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Mr. Jones is a 35-year-old male with severe depression and has had failed treatment with SSRIs such as Citalopram (Celexa) and Fluoxetine (Prozac). He has a passive concentration and anhedonia. He has also lost 20 lbs in the last 3 months and has a poor appetite. He is scheduled for ECT tomorrow, and you are his nurse.Some important considerations prior to ECT may be on a Pre-Op checklist that the nurse completes and some interventions include (select all that apply):

A.

Advising the patient he will have permanent memory loss.

B.

Authorizing MD signs off medical clearance that may require pre-op checklist to include EKG or lab work.

C.

Signed informed consent by MD and patient and nurse follows up using “Teach Back Method” answering any further post-op or pre-op questions.

D.

NPO after midnight and hold all meds unless specified such as a sip of water and blood pressure pill ordered by MD.

Question Solution

Correct Answer : B,C,D

Choice A reason:

Advising the patient he will have permanent memory loss is incorrect. While temporary memory loss can occur with ECT, it is not typically permanent. It is important to provide accurate information about potential side effects without causing unnecessary fear.

 

Choice B reason:

Authorizing MD signs off medical clearance that may require pre-op checklist to include EKG or lab work is an important consideration. Medical clearance ensures that the patient is physically fit for the procedure and helps identify any potential risks.

 

Choice C reason:

Signed informed consent by MD and patient and nurse follows up using “Teach Back Method” answering any further post-op or pre-op questions is essential. Informed consent ensures that the patient understands the procedure, risks, and benefits. The “Teach Back Method” confirms that the patient comprehends the information provided.

 

Choice D reason:

NPO after midnight and hold all meds unless specified such as a sip of water and blood pressure pill ordered by MD is a standard pre-op instruction. Fasting reduces the risk of aspiration during anesthesia, and holding medications ensures that the patient does not take anything that could interfere with the procedure.


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View Related questions

Correct Answer is ["A","C","D"]

Explanation

Choice A reason:

“Do you feel your life is empty?” is a relevant question on the geriatric depression scale. Feelings of emptiness can indicate depression, especially in older adults who may experience significant life changes and losses.

Choice B reason:

“Are you on a low cholesterol diet?” is not a relevant question for assessing depression. This question pertains to dietary habits and cardiovascular health rather than mental health.

Choice C reason:

“Have you dropped your activities or interests?” is a pertinent question on the geriatric depression scale. A loss of interest in activities that were once enjoyable is a common symptom of depression.

Choice D reason:

“Do you feel happy most of the time?” is a relevant question on the geriatric depression scale. Assessing overall happiness helps identify depressive symptoms, as individuals with depression often report feeling unhappy or sad most of the time.

Correct Answer is ["B","C","D"]

Explanation

Choice A reason:

Canceling Netflix by Internet service is not relevant to Mr. Jones’ discharge planning. While managing finances and subscriptions may be part of overall life management, it does not address the immediate safety and mental health needs of Mr. Jones.

Choice B reason:

Releasing information signed for family to secure Mr. Jones’ loaded gun or having the police secure the gun if needed prior to discharge is crucial for ensuring his safety. Removing access to firearms reduces the risk of self-harm and is an important step in discharge planning for someone with suicidal ideation.

Choice C reason:

Obtaining a psychiatric provider follow-up appointment as soon as possible and evaluating for PHP (Partial Hospitalization Program) or residential treatment with the treatment team is essential. Continuity of care and appropriate follow-up are critical for managing Mr. Jones’ depression and preventing relapse.

Choice D reason:

Assisting in developing a safety plan prior to discharge that is written with phone numbers and interventions is vital. A safety plan provides Mr. Jones with clear steps to take if he feels at risk of harming himself, including contact information for crisis services and supportive individuals.

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