A client diagnosed with major depressive disorder is being considered for electroconvulsive therapy (ECT). Which client teaching should the nurse prioritize?

Empathize with the client about fears regarding ECT.

Monitor for any cardiac alterations to avoid possible negative outcomes.

Discuss with the client and family expected short-term memory loss.

Inform the client that injury related to induced seizure commonly occurs.

Answer and Explanation

The Correct Answer is C

Electroconvulsive therapy (ECT) is a neuromodulation treatment used for severe, treatment-resistant major depressive disorder. It involves brief electrical stimulation of the brain under anesthesia to induce a controlled seizure. The most common adverse effect is short-term memory loss, which may persist for weeks. ECT is contraindicated in patients with recent myocardial infarction or unstable cardiac conditions due to transient increases in intracranial pressure and cardiovascular strain. Despite its risks, ECT remains one of the most effective interventions for severe depression, especially with psychotic features or suicidality.

Rationale for correct answer

3. Memory loss is the most frequent and expected side effect of ECT. Clients and families must be informed of transient anterograde and retrograde memory deficits.

Rationale for incorrect answers

1. Empathy is important but not a priority teaching point. Therapeutic communication supports trust but does not address physiological or procedural risks.

2. Cardiac monitoring is essential during ECT, especially for clients with known heart disease, but it is not the primary teaching focus unless cardiac risk is present.

4. Injury from induced seizure is rare due to muscle relaxants and anesthesia. Modern ECT protocols minimize physical harm, making this teaching point less relevant.

Take Home Points

ECT is indicated for severe, treatment-resistant depression, especially with suicidality or psychotic features.
Short-term memory loss is the most common adverse effect and must be discussed with clients and families.
Cardiac risks exist but are rare in healthy individuals; pre-procedure screening mitigates complications.
ECT is safe when administered under anesthesia with muscle relaxants, reducing seizure-related injury.

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Correct Answer is A

Explanation

Electroconvulsive therapy (ECT) is a highly effective treatment for severe major depressive disorder, especially when pharmacologic options fail. While ECT can rapidly alleviate symptoms, it is associated with transient memory loss, particularly around the time of treatment. Post-ECT care focuses on educating clients about expected cognitive changes, monitoring recovery, and reinforcing understanding of the procedure’s effects. Most memory deficits resolve over time, but confusion or concern may persist without proper education.

Rationale for correct answer

1. After completing ECT, clients often experience memory loss, especially short-term or retrograde amnesia. If the client lacks understanding of this expected side effect, the most appropriate nursing diagnosis is deficient knowledge. Education helps reduce anxiety and promotes realistic expectations about recovery and cognitive function.

Rationale for incorrect answers

2. Noncompliance implies refusal or failure to follow treatment, which is not applicable post-ECT if the client has completed the full course. The issue is not adherence but understanding of residual effects.

3. Disturbed thought processes suggest cognitive disorganization, hallucinations, or delusions, which are not typical post-ECT. Mild confusion may occur transiently, but it does not meet the criteria for this diagnosis unless severe or persistent.

4. Fear related to the unknown is relevant before ECT, when clients may be anxious about the procedure. After completion, the focus shifts to recovery and education, not anticipatory fear.

Take Home Points

Memory loss is a common and expected side effect of ECT, requiring post-treatment education.
Noncompliance is not applicable once the treatment course is completed.
Thought disturbances are not typical post-ECT unless other psychiatric symptoms persist.
Pre-treatment fear transitions to post-treatment knowledge needs in nursing care planning.

A. “I don’t want to die because it would hurt my family.” B. “I need to go to group and get out of this room.” C. “I think I am going to talk to my boss about conflicts at work.” D. “I thank you for your compassionate care.”

Correct Answer is C

Explanation

Hopefulness in depression reflects a shift from passive despair to active engagement with future possibilities. Major depressive disorder impairs motivation, cognition, and affect, often leading to hopelessness and withdrawal. A sign of improvement is when the client begins to express future-oriented thinking, problem-solving, or plans that imply belief in change. Statements that show initiative, intention, or desire to resolve issues signal emerging hope and therapeutic progress.

Rationale for correct answer

3. Future planning is evident in the client’s intent to address workplace conflict. This shows restored motivation and belief in personal agency, aligning directly with the outcome of verbalizing hope.

Rationale for incorrect answers

1. Despair is still present. Avoiding suicide due to guilt or concern for others does not reflect internal hope or future engagement.

2. Activity participation is positive but nonspecific. It reflects behavioral activation, not necessarily hope about the future or resolution of internal distress.

4. Gratitude is interpersonal and reflective, not future-oriented. It does not indicate the client’s outlook or plans beyond the present moment.

Take Home Points

Hope in depression is marked by future-oriented statements and problem-solving intentions.
Behavioral activation alone does not confirm hope unless tied to future goals.
Avoidance of suicide due to guilt or external pressure is not equivalent to internal hope.
Therapeutic progress includes both emotional recovery and cognitive re-engagement with life plans.

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A client diagnosed with major depressive disorder is being considered for electroconvulsive therapy (ECT). Which client teaching should the nurse prioritize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing diagnosis would be most appropriate for the client who has undergone the full course of electroconvulsive therapy (ECT)?

Correct Answer is A

Explanation

A client diagnosed with major depressive disorder has an outcome that states, “The client will verbalize a measure of hope about the future by day 3.” Which client statement indicates this outcome was successful?

Correct Answer is C

Explanation

Which of the following medications may be administered before electroconvulsive therapy? Select all that apply.

A newly admitted client diagnosed with major depressive disorder isolates self in room and stares out the window. Which nursing intervention would be the most appropriate to implement initially, when establishing a nurse-client relationship?

Which client statement is evidence of the etiology of major depressive disorder from a genetic perspective?

A nursing student is studying major depressive disorder. Which student statement indicates that learning has occurred?

Which symptom is an example of an affective alteration exhibited by clients diagnosed with severe depression?

A client is admitted to an in-patient psychiatric unit with a diagnosis of major depressive disorder. Which of the following data would the nurse expect to assess? Select all that apply.

Which client is at highest risk for the diagnosis of major depressive disorder?