A nurse should understand that electroconvulsive therapy is primarily used in psychiatric care for the treatm… - JODHPUR AIIMS SNO-2018

JODHPUR AIIMS SNO-2018

Mental Health Nursing

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

The most common and well-established indication for Electroconvulsive Therapy (ECT) is major depressive disorder.
ECT is considered the fastest and most effective treatment available for severe depression, especially when it is life-threatening (e.g., high suicidal risk, refusal of food) or resistant to other treatments.
While ECT can be used for other conditions, its primary role in modern psychiatric practice is for managing severe depressive episodes.

Option A: ECT is not an indicated or effective treatment for anxiety disorders. Standard treatments for anxiety include psychotherapy (like CBT) and medications (like SSRIs).
Option B: ECT is not a first-line or primary treatment for schizophrenia. Its use is limited to specific situations, such as acute exacerbations with catatonia or severe positive symptoms that do not respond to antipsychotic medications.
Option D: While ECT is an effective treatment for acute manic episodes, pharmacotherapy (e.g., mood stabilizers) is generally the first-line and preferred treatment. ECT is typically reserved for severe, treatment-refractory mania.

Clinical Relevance

Nursing practice connection: Knowing Primary Indication for Electroconvulsive Therapy (ECT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a vital role in patient safety and education regarding ECT. This includes pre-procedure preparation (NPO status, consent), monitoring during the procedure, and post-procedure care focusing on orientation, vital signs, and managing potential side effects like headache and short-term memory loss.
It is a nursing responsibility to allay patient and family anxiety by providing clear, factual information about the procedure, its benefits, and risks, correcting common misconceptions.
What if? If a patient scheduled for ECT has loose teeth, the nurse must document and report this to the anesthetist and psychiatrist immediately. This is a safety risk, as teeth can be damaged or aspirated during the seizure, and the procedure may need to be postponed or modified.

How to Approach the Question

First, identify the key subject of the question, which is 'electroconvulsive therapy' (ECT).
Pay close attention to the qualifying word 'primarily'. This means you are looking for the main, most common reason ECT is used, not just any possible application.
Review the options provided: Anxiety, Schizophrenia, Depression, and Mania.
Recall the hierarchy of indications for ECT. While it has applications in several severe mental health conditions, one stands out as its principal use.
Compare the options. ECT is highly effective for severe depression. It has a role in mania and schizophrenia but is used more selectively. It is not used for anxiety.
Conclude that severe depression is the primary indication for ECT.

Concept Tested & Keywords

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 2299-2301, 2300-2302

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 140-142