A nurse is providing care for a client who is scheduled for electroconvulsive therapy. Which of the following conditions should the nurse identify as an increased risk for complications?
Diabetes mellitus
Subdural hematoma
Hyperthyroidism
Renal calculi
The Correct Answer is B
Rationale:
A. Diabetes mellitus: Diabetes is not a direct contraindication or risk factor for complications from electroconvulsive therapy (ECT). Blood glucose should be monitored, but it does not increase procedural risk.
B. Subdural hematoma: A subdural hematoma increases the risk of complications during ECT because the induced seizure can elevate intracranial pressure, potentially worsening the hematoma or causing neurological deterioration. This is a significant safety consideration.
C. Hyperthyroidism: While hyperthyroidism can affect cardiovascular response, it is not as high-risk as intracranial pathology. Pre-procedure assessment may include thyroid function evaluation if indicated.
D. Renal calculi: Kidney stones do not increase the risk of ECT complications. This condition is unrelated to seizure induction or anesthetic considerations.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. "I understand that my scars will eventually fade.": This statement reflects acceptance and understanding of the healing process rather than distress about appearance. It indicates the client is cognitively processing changes without expressing body image disturbance.
B. "I am ready to join a breast cancer support group.": Willingness to participate in a support group demonstrates coping and adjustment. The client is seeking social and emotional support, which is a healthy response to surgery rather than a sign of altered body image.
C. "I want to have reconstructive surgery as soon as I can.": Desire for reconstructive surgery is a proactive coping strategy and a way to regain body image control. It reflects planning for recovery rather than expressing negative feelings about current body changes.
D. "I prefer to leave the lights off when I am changing my clothes.": Avoiding exposure of the body and seeking darkness when changing clothes indicates discomfort and distress with physical appearance. This behavior reflects an altered body image and difficulty accepting the changes after surgery.
Correct Answer is C
Explanation
Rationale:
A. Obtaining the initial assessment of assigned clients: The initial assessment requires nursing judgment and clinical decision-making, which are within the scope of practice of a registered nurse only. It involves data interpretation and establishing a baseline for care, tasks that cannot be delegated to assistive personnel.
B. Educating a client and family members on home care: Client and family teaching requires specialized nursing knowledge to ensure understanding and accuracy. This task involves evaluating learning needs and reinforcing critical information, responsibilities that cannot be legally delegated to assistive personnel.
C. Changing a nonsterile dressing: Assistive personnel can safely perform nonsterile procedures such as changing a clean dressing under the supervision of a nurse. This task involves routine care that does not require nursing judgment, making it appropriate for delegation.
D. Interpreting a client's diagnostic laboratory results: Interpretation of laboratory data involves analysis, clinical reasoning, and the ability to make informed nursing decisions. These actions fall strictly within the nurse’s professional scope of practice and cannot be delegated to assistive personnel.
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