A nurse is caring for a client who has alcohol use disorder and is experiencing withdrawal. The nurse should monitor the client for which of the following manifestations?

The correct answer is c. Recent head injury.

Rationale for choice c:

• Bupropion lowers the seizure threshold.
• Individuals with a history of head injury have an increased risk of seizures.
• Administration of bupropion to a client with a recent head injury could significantly elevate the risk of seizure activity.
• It's crucial for the provider to be aware of this risk and make an informed decision about whether to prescribe bupropion or consider alternative smoking cessation therapies.

Rationale for choice a:

• Hepatitis B infection does not generally contraindicate the use of bupropion.
• However,it's important to inform the provider of any underlying medical conditions for comprehensive assessment and management.

Rationale for choice b:

• Knee arthroplasty 1 month ago is not a contraindication for bupropion use.
• While pain management following surgery might be a consideration,bupropion is not known to interact with common analgesics used post-operatively.

Rationale for choice d:

• Hypothyroidism also does not contraindicate bupropion use.
• However,thyroid hormone levels should be monitored as bupropion may potentially impact thyroid function in some individuals.

Choice A rationale:

Documenting the client's behavior every 15 minutes is a valid nursing action when a client is placed in seclusion. However, it is not the most critical step to take in this situation. The safety and well-being of the client and staff are paramount, and obtaining the provider's prescription is more crucial.

Choice B rationale:

The correct choice. Obtaining the provider's prescription within 60 minutes is essential when a client is placed in seclusion. Seclusion is an intervention that restricts the client's freedom, and it should only be done under the supervision of a licensed healthcare provider. The nurse must obtain a prescription for this intervention as soon as possible to ensure that the client's rights and safety are respected.

Choice C rationale:

Offering the client food and fluids every 2 hours is a valid nursing action in a seclusion situation. However, it is not the most immediate priority. Obtaining the provider's prescription takes precedence to ensure the appropriateness of the intervention.

Choice D rationale:

Monitoring the client's vital signs every 4 hours is an important nursing action, but it is not the primary step to take immediately after placing a client in seclusion. Obtaining the provider's prescription is more urgent to ensure the legality and appropriateness of the intervention.