A nurse is reinforcing teaching with a client who is to receive electroconvulsive therapy. Which of the following statements should the nurse include in the teaching?
You will be given an opioid analgesic before the procedure.
Expect to be confused several hours after the procedure.
You cannot eat or drink for 24 hours before the procedure.
A consent form is not required to have this procedure.
The Correct Answer is B
Choice A reason: Opioid analgesics are not typically given before electroconvulsive therapy (ECT). Instead, a general anesthetic and a muscle relaxant are administered to ensure the patient is asleep and to prevent muscle contractions during the procedure. The nurse should inform the client about the medications they will receive before ECT, but opioid analgesics are not usually part of the protocol.
Choice B reason: Confusion and temporary memory loss are common side effects immediately following ECT. Clients should be informed to expect these cognitive effects, which can last for a few hours to days. Educating the client about these side effects helps prepare them for what to expect post-procedure and ensures they have appropriate support during their recovery period.
Choice C reason: Clients are usually instructed to fast (not eat or drink) for a shorter period, typically 6-8 hours, before the procedure to reduce the risk of aspiration during anesthesia. Informing the client to fast for 24 hours is excessive and not in line with standard preoperative fasting guidelines.
Choice D reason: A consent form is required before undergoing ECT. Informed consent is a critical component of the process, ensuring that the client understands the procedure, its benefits, risks, and potential side effects. The nurse must reinforce the importance of obtaining and signing the consent form before proceeding with ECT.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Informing the provider about the conversation might be necessary if there are concerns about confidentiality breaches, but it does not address the immediate issue of discussing private patient information in a public place. The charge nurse's first responsibility is to stop the inappropriate discussion and remind the staff nurse about the importance of maintaining patient privacy.
Choice B reason: While continuing the conversation in a private place is better than discussing it in a public hallway, the staff nurse should not be discussing private patient information unless it is necessary for the patient's care. The charge nurse should emphasize the importance of confidentiality and ensure that such conversations occur only when necessary and in appropriate settings.
Choice C reason: This response directly addresses the issue of discussing private patient information and reinforces the importance of maintaining confidentiality. By stating that it is an invasion of privacy to discuss the information, the charge nurse makes it clear that such conversations are inappropriate and should not occur.
Choice D reason: Telling the staff nurse not to use the client's name in public discussions misses the broader point about confidentiality. Even without using a name, discussing specific details about a patient's condition or admission can still breach their privacy. The charge nurse should emphasize the importance of not discussing patient information in public settings at all.
Correct Answer is C
Explanation
Choice A reason: Hypoactive bowel sounds can indicate a variety of gastrointestinal issues, but they are not typically associated with haloperidol use. While it is important to monitor bowel sounds, it is not the priority in this context.
Choice B reason: Dry mouth is a common side effect of many medications, including haloperidol. While it can be uncomfortable for the client, it is not usually a serious concern and can be managed with hydration and other supportive measures.
Choice C reason: Constant opening and closing of the mouth, also known as tardive dyskinesia, is a serious side effect of haloperidol and other antipsychotic medications. This condition involves involuntary muscle movements and can be irreversible. It is crucial to report this finding to the provider immediately for assessment and potential adjustment of the medication regimen.
Choice D reason: Photosensitivity is not a common side effect of haloperidol. While it is important to monitor for any new or unusual symptoms, photosensitivity is not typically associated with this medication.
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