Ch. 10 Brain Stimulation Therapies

Question 1

Indications for ECT

Answer 1

Major Depressive Disorder
Actively suicidal or homicidal
Experiencing psychotic manifestations
Schizophrenia spectrum disorders that are less responsive to medications
Acute Manic Episodes

Question 2

Use of ECT with bipolar disorder

Answer 2

Rapid cycling (four or more episodes of acute mania within 2 year) & very destructive behavior
Both of these features respond poorly to lithium therapy
Clients receive ECT, then regimen of lithium therapy

Question 3

Contraindications

Answer 3

• Recent MI
• History of CVA
• Cerebrovascular malformation
• Intracranial mass lesion
• Increased ICP

Question 4

Conditions ECT not useful for

Answer 4

• Substance use disorders
• Personality disorders
• Dysthymic disorder

Question 5

ECT Postop Care

Answer 5

• Vitals, LOC, O2, and cardiac status monitoring
• Side lying to facilitate drainage and prevent aspiration
• Monitor for ability to swallow & gag reflex

Question 6

ECT Complications

Answer 6

Memory loss & Confusion
ECG Changes
Headache, muscle soreness, nausea
Relapse of depression

Question 7

TMS

Answer 7

Noninvasive therapy that uses magnetic pulsations to stimulate specific areas of the brain

Question 8

TMS indications

Answer 8

MDD

Question 9

TMS Complications

Answer 9

• Discomfort or tingling at the site of the electromagnet
• Monitor for lightheadedness after the procedure
• Seizures are rare, but potential complication

Question 10

VNS

Answer 10

Provides electrical stimulation through the vagus nerve to the brain through a device that is surgically implanted under the skin on the client’s chest

Question 11

VNS Indications

Answer 11

Depression

Possibly anxiety d/o

Question 12

VNS Complications

Answer 12

• Voice changes
• Hoarseness, throat or neck pain, dysphagia, these commonly improve with time
• Dyspnea, especially with physical exertion