Personality and Mood Disorders Q 46
Which is the highest priority in the post-ECT care?
A. Observe for confusion.
B. Monitor respiratory status.
C. Reorient to time, place and person.
D. Document the client’s response to the treatment.
Correct Answer: B. Monitor respiratory status.
A side effect of ECT which is life-threatening is a respiratory arrest. The anesthesiologist who manages the airway during this period is careful to protect the patient from aspiration while maintaining ventilation and oxygenation. Sometimes a soft preshaped airway device (oral airway) is placed to facilitate this. In most patients, the return of spontaneous respiration occurs within 3 to 5 minutes after induction, before the effects of the anesthetic have worn off and the patient is awake.
Option A: Clinically, patients may exhibit confusion, delirium, disorientation, and memory loss. ECT is classified as a low-risk procedure by the AHA-ACC guidelines because it is well-tolerated, and demonstrates only transient hemodynamic lability and low mortality rate.
Option C: Confusion and disorientation are side effects of ECT but these are not the highest priority. The stigma associated with ECT is largely due to the lack of anesthesia with early treatments resulting in significant injury and severe memory loss. The antidepressant effect is seen relatively quickly and may last up to a few years. Overall, the mortality rate is very low with ECT administered in a controlled setting, but it continues to cause mild memory loss in the long term.
Option D: The procedure is relatively safe, and does work. However, the delivery of ECT requires an interprofessional team that includes a nurse, anesthesiologist, psychiatrist, and neurologist. The benefits of ECT are seen after several sessions and the results are durable. The key is to educate the patient and family about ECT because the procedure has been associated with many false and illogical beliefs.