A nurse is reinforcing teaching with a client who is scheduled to receive electroconvulsive therapy (ECT). Which of the following statements should the nurse include in the teaching?
"The most common adverse effects of ECT are related to the anesthesia."
"You might feel a bit confused and disoriented when you first wake up."
"You should expect to have ECT once per week for 6 weeks."
"You may experience muscle cramping from the induced seizure."
The Correct Answer is B
Electroconvulsive therapy (ECT) is a procedure used to treat certain mental health conditions. When providing teaching to a client scheduled to receive ECT, it is important to provide accurate information about what they can expect during and after the procedure.
The statement "You might feel a bit confused and disoriented when you first wake up" is important because confusion and disorientation are common side effects of ECT. Clients often experience some memory loss and temporary cognitive impairment after the procedure, which can cause these symptoms. By preparing the client for these potential effects, the nurse helps reduce anxiety and ensures that the client understands what is considered normal post-ECT.
Incorrect:
A. "The most common adverse effects of ECT are related to the anesthesia." While anesthesia is used during ECT to ensure the client's comfort and safety, the most common adverse effects of ECT are related to the procedure itself, such as memory loss and cognitive changes.
C. "You should expect to have ECT once per week for 6 weeks." The frequency and duration of ECT treatments vary depending on the individual client's condition and treatment plan. It is not appropriate to provide a specific treatment schedule without knowing the client's unique circumstances.
D. "You may experience muscle cramping from the induced seizure." Muscle cramping is not a common adverse effect of ECT. The induced seizure is typically brief and controlled, and muscle relaxants are administered to prevent any excessive muscle activity during the procedure.
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Correct Answer is C
Explanation
This response acknowledges the client's expressed desire not to talk and respects their boundaries. It shows support and presence by offering companionship without pressuring the client to discuss their feelings. The nurse's willingness to sit with the client demonstrates empathy and provides a sense of comfort and reassurance.
The other options are not as appropriate:
1. "It might help you feel better if you talk about it." This response disregards the client's stated preference not to talk and may create a sense of pressure or intrusiveness. It is important to respect the client's autonomy and readiness to share their feelings.
2. "Why are you feeling so down?" This response directly asks the client to explain their feelings, which they have already indicated they do not want to discuss. It can be seen as intrusive and may make the client feel uncomfortable or defensive.
3. "I understand. I've felt like that before, too." While empathy is important, this response brings the focus back to the nurse's own experiences, potentially diverting the attention from the client. It is important for the nurse to remain focused on the client's needs and create a supportive environment for them to express their feelings if they choose to do so.
Correct Answer is D
Explanation
It is important for the nurse to establish and maintain appropriate professional boundaries with the client. This includes respecting the client's personal space and privacy. By maintaining appropriate boundaries, the nurse ensures a therapeutic and professional relationship that focuses on the client's needs and promotes their well-being.
The other options are not appropriate when developing a relationship with the client:
1. Share personal information to help the client feel comfortable: While it is important to build rapport and create a supportive environment, sharing personal information may blur professional boundaries and divert the focus from the client to the nurse. The therapeutic relationship should primarily revolve around the client's needs and experiences.
2. Develop an emotional commitment to the client: While empathy and compassion are essential in providing care, it is important for the nurse to maintain professional objectivity. Developing an emotional commitment can make it challenging for the nurse to maintain appropriate boundaries and could lead to potential ethical issues.
3. He reminds the nurse of a personal friend or relative: It is important for the nurse to remain unbiased and treat each client as an individual. Drawing comparisons or associations with personal acquaintances can influence the nurse's objectivity and professionalism in providing care.
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