A nurse is reviewing the medical record of a client who is to receive electroconvulsive therapy. The nurse should notify the provider for which of the following findings?

• A. Asthma
• B. Renal colic
• C. Crohn's disease
• D. Cardiac arrhythmia

Answer: (D)

The main idea is that electroconvulsive therapy creates transient cardiovascular stress during the seizure, with a rapid autonomic surge that can provoke or worsen heart rhythm problems. If a client has a cardiac arrhythmia, this added stress increases the risk of dangerous rhythm changes or ischemia during the procedure. That’s why the nurse should notify the provider so the team can assess cardiovascular stability, possibly obtain clearance, adjust anesthesia, or delay ECT if needed.

Asthma, Crohn's disease, and renal colic do not, by themselves, represent the same level of immediate cardiovascular risk during ECT. They may require consideration for airway management or other medical planning, but they’re not the primary reason to halt or delay treatment.