AIIMS Manglagiri NO - 2019
Mental Health Nursing
Easy
The absolute contraindication for electroconvulsive therapy is:-
Appeared in: AIIMS Manglagiri NO - 2019
Explanation
- Electroconvulsive Therapy (ECT) is a medical procedure that involves inducing a brief seizure to treat certain mental health conditions.
- During the seizure, there is a temporary but significant increase in blood pressure and intracranial pressure (ICP).
- In a patient who already has raised ICP (e.g., due to a brain tumor, hemorrhage, or hydrocephalus), this additional pressure spike can force brain tissue to shift.
- This shifting, known as brainstem herniation, is a catastrophic and often fatal event as it compresses vital brainstem structures that control breathing and heart rate.
- Therefore, raised intracranial tension is considered the only absolute contraindication, as the risk of death is unacceptably high.
Why Other Options Were Wrong
- Option B: Retinal detachment is a relative contraindication, not an absolute one.
- Option C: Myocardial infarction, particularly a recent one, is a high-risk relative contraindication, but not an absolute one.
- Option D: Diabetes Mellitus is a common comorbidity that requires management but does not contraindicate ECT.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Absolute contraindications for Electroconvulsive Therapy (ECT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- The nurse's primary role in pre-ECT care includes a thorough assessment and verification of the patient's medical history to identify any contraindications.
- Nurses must be vigilant for signs and symptoms of raised ICP, such as new or worsening headache, nausea/vomiting, blurred vision, or a decreased level of consciousness, and report them immediately.
- Ensuring that a valid informed consent has been obtained is a critical nursing responsibility, which includes confirming the patient and family understand the risks, benefits, and alternatives, including those related to relative contraindications.
How to Approach the Question
- First, identify the key terms in the question: "absolute contraindication" and "electroconvulsive therapy (ECT)".
- Understand the difference between an 'absolute' contraindication (the procedure must never be done) and a 'relative' contraindication (the procedure can be done with caution if benefits outweigh risks).
- Recall the physiological effects of ECT, specifically that it causes a temporary, sharp rise in blood pressure and intracranial pressure.
- Evaluate each option based on this knowledge.
- Option A: Raised intracranial tension. A further rise in already high pressure is extremely dangerous (risk of herniation). This fits the definition of an absolute contraindication.
- Options B, C, D: Consider if these conditions pose a definite, unavoidable fatal risk or if they are manageable risks. Retinal detachment, MI, and diabetes are all conditions that add risk but can often be managed with specialist care, making them relative contraindications or manageable comorbidities.
Concept Tested & Keywords
- Concept Tested: Absolute contraindications for Electroconvulsive Therapy (ECT)
- Stem keywords: electroconvulsive therapy, absolute contraindication
- Lead-in keywords: is
- Negative lead-in flag: false
Question ID
Q_byKLOeSx_gIl2BMdDHpj
Reference Book
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 141-143
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 14092-14094
Practise the full AIIMS Manglagiri NO - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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