A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive therapy (ECT). The client refuses the treatment and will not discuss why with the healthcare team. Which of the following actions should the nurse take?
Ask the client's family to encourage the client to receive ECT.
Tell the client they cannot refuse the treatment because they were involuntarily committed.
Document the client's refusal of the treatment in the medical record.
Inform the client that ECT does not require client consent.
The Correct Answer is C
Choice A reason:
Asking the client's family to encourage the client to receive ECT may be a supportive measure, but it should not be the first action taken. The client's autonomy and right to refuse treatment must be respected, even if they are involuntarily committed. Family members can be involved in the discussion, but the client's decision should be paramount.
Choice B reason:
Telling the client they cannot refuse treatment because they were involuntarily committed is incorrect. Involuntary commitment does not automatically override a client's right to refuse treatment. Clients have the right to be informed about their treatment and to refuse it unless specific legal criteria are met.
Choice C reason:
Documenting the client's refusal of the treatment in the medical record is the correct action. It is essential to record the client's decision and the discussion surrounding it. This documentation ensures that the client's rights are respected and provides a legal record of the interaction.
Choice D reason:
Informing the client that ECT does not require client consent is incorrect and unethical. Consent is a fundamental patient right, and all clients, including those involuntarily committed, have the right to be informed about their treatment options and to give or withhold consent unless they are legally deemed incompetent to make such decisions.
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Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A reason:
Placing the client in a reclining chair is not a recommended intervention for managing wandering behavior. While it might seem like a way to keep the client stationary, it does not address the underlying issue of wandering and can lead to discomfort or pressure sores if the client remains in the chair for extended periods.
Choice B reason:
Installing sensor devices on outside doors is an effective intervention. These devices can alert caregivers when the client attempts to leave the house, thereby preventing wandering and potential falls. This measure enhances safety by providing immediate notification of the client's movements.
Choice C reason:
Positioning the mattress on the floor can help prevent injuries from falls. If the client rolls out of bed, the risk of injury is minimized because the fall distance is significantly reduced. This is a practical solution for clients who are prone to falling out of bed.
Choice D reason:
Encouraging physical activity prior to bedtime can be beneficial for overall health but may not be the best strategy for managing nighttime wandering. Physical activity should be balanced and not too close to bedtime, as it can sometimes lead to increased alertness rather than promoting sleep.
Choice E reason:
Putting locks at the top of doors is a useful safety measure. Clients with Alzheimer's disease may not notice or be able to reach locks placed higher up, which can prevent them from wandering outside unsupervised. This intervention helps ensure the client's safety by restricting access to potentially dangerous areas.
Correct Answer is B
Explanation
Choice A reason:
Urinary retention is not commonly associated with citalopram. Citalopram, an SSRI (Selective Serotonin Reuptake Inhibitor), primarily affects serotonin levels in the brain and does not typically impact the urinary system to the extent of causing retention.
Choice B reason:
Decreased libido is a known adverse effect of citalopram. SSRIs, including citalopram, can affect sexual function, leading to decreased libido, difficulty achieving orgasm, or erectile dysfunction. This is due to the increased serotonin levels which can negatively impact the sexual response cycle.
Choice C reason:
While bruising is not a hallmark side effect of citalopram, it can occur, especially if there is an interaction with other medications that affect blood clotting. Citalopram can potentially increase the risk of bleeding, and easy bruising may be a sign of this. However, it is less common than other side effects like sexual dysfunction.
Choice D reason:
Jaundice is not a typical adverse effect of citalopram. Jaundice usually indicates a problem with the liver, and while liver function abnormalities have been reported with citalopram use, they are rare. Monitoring for jaundice is not part of the routine assessment for patients on citalopram unless there is a pre-existing liver condition or concurrent use of other hepatotoxic drugs.
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