVE

Answer 6

ECT

Question 7

Induction of _____ volts of electricity in ____ secs. Then, it is followed by a grand-mal seizure lasting ______ secs.

Answer 7

70-150 volts
.5 - 2 seconds
30-60 seconds

Question 8

why atropine sulfate is given

Answer 8

Prone to aspiration that is why atropine
sulfate is given to decrease secretions and
prevent aspiration

Question 9

Should be in _____during ECT, then
after place in a ______ position to
allow drainage of secretions

Answer 9

supine
side-lying

Question 10

ECT Protocols & Medications:
1. treatments

Answer 10

6-12 treatments, “every other day”

Question 11

ECT Protocols & Medications:
2. Before ECT, diet should be

Answer 11

o Should be on NPO

Question 12

ECT Protocols & Medications:
3. Food is introduced when

Answer 12

gag reflex is back

Question 13

ECT Protocols & Medications:
4. Before ECT a major depressed client undergoes the ff meds:

Answer 13

phenobarbitals (anticonvulsant)
antidepressants
- TCA
- SSRI
- MAOI

Question 14

are given as anticonvulsants and
may also decrease heart rate of patients and anti-seizure management

Answer 14

Phenobarbitals

Question 15

ECT - SSRI

Answer 15

2 WEEKS

Question 16

ECT - TCA AND 2ND GEN

Answer 16

2-4 WEEKS

Question 17

ECT - MAOIs

Answer 17

taken for 2 weeks

Question 18

After ECT, reorient the patient, why?

Answer 18

Temporary RECENT Memory Loss
ANTEROGRADE amnesia

Question 19

INTERVENTION AFTER ECT

Answer 19

o Intervention: Re-orient client to 3 spheres
o Reintroducing yourself, therapy, where
patient is, time and date, secure the safety
of a patient as well
o confusion/disorientation (usually 24
hours)

Question 20

S/SX

Answer 20

o Headache →↑O2 demand, ↑cerebral
hypoxia
o Muscle spasm
o Wt. gain (stimulate thalamic/limbic
→appetite)

Question 21

o confusion/disorientation (usually ___
hours)

Answer 21

24

Question 22

4 CONTRAINDICATIONS OF ECT

Answer 22

• Post MI, Post CVA, pacemaker, pregnant women
• People with cardiovascular problems
• Neurologic problem →Alzheimer’s,
  degenerative disorder
• Brain tumor, weakness of lumbosacral spine

Question 23

if client is coherent, if not a
guardian may sign the consent forms.

Answer 23

INFORMED CONSENT

Question 24

PREPARING PATIENT FOR ECT

Answer 24

• Informed Consent – if client is coherent, if not a
  guardian may sign the consent forms.
• No metallic objects
  o Metals can interfere with electrical
  transmissions
• No nail polish
• No contact lenses it may adhere to the cornea
• Let the patient void first
• Wash & dry hair
• Give following medications BEFORE ECT:
• Atropine sulfate – anticholinergic
  o PRIMARY purpose – to dry secretions
  and prevent aspiration
  o SECONDARY purpose – to prevent
  bradycardia

Question 25

NO METALLIC OBJECTS

Answer 25

Metals can interfere with electrical transmissions

Question 26

CONTACT LENSES MAY

Answer 26

it may adhere to the cornea

Question 27

* Give following medications BEFORE ECT:

Answer 27

* Atropine sulfate – anticholinergic o PRIMARY purpose – to dry secretions and prevent aspiration o SECONDARY purpose – to prevent bradycardia

Question 28

3 NURSING DIAGNOSIS FOR ECT

Answer 28

* Risk for Airway Obstruction/aspiration * Risk for Injury * Impaired/Altered Cognition/LOC

Question 29

5 S IN SEIZURE

Answer 29

o Safety (#1 objective) o Side-lying (#1 Position) o Side rails up o Stimulus ↓ (no noise & bright lights) o Support the head with a pillow AFTER the seizure

Question 30

FIRST & TOP priority:

Answer 30

Ensure a patent airway. Side-lying after. Observe for respiratory problems

Question 31

Remain with client until alert. VS q 5 min until stable.

Answer 31

Remain with client until alert. VS q 5 min until stable.

Question 32

REORIENT TO:

Answer 32

REORIENT: Time, place, person; Reassure regarding confusion and memory loss—before & after.