Describe the procedure for ECT, its indications, and its potential side effects.

QUESTION

Case Study, Mohr

CHAPTER 18, Somatic Therapies

In completing the case study, students will be addressing the following learning objectives:

Identify the nurse’s role in caring for people undergoing electroconvulsive therapy (ECT) and their families.

Describe the procedure for ECT, its indications, and its potential side effects.

1. Julie Abrams, a married 45-year-old African American client, is admitted to the hospital for severe depression. Although Julie is taking her antidepressant medication, she seldom leaves her bed, sleeps most of the time, and has refused to eat for 6 days. Her psychiatrist has decided that ECT treatments are necessary to improve Julie’s depression. Mr. Abrams, Julie’s husband, is alarmed to learn that Julie will receive ECT. The psychiatric nurse practitioner explains the ECT procedure and treatment that Julie will receive. Mr. Abrams asked the nurse practitioner what ECT is, how it will help Julie, and if there will be any harmful effects for her.

(Learning Objectives: 2, 3)

a. What information will you provide to Mr. Abrams concerning ECT, how it works, and any adverse effects?

b. Prioritize the nursing care responsibilities for Julie.

ANSWER

Electroconvulsive Therapy (ECT): Exploring the Procedure, Benefits, and Nursing Care Responsibilities

Introduction

Electroconvulsive therapy (ECT) is a medical procedure used in the treatment of severe depression that has not responded to other forms of therapy. As a nurse, understanding the procedure, potential side effects, and the role in providing care for individuals undergoing ECT is crucial. In this essay, we will address the concerns of Mr. Abrams, whose wife Julie is scheduled to receive ECT, by explaining the procedure, its benefits, and any potential adverse effects. Furthermore, we will outline the key nursing care responsibilities to ensure optimal patient care throughout the ECT treatment process.

Explaining ECT and Its Benefits

ECT involves the controlled application of an electric current to induce a brief seizure in the brain. By altering the brain’s neurochemical balance and promoting the release of mood-stabilizing neurotransmitters, ECT has been shown to effectively alleviate severe depressive symptoms. It is typically considered when other treatment modalities, such as medication and psychotherapy, have not yielded satisfactory results. It is important to reassure Mr. Abrams that ECT is a safe and well-tolerated procedure.

Addressing Adverse Effects

While ECT is generally safe, it is crucial to inform Mr. Abrams about potential adverse effects associated with the procedure. The most commonly reported side effect is temporary memory loss, particularly for events around the time of treatment. However, this memory impairment is usually transient, and most patients regain their memory within weeks or months after completing the treatment (Kerner & Prudic, 2014). Other potential side effects include confusion and disorientation immediately following the procedure and physical symptoms like headache, muscle aches, and nausea. It is important to stress that these side effects are generally mild and short-lived.

Nursing Care Responsibilities for Julie

Comprehensive Assessment: Before initiating ECT, a thorough assessment of Julie’s physical and mental health should be conducted. This assessment includes gathering information on her medical history, medication use, allergies, and current depressive symptoms. It is vital to ensure that Julie is an appropriate candidate for ECT and that any potential contraindications are addressed.

Education and Emotional Support: Nurses play a pivotal role in providing information and emotional support to both the patient and their family. Educate Mr. Abrams about the procedure, addressing any concerns or misconceptions he may have (Bastick & Shrimpton, 2021). Reassure him about the benefits of ECT and the clinical team’s expertise in ensuring Julie’s safety and well-being throughout the treatment process.

Pre-Procedure Preparation: Collaborate with the interdisciplinary team to ensure Julie’s readiness for ECT. This involves conducting pre-ECT assessments, coordinating necessary laboratory tests, and confirming medical clearance for anesthesia. Communicate with Julie to alleviate any anxiety or fears she may have, providing clear instructions regarding fasting, medication administration, and any necessary lifestyle modifications.

Intra-Procedure Support: During the ECT procedure, the nurse plays a vital role in monitoring Julie’s vital signs, administering anesthesia, and providing comfort and reassurance. Maintaining a safe environment and ensuring appropriate equipment are available are paramount. The nurse should closely monitor Julie’s response to the procedure, assessing for any immediate side effects or complications.

Post-Procedure Care: Following ECT, Julie should be monitored closely for the resolution of anesthesia-related effects, confusion, and disorientation (Navidian et al., 2015). The nurse should provide post-procedure assessments, including vital signs, neurological status, and pain management. Emphasize the importance of rest and proper nutrition to support Julie’s recovery.

Conclusion

Electroconvulsive therapy (ECT) is a valuable treatment option for severe depression when other modalities have proven ineffective. By addressing Mr. Abrams’ concerns regarding the procedure, benefits, and potential adverse effects, the nurse can alleviate anxiety and promote informed decision-making. Prioritizing nursing care responsibilities, including comprehensive assessment, education, emotional support, and attentive intra- and post-procedure care, ensures the safety and well-being of patients like Julie undergoing ECT. Through a collaborative approach, healthcare professionals can provide holistic care, optimizing the outcomes of ECT treatment for individuals battling severe depression.

References

Bastick, L., & Shrimpton, T. (2021). Reflections on Advanced Practice of Nurse Administered ECT as a Treatment Resource during the COVID-19 Pandemic. Open Journal of Nursing, 11(11), 909–919. https://doi.org/10.4236/ojn.2021.1111074 

Kerner, N., & Prudic, J. (2014). Current electroconvulsive therapy practice and research in the geriatric population. Neuropsychiatry, 4(1), 33–54. https://doi.org/10.2217/npy.14.3 

Navidian, A., Ebrahimi, H., & Keykha, R. (2015). Supportive Nursing Care and Satisfaction of Patients Receiving Electroconvulsive Therapy: A Randomized Controlled Clinical Trial. Iranian Red Crescent Medical Journal. https://doi.org/10.5812/ircmj.27492