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legal_issues - Somatic Therapy 1 Electroconvulsive Therapy...

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1 Somatic Therapy
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2 Electroconvulsive Therapy Historic background – 1938 Mechanism – unknown Modern ECT Nursing care – before ECT – like before surgery Explanation – fear, stigma, fear, anxiety… Physical exam - vital signs, lab data, spinal X-ray Consent form & preparation NPO for 8 hours, moveable accessory, Atropine Empty bladder
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3 Nursing care During ECT – typical grand mal seizure with tonic and clonic phases After ECT Respiratory problems – apnea, oxygen Confusion & disorientation Memory impairment Recording
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4 Issues related to ECT Advantages - $, safety, effect, Disadvantages – memory impairment
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5 Legal Issues
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6 Introduction Significance Safety – self & clients Quality of care Background Extended roles of the nurse Myth of psychiatric treatment Patient’s right Ethical theories
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7 Rights of the Psychiatric/ Mental Health Client What are some unique circumstances in psychiatric/mental health care that make this topic critical to health care providers? What is unique to nursing practice that makes this topic critical for professional nursing care?
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8 Rights of the Psychiatric/ Mental Health Client Informed Consent Client understands a proposed treatment or procedure including: Administration of the treatment Outcome of the procedure Side effects Risks of having procedure as well as risks of not having the procedure Alternatives to the procedure
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9 Rights of the Psychiatric/Mental Health Client Special Considerations in Psychiatric Settings Client competence to make valid decisions for themselves must be adequately and appropriately assessed Potential need for substituted consent by court- appointed guardian Current court-appointed guardian
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10 Rights of the Psychiatric/ Mental Health Client Confidentiality What makes confidentiality so critical in psychiatric/mental health care that make this topic critical to health care providers? Health Insurance Portability and Accountability Act (HIPPA) – newest federal law effective October 15, 2002 that further protects health information of clients.
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11 Rights of the Psychiatric/Mental Health Client Confidentiality Medical Record and Nursing Documentation Descriptive – accurate observations using nursing assessment skills Nonjudgmental – use of verbal exchanges and quotes Objective – descriptions of client response to care provided
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12 Rights of the Psychiatric/Mental Health Client A . B. was observed pacing in the day room and mumbling incoherently. B.’s pacing speed began increasing and he began shouting out at times but not to any of the other residents in the day room, “Stop it”, “Leave me alone”. Nurse M. approached B. and began to walk slowly with him, speaking softly and asking B. if he would like to talk with Nurse M. B.
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