Use the following scenario and client data to answer the question. A nurse is preparing to…
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Question “Use the following scenario and client data to answer the question. A nurse is preparing to…”
Answer
What 3 medications require clarification before administration?
Answer:
Introduction: These are the guidelines for ECT patients:
{The common instructions given to the patient scheduled for ECT are nil by mouth from midnight to the morning of the treatment without anything to eat or drink .They have to take the blood pressure medication with small sips of water in the morning before the procedurePatients scheduled for ECT should follow the same instructions as before. They must take the inhaler for COPD, asthma, and chronic bronchitis with small sips of liquids every hour. The treatment must be stopped 24 hours prior to the start of lithium, which acts as a mood stabilizer. To prevent hypoglycemia, anti-hypoglycemic drugs such as metformin glucophage shouldn’t be taken 12 hours prior to treatment. The patient must not eat or fast for the next 24 hours. The drugs like benzodiazepines (hence diazepam withheld here lamictal, .|You should not take benzodiazepines such as diazepam (hence lamictal withheld here) or benzodiazepines.} (neurocontin/gabapentin (hence gabapentin mitheld here) and other antiepileptic medications can affect the ECT treatment. The patient must empty his bladder or pass urine prior to the procedure (hence furosemide withheld).The patient is premedicated with atropine(hence no clarification needed) to prevent vasovagal attack and administered relaxation using thiopentone and succinylcholine,(hence no clarification needed) during the procedure.
answer1:
Because the client is due for ECT, the nurse should clarify the prescription.
Explanation:
Electroconvulsive therapy induces a generalised seizure by using an electric current stimulus. Before the electroconvulsive therapy is scheduled, it is important to stop taking benzodiazepine drugs such as diazepam.
The preferred method is to skip the overnight and morning doses of diazepam before electroconvulsive treatment.
This is why other reasoning options are incorrect:
The administration of diazepam medication is within the scope of nursing practice. It is not connected to blood pressure, history of allergy/ congestive heart failure, or sodium levelc (here hypernatremia). These are not the right answers.
Answer 2:
Because the client is due for ECT, the nurse should clarify the prescription of furosemide.
Explanation:
Because the patient is due for electroconvulsive treatment in an hour, the nurse should clarify the use of furosemide. It is a loop diuretic drug that increases the amount of urine and fills the bladder. This increases the risk of urinary leakage/incontinence during seizures. This drug should be withheld prior to the ECT procedure. (Prerequisite for ECT is an empty bladder). It is then administered after the procedure if the patient is stable. The nurse should ask the doctor if it is possible to give the drug before the procedure, as the client has ECT within one hour.
This is why other reasoning options are incorrect:
Furosemide medication administration does not fall outside of the scope of nursing practice. It is not necessary to clarify the client’s blood pressure, history of allergy/ congestive heart failure/sodium levels [here hypernatremia]. Hyponatremia can be caused by loop diuretics such as furosemide.
Answer 3
Because the client is a scheduled patient for ECT, the nurse should clarify the gabapentin prescription.
Explanation: Gabapentin is a mood stabilizer/anticonvulsant drug.Its administration prior to ECT decrease the quality of seizure in ECT and potentially decreases the efficacy of the treatment.So the nurse must clarify from the physician whether it can be given before the procedure as the client is scheduled for ECT in one hour.
Why are the other options not correct?
Gabapentin medication administration does not fall outside of the scope of nursing practice. It is not connected to client blood pressure/history or congestive heart failure/ sodium level [here hypernatremia]. Gabapentin can cause hyponatremia.
The reason why drugs atropine, lisinopril, and succinylcholine do not provide clarity options:
Premedications such as Atropine and succinylcholine should be taken 30 minutes before ECT. This is to prevent the possibility of vasovagal attack. All three drugs are approved for the ECT procedure. Therefore, clarification is not required.
Conclusion
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