After completing a third electroconvulsive therapy treatment, a patient says, "I haven't been able to remember anything since that last treatment. It wasn't like this before." The psychiatric and mental health nurse's best response is to:

Appeared in: Uttarakhand CHO - 2021

Explanation

The primary nursing action when a patient expresses distress about an expected side effect is to provide therapeutic reassurance and education.
Memory impairment is a well-documented and common side effect of ECT, which is typically temporary (Source: SRC_14302).
Addressing the patient's fear directly by normalizing the experience helps to reduce anxiety and build a therapeutic nurse-patient relationship.
This response prioritizes the patient's immediate psychosocial needs over procedural or secondary assessment tasks.

Why Other Options Were Wrong

Option A: This action is not patient-centered as a first response. It focuses on a technical aspect of the treatment rather than the patient's expressed feelings of fear and confusion.
Option B: While journaling is a useful therapeutic tool, it does not address the patient's immediate need for information and reassurance about their current distressing symptom.
Option C: This is a premature escalation. Notifying the physician is not the first step for a common, expected side effect. Doing so may unnecessarily increase the patient's anxiety.

Related Visual

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Nursing management of side effects related to Electroconvulsive Therapy (ECT) in the correct sequence, documenting the action clearly, and monitoring for the expected response.
A key nursing role in ECT is patient education and managing anxiety. Patients and families are often fearful of ECT, and providing clear, accurate information about what to expect is crucial for informed consent and treatment adherence.
Nurses must be able to differentiate between common, transient side effects and more serious adverse events that require immediate escalation to the physician.
Post-ECT care involves close monitoring of vital signs, orientation, and safety until the patient is fully recovered from anesthesia.

How to Approach the Question

First, identify the core issue in the clinical scenario: The patient is distressed and fearful about memory loss after ECT.
Analyze the question's lead-in, which asks for the 'best' response. This indicates a priority-setting question.
Evaluate each option based on therapeutic communication principles and the nursing process (Assessment, Diagnosis, Planning, Implementation, Evaluation).
Recognize that for common, expected side effects, the initial priority is often patient education and emotional support (Implementation) to alleviate anxiety.
Distinguish between immediate therapeutic responses (reassurance), secondary assessment actions (checking the record), long-term coping strategies (journaling), and escalation (notifying the physician).
Select the option that directly addresses the patient's stated concern in the most therapeutic and immediate manner.

Concept Tested & Keywords

Concept Tested: Nursing management of side effects related to Electroconvulsive Therapy (ECT).
Stem keywords: electroconvulsive therapy, ECT, memory loss, psychiatric and mental health nurse
Lead-in keywords: best response
Clinical cues: Patient reporting increased memory loss after the third treatment.
Clinical cues: Patient stating 'It wasn't like this before,' indicating a change from their perspective.

Question ID

QaEf7JDH6o5H_mbqs0oecM

Reference Book

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 142-144

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 14081-14083, 14105-14107

Practise the full Uttarakhand CHO - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.

Attempt this paper Attempt in the NPrep app