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. Encourage the client to watch television: Distracting the client with television is not effective during an acute panic attack. The client may be too anxious to focus, and this approach does not provide emotional support or safety.
B. Teach the client how to meditate: Teaching meditation is a long-term coping strategy and is not helpful during an acute panic attack, when the client requires immediate support and reassurance.
C. Administer a dose of atomoxetine to decrease anxiety: Atomoxetine is used to treat attention-deficit/hyperactivity disorder (ADHD) and is not indicated for acute anxiety or panic attacks. Medications for acute panic typically include fast-acting benzodiazepines if prescribed.
D. Sit with the client to provide a sense of security: Providing a calm presence and sitting with the client helps reduce feelings of fear and isolation. This intervention offers immediate emotional support, reassurance, and a sense of safety during the panic episode.
Correct Answer is C
Explanation
Rationale:
A. Guide the client by walking parallel with them: Clients with visual impairment should be guided by walking slightly ahead of them, allowing them to hold the nurse’s arm and follow safely. Walking parallel can limit spatial awareness and increase the risk of collision or falls.
B. Rearrange clients bedside table items frequently: Frequently moving personal items can confuse a client with reduced vision and increase the risk of injury. Maintaining a consistent environment promotes independence and safety.
C. Remove objects from client's path to the bathroom: Clearing pathways reduces the risk of trips and falls, which is essential for clients with impaired vision. Ensuring a clutter-free environment is a key safety intervention in the plan of care.
D. Use a loud tone of voice when speaking with the client: A louder voice is unnecessary unless the client has a hearing impairment. Communication should focus on clear, descriptive verbal guidance rather than volume, emphasizing orientation and safety.
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