Assessment of a client reveals severe and sudden mood swings from mania to depression. Which diagnosis should the nurse suspect?

D. Dissociative disorders, particularly post-traumatic stress disorder (PTSD) and acute stress disorder, can involve the reliving of traumatic events through flashbacks, nightmares, or intrusive memories.

Hospitalization may be required if the client experiences severe distress, is at risk of self-harm or harm to others during flashbacks.

A. Dissociative amnesia is characterized by significant memory loss that cannot be explained by ordinary forgetfulness. If a client experiences sudden travel and cannot remember how they arrived at a distant location, it could indicate dissociative amnesia. Hospitalization is not absolutely necessary.

B Dissociative disorders are primarily treated with psychotherapy rather than medication adjustments. However, if medication adjustments are necessary for co-occurring conditions or to manage symptoms like anxiety or depression, hospitalization is not necessary.

C. Monitoring of identities is typically done on an outpatient basis, unless there are additional complications or risks identified by a healthcare professional.

A. ECT is often considered for severe major depression that has not responded to other treatments, especially when there is a risk of suicide. ECT can provide rapid relief of symptoms, which is crucial in cases where immediate intervention is needed to prevent harm to the patient.

B. While ECT is generally safe for individuals with medical conditions, including heart disease, special precautions might be needed. However, the presence of heart disease alone would not necessarily preclude ECT if the benefits outweigh the risks and if the client's cardiac status is stable.

C. Dysthymic disorder, characterized by persistent depressive symptoms that are less severe than major depression, typically does not warrant ECT. ECT is usually reserved for more severe forms of depression that significantly impair daily functioning or pose a risk to the patient's safety.

D. ECT may be contraindicated or require careful consideration in clients with brain metastasis due to potential risks related to increased intracranial pressure or neurological complications. Alternative treatments may be preferred in such cases.