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NUR 607 EXAM III- ECT

Terms in this set (46)

ECTs are most commonly used for
treatment of major depression
Using a stimulating rod placed to the top of the head, a
70 - 130 volt current is delivered for 0.1 - 0.5 seconds.
The patient undergoes tonic contractions for approximately
10 - 15 seconds
somewhat longer period of clonic convulsions
typically 30 - 60 seconds
The seizure must last at least
30 seconds to be effective
Perform a complete head to toe assessment, paying special attention to the following areas
Airway
Neurologic sequelae (recent TIAs, CVAs)
Cardiac disease
Retinal/ocular disease
Renal disease
Recent long bone fractures- seizing and emboli
GERD, Hiatal hernia- intubate
Cardiac disease
These patients will require "clearance" from their internist or cardiologist. A pre-procedure 12 lead is a must. Listen to heart sounds
Patients who have a history of CHF, valvular heart disease, recent MI (within 6 months), thoracic/aortic anerysm, pacemaker/AICD
require additional monitoring
GERD / Hiatal Hernia
Because the procedure routinely involves airway maintenance via a Jackson Reese or Bag Valve Mask, these patients will require intubation.
Pretreatment for GERD/Hiatal Hernia
with Sodium Citrate, Metoclopramide &/or histamine antagonists may be warranted.
absolute CONTRAINDICATIONS TO ECT
Pheochromocytoma
Recent MI
Recent CVA
Recent intracranial surgery
Intracranial mass lesion
Pheochromocytoma
is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure
relative contraidications
Angina
CHF
Pacemaker/AICD
Severe pulmonary disease
Major bone fractures
Glaucoma
Retinal detachment
Thrombophlebitis
Pregnancy
Tricyclic antidepressants
Block the reuptake of catecholamines at the presynaptic nerve terminals.
effects of tricyclic antidepressants
Increases resting vascular tone
Increases circulating catecholamines
Sympathomimetics may have an exaggerated effect (ephedrine)
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