A college student has been diagnosed with Generalized Anxiety Disorder (GAD). Which of the following symptoms should a campus nurse expect this client to exhibit? (Select all that apply.)

Choice A reason: Separating finances is a practical step but does not address the underlying issues of alcoholism as a family illness.

Choice B reason: Attending Al-Anon meetings is a positive step towards understanding and coping with the effects of a family member's alcoholism.

Choice C reason: Allowing the client to face the consequences of their actions can be part of setting boundaries, which is important in dealing with alcoholism.

Choice D reason: Calling in sick for the client enables the behavior and prevents the client from facing the natural consequences of their alcoholism, indicating a need for further education on the illness.

Choice A reason:

Informed consent is a critical component of many medical treatments, including ECT. It involves the patient's understanding and agreement to the procedure after being fully informed of the risks, benefits, and alternatives. Cognitive deficits can impair a patient's ability to provide informed consent, but they do not automatically waive the requirement for such consent. In fact, additional safeguards are often put in place to protect the rights of individuals with cognitive impairments.

Choice B reason:

ECT is a medical procedure that requires informed consent due to the potential risks and side effects associated with it. If a client has cognitive deficits severe enough to impact their decision-making capacity, they may not be able to provide informed consent. In such cases, treatment options would need to be reconsidered, and alternative methods of obtaining consent, such as through a legal guardian or a court order, might be necessary.

Choice C reason:

While it is true that ECT is considered an effective treatment for severe depression and suicidality, the decision to use ECT should not be based solely on these criteria². The ability of the client to understand and consent to the treatment is also a crucial factor. Therefore, the extremity of the client's suicidal ideation alone does not make ECT automatically the appropriate option without considering the consent issue.

Choice D reason:

ECT is indeed an alternative treatment when antidepressant medications have been ineffective, especially in cases of severe depression and suicidality². However, the effectiveness of ECT does not negate the need for informed consent. The client's cognitive ability to provide consent remains a determining factor in the feasibility of ECT as a treatment option.