A nurse is assisting with the admission of an older adult client. Which of the following subjective findings suggests that the client may have cataracts?

A respiratory rate of 8 breaths per minute with shallow respirations and cyanosis indicates severe respiratory distress or failure. In this situation, the client's oxygenation is compromised, and immediate intervention is needed to ensure an open and unobstructed airway. The nurse should prioritize ensuring the client has a patent airway by assessing for any airway obstruction and taking appropriate measures to clear the airway if necessary. This may involve techniques such as the head tilt-chin lift or jaw thrust maneuver.

While administering oxygen, checking the client's pulse rate, and placing a pulse oximeter on the client's finger are all important interventions in managing respiratory distress, the first and most critical step is to establish a patent airway. Without a clear airway, the client's oxygenation cannot be adequately addressed, and other interventions may be ineffective. Once the airway is secured, the nurse can proceed with providing oxygen, assessing the client's vital signs, and monitoring oxygen saturation using a pulse oximeter.

Answer: A, B, D, F

Rationale:

A. "The ECT procedure will cause you to have a brief seizure.":
This statement is accurate as electroconvulsive therapy (ECT) intentionally induces a controlled seizure, which is thought to positively impact brain chemistry and alleviate symptoms of major depressive disorder. Educating the client about this aspect helps demystify the procedure and reduces anxiety.

B. "You will not be awake during the ECT procedure.":
The client receives general anesthesia before ECT, so they will be unconscious during the procedure. This reassurance can help alleviate fears associated with being awake and experiencing discomfort during the procedure.

C. "You will be placed on a ventilator to help you breathe during the ECT procedure.":
During ECT, clients do not require a ventilator, although they may receive oxygen support. An anesthetic and muscle relaxant are administered, and while the client’s breathing is closely monitored, a ventilator is unnecessary for this brief procedure.

D. "You will probably sleep the rest of the day following the ECT procedure.":
Many clients feel drowsy and need extra rest after ECT due to the effects of anesthesia and the brief seizure. Informing the client helps them prepare for this common effect and sets realistic expectations for their recovery period.

E. "It should only take one ECT treatment to bring you out of your depression.":
ECT is typically given as a series of treatments over several weeks to achieve lasting improvement in depressive symptoms. One treatment alone is usually insufficient, so this statement could mislead the client regarding the treatment plan.

F. "Some clients experience temporary memory loss following ECT therapy.":
Temporary memory loss, especially of recent events, is a known side effect of ECT. This side effect is generally transient but can help the client to be aware of this possibility, helping them to anticipate and manage any concerns post-treatment.