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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. The client exhibits a flat affect: A flat affect reflects blunted emotional expression and is typically a symptom of depression. Its persistence suggests the condition has not yet improved.
B. The client can express angry feelings: The ability to identify and express emotions, including anger, indicates improved emotional responsiveness and progress in managing depressive symptoms. This reflects increased insight and healthier coping.
C. The client experiences self-doubt when making decisions: Persistent self-doubt is a common feature of depression and suggests that the client still struggles with confidence and decision-making.
D. The client looks down when speaking to others: Avoiding eye contact and looking down are associated with low self-esteem and social withdrawal, which are characteristic of depression and indicate the condition is not yet improving.
Correct Answer is A
Explanation
Rationale:
A. Smoked salmon: Smoked and cured meats are rich in tyramine, which can trigger a hypertensive crisis when combined with monoamine oxidase inhibitors (MAOIs) such as phenelzine. Clients must avoid aged, fermented, or smoked foods to prevent dangerous elevations in blood pressure related to MAOI therapy.
B. Grapefruit: Grapefruit primarily interacts with medications metabolized by the cytochrome P450 enzyme system, but it does not have a clinically significant interaction with MAOIs like phenelzine. Therefore, grapefruit is not restricted for clients taking this medication.
C. Spinach: Fresh vegetables, including spinach, contain negligible amounts of tyramine and are safe to consume with phenelzine. A diet rich in fresh fruits and vegetables is encouraged to support overall health and medication adherence.
D. Cottage cheese: Unlike aged cheeses, cottage cheese contains minimal tyramine and is considered safe for clients on MAOIs. It provides a good source of protein and calcium without the risk of precipitating hypertensive complications.
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