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ATI Mental Health > 10 Brain stimulation therapy > Flashcards

10 Brain stimulation therapy Flashcards

1
Q

brain stimulation therapy

A

offers non-pharmacological treatment for clients w certain mental health disorders

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2
Q

types of brain stim therapy

A

ECT electroconvulsive therapy
TMS transcranial magnetic stimulation
VNS vagus nerve stimulation

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3
Q

Electroconvulsive therapy

A

uses electrical current to induce brief seizure activity while pt is anesthetized
-exact mechanism is unknown

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4
Q

ECT is thought to enhance…

A

the effects of neurotransmitters (serotonin, dopamine, norepinephrine, etc)

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5
Q

ECT is indicated for..

A
  • major depressive disorder
  • schizo spectrum disorder
  • acute manic episodes
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6
Q

ECT indicated for major depressive disorder

A
  • unresponsive to meds
  • risk of other tx outweigh risk of ECT
  • rapid tx needed bc suicidal/homicidal
  • current psychotic manifestations
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7
Q

ECT indicated for schizo

A
  • schizo w catatonic manifestations

- schizoaffective disorder

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8
Q

ECT indicated for acute mania

A
  • bipolar disorder w rapid cycling
  • —4+ eps of acute mania in 1 yr
  • unresponsive to tx w lithium + antipsychotic meds
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9
Q

CI for ECT

A

no absolute CI

but careful w cardiovasc disorders + cerebrovasc disorders

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10
Q

ECT + cardiovascular disorders

A

ECT can incr stress on heart due to seizure activity

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11
Q

ECT + cerebrovascular disorders

A

ECT can incr intracranial pressure + blood flow thru brain

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12
Q

typical course of ECT is __ times per week for a total of ____ for depression

A
  • 2-3x/week

- total 6-12x

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13
Q

if ECT is involuntary, consent may be obtained fr..

A

nect of kin or court order

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14
Q

Pre-ECT work ups

A
  • chest x ray
  • blood work
  • ECG
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15
Q

___ should be discontinued as they will interfere w seizure process

A

benzodiazepines

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16
Q

30 mins before ECT, an IM injection of ____ is administered to ______

A
  • atropine sulfate or glycopyrrolate

- decr secretion that could cause aspiration + counteract any vagal stim effects like bradycardia

17
Q

at time fo ECT procedure, short acting anesthetic __ is given via IV bolus

A

etomidate or propofol

18
Q

during ECT, muscle relaxant ___ is admin to paralyze

A

succinylcholine

19
Q

short period of ___ may occur immediately after ECT procedure

A

HTN

20
Q

during ECT, electrodes are applied to scalp to monitor __

A

EEG electroencephalogram

21
Q

clients are expected to be alert __ after ECT

A

15 min

22
Q

ECT complications

A
  • memory loss/confusion
  • rxn to anesthesia
  • cardiovasc changes
  • relapse of depressn
23
Q

memory loss/confusion fr ECT

A
  • short term mem loss/confusion occurs immediately after ECT + can persist for several wks
  • can have retrogade amnesia
  • most recover fr deficits
24
Q

is ECT permanent?

A

NO, weekly/monthly maintenance is needed

-ECT on decr incidence of relapse

25
Q

Transcranial Magnetic Stim

A
  • uses magnetic pulsation (MRI strength) to stim CEREBRAL CORTEX
  • noninvasive
26
Q

TMS indications

A

-major depressive (when unresponsv to meds)

27
Q

TMS is similar to ECT but it does not induce…

A

seizure activity

28
Q

TMS is usually prescribed for a period of ____ + each procedure last ____

A

:4-6 wks

: 30-40min

29
Q

is the client sedated during TMS?

A

client is alert during procedure

-might feel tapping/knocking sensation in head, scalp contractions, + tightening of jaw muscles

30
Q

TMS complications

A
  • mild discomfort/tingling at site of electromagnetics
  • headache
  • lightheaded
  • seizure is RARE
31
Q

TMS is CI for…

A
  • cochlear implants
  • brain stimulators
  • medical pumps
  • any other metal in devices bc it can interfere w Tx
32
Q

Vagus Nerve Stim

A

provides electrical stim thru vagus nerve by a device that is surgically implanted under the skin on chest

33
Q

VNS is believed to ___ + ___

A
  • incr level of neurotransmitters

- enhance actions of antidepressants

34
Q

VNS is indicated for..

A

-depression that is resistant to med or ECT

35
Q

VNS device delivers around the clock programmed pulsations. Usually ever __ for a duration of ___

A

5 min, 30 sec

36
Q

T/F VNS stays on all of the time

A

FALSE. pt can turn off anytime by playing special magnet over site of device

37
Q

VNS complications

A
  • voice changes bc device is close to larynx/pharynx
  • hoarseness, throat/neck pain, cough [improve over time]
  • dyspnea esp w exertion
38
Q

VNS + dyspnea

A

-may turn off device during exercise or prolonged speaking

ATI Mental Health (22 decks)

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