AIIMS Raipur NO - 2019 (Shift-1)
Mental Health Nursing
Easy
The following are the indications of electroconvulsive therapy; EXCEPT:
Appeared in: AIIMS Raipur NO - 2019 (Shift-1)
Explanation
- Post-traumatic stress disorder (PTSD) is primarily an anxiety disorder, not a mood or psychotic disorder for which ECT is a standard treatment.
- The established first-line treatments for PTSD are psychotherapy (e.g., Trauma-Focused CBT, EMDR) and pharmacotherapy (e.g., SSRIs/SNRIs).
- The efficacy of ECT for the primary symptoms of PTSD has not been established, and it is not recommended in clinical practice guidelines for this condition.
Why Other Options Were Wrong
- Option A: This is a primary indication for ECT. Major depression, especially when severe, treatment-resistant, or with psychotic features, is the most common reason for using ECT.
- Option B: This is a valid indication. ECT is used to treat severe psychosis, particularly in the context of schizophrenia that is treatment-refractory or involves acute exacerbation of positive symptoms.
- Option C: This is a primary indication. ECT is considered a first-line and highly effective treatment for severe catatonia, often producing a rapid response.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Indications for Electroconvulsive Therapy (ECT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses play a critical role in the care of patients undergoing ECT, including providing education, ensuring informed consent is obtained, preparing the patient for the procedure (e.g., NPO status, removing dentures), and monitoring for side effects post-procedure (e.g., confusion, memory loss, vital signs).
- A key nursing responsibility is to identify and report any potential contraindications, with raised intracranial pressure being an absolute contraindication that requires immediate attention.
- What if? If a patient with severe depression is also pregnant, ECT may be considered a safer option than some psychiatric medications that could harm the fetus. The nursing plan would involve collaboration with obstetrics for fetal monitoring.
How to Approach the Question
- First, identify the keyword 'EXCEPT'. This tells you that three of the options are correct indications for ECT, and your task is to find the one that is not.
- Next, recall the primary uses of ECT. It is mainly reserved for severe, life-threatening, or treatment-resistant psychiatric conditions.
- Evaluate each option against your knowledge. Major depression is the most common indication. Severe catatonia and severe psychosis are also well-established indications.
- Consider the remaining option, Post-traumatic stress disorder. PTSD is an anxiety disorder, and its treatment paradigm is different, focusing on psychotherapy and specific medications.
- Conclude that PTSD is the outlier and therefore the correct answer to the 'EXCEPT' question.
Concept Tested & Keywords
- Concept Tested: Indications for Electroconvulsive Therapy (ECT)
- Stem keywords: electroconvulsive therapy, ECT, indications
- Lead-in keywords: EXCEPT
- Negative lead-in flag: Question is negatively framed, asking for the exception.
Question ID
QE4HpCrD6V4Qvl_DrUPtpQ
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2299-2301
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 14073-14075, 11172-11174
Practise the full AIIMS Raipur NO - 2019 (Shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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