30 Questions
What is the purpose of administering muscle relaxants during the procedure described?
To prevent severe muscle contraction during seizures
Which anesthetic agents are commonly used during the procedure?
Methohexital and propofol
What is the purpose of administering succinylcholine (Anectine) during the procedure?
To prevent severe muscle contraction during seizures
Where are the electrodes typically placed for bilateral ECT?
On both sides of the head
What distinguishes unilateral ECT from bilateral ECT in terms of electrode placement?
Unilateral ECT places electrodes only on one side of the head
Why is 100% oxygen administered throughout the procedure described?
To prevent oxygen deficiency during seizures
What is the primary mechanism of action of typical antipsychotics like haloperidol?
Block dopamine receptors in the basal ganglia
Which type of antipsychotic medications are more effective for negative symptoms of schizophrenia?
Atypical antipsychotics
What is a common side effect of typical antipsychotics related to their impact on the brain?
Parkinsonian symptoms
Which area of the brain does haloperidol primarily target with its mechanism of action?
Basal ganglia
What is the main difference between typical and atypical antipsychotics in terms of efficacy?
Atypical antipsychotics are more effective for positive symptoms.
Which symptom of schizophrenia is NOT effectively treated by atypical antipsychotics?
Aggression
What is the potential consequence of abruptly stopping certain medications like G,M,S?
Development of GI distress, movement problems, and sleep disturbances
Which medication combination should be avoided due to the risk of serotonin syndrome?
SSRIs with MAOIs
What is a key side effect associated with certain medications mentioned in the text?
Nausea and vomiting
Why is it important to monitor the suicidal client, especially during improved mood and increased energy levels?
To prevent self-harm or suicide attempts
When should medications be taken to reduce the risk of insomnia?
In the morning
What is a potential serious condition that might develop if a client experiences priapism?
Tissue damage in the penis
What is a contraindication for using benzodiazepines?
Acute narrow-angle glaucoma
Which benzodiazepine is indicated for panic, generalized anxiety, phobias, and social anxiety?
Clonazepam (Klonopin)
What side effect is NOT commonly associated with benzodiazepines?
Tachycardia
What is a key nursing intervention for clients taking benzodiazepines?
Monitor for visual disturbances
Which neurotransmitter's action is promoted by barbiturates and sedative-hypnotics?
GABA
What is the primary use of barbiturates and sedative-hypnotics?
Short-term treatment of insomnia and anxiety
What is a behavior-specific sign to look out for in a person exhibiting suicidal behavior?
Visiting or calling people to say goodbye
What is recommended to avoid when dealing with a client showing possible suicidal tendencies?
Taking the client's side in family disputes
Which action should be taken if a suicidal client is in possession of harmful objects like razors or ropes?
Removing the harmful objects without causing harm to oneself or the client
What can increased anxiety and insomnia in a client indicate?
Impending suicide attempt
What can withdrawing from activities, isolating from family and friends, and giving away prized possessions be signs of?
Suicidal behavior
Why is it important to avoid excess support when dealing with someone exhibiting suicidal behavior?
To promote feelings of abandonment
Study Notes
Antipsychotics
- Improve thought process and behavior in clients with psychotic symptoms, especially those with schizophrenia
- Block dopamine receptors in the basal ganglia of the brain, inhibiting transmission and reducing psychotic symptoms
- Indicated for acute and chronic psychosis
Typical Antipsychotics (First Generation)
- Developed between 1950 and 1990
- More effective for positive symptoms of schizophrenia, such as:
- Hallucinations
- Aggression
- Delusions
- Also block the chemoreceptor trigger zone and vomiting center in the brain, producing an antiemetic effect
Atypical Antipsychotics (Second Generation)
- Developed from 1990 onwards
- More effective for negative symptoms of schizophrenia, such as:
- Withdrawal
- Apathy
- Alogia (inability to speak)
Electroconvulsive Therapy (ECT)
- Administered with muscle relaxants and short-acting anesthesia to prevent fractures
- Most common anesthetic agents: methohexital and propofol
- 100% oxygen by mask via positive pressure is administered throughout the procedure
- Bilateral ECT: most common, most effective, and most cognitive dysfunction
- Unilateral ECT: less cognitive effect, may be clinically less effective
Nursing Interventions
- Monitor VS, weight, and potential for discontinuation syndrome
- Educate client about potential for serotonin syndrome
- Report any visual changes to physician
- Monitor for suicidal behavior, especially during improved mood and increased energy levels
Benzodiazepines
- Contraindicated in clients with acute narrow-angle glaucoma
- Used cautiously in children and older adults
- Abrupt withdrawal can be potentially life-threatening and should be done under medical supervision
- Side effects include:
- Daytime sedation
- Dizziness
- Drowsiness
- Poor coordination
- Hypotension
- Constipation
- Urinary incontinence
- Impaired memory
Barbiturates and Sedative-Hypnotics
- Depress the reticular activating system by promoting the inhibitory synaptic action of GABA
- Used for short-term treatment of insomnia or for sedation to relieve anxiety, tension, and apprehension
Suicidal Behavior Disorder
- Behavioral signs to look out for:
- Increased use of alcohol or drugs
- Looking for a way to kill themselves
- Acting recklessly
- Withdrawing from activities
- Isolating from family and friends
- Sleeping too much or too little
- Visiting or calling people to say goodbye
- Giving away prized possessions
- Aggression
- Nursing interventions:
- Give client a sense of control
- Assist with problem-solving and decision-making
- Develop and use a suicidal contract
- Avoid excess support, as it encourages dependency and eventual feelings of abandonment
Test your knowledge on medication discontinuation syndrome and serotonin syndrome, characterized by potential visual changes, GI distress, movement problems, sleep disturbances, elevated temperature, elevated CPK, and muscle rigidity. Learn about the risks involved with abrupt medication changes and combining SSRIs with MAOIs.
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