A nurse is caring for a client who is being prescribed electroconvulsive therapy by the provider. The client states they do not want this treatment. Which of the following statements should the nurse make to the client?

Choice A reason: Memory loss of personal history is a hallmark of Alzheimer’s due to hippocampal degeneration but is not the priority. It affects identity but poses no immediate safety risk compared to wandering, which can lead to life-threatening situations like getting lost or injured.

Choice B reason: Wandering is a priority in Alzheimer’s, as it poses immediate safety risks, including getting lost, injury, or exposure. Driven by disorientation and restlessness from cortical atrophy, it requires urgent interventions like environmental modifications to prevent harm, making it the critical focus.

Choice C reason: Placing shoes on the wrong feet reflects visuospatial deficits in Alzheimer’s but is not life-threatening. It indicates cognitive decline but does not require immediate intervention, as it poses minimal safety risk compared to wandering, which demands urgent attention.

Choice D reason: Not recognizing a partner is distressing but not an immediate safety concern. This agnosia results from temporal lobe degeneration but does not pose the acute risk of wandering, which can lead to physical harm or elopement, prioritizing safety interventions.

Choice A reason: A show of force with security can escalate agitation, as it may be perceived as threatening. Violence risk increases with confrontation, and non-threatening de-escalation techniques, like offering a timeout, are prioritized to reduce stimulation and promote calm, per mental health protocols.

Choice B reason: Restraints are a last resort due to risks of physical and psychological harm. Preemptive restraint before attempting de-escalation violates least-restraint principles. Offering a timeout is safer, allowing the client to self-regulate and avoid escalation to violence without restrictive measures.

Choice C reason: Offering timeout options empowers the client to choose a calming strategy, reducing agitation. Violence often stems from overstimulation or loss of control, and providing choices fosters autonomy, de-escalates tension, and aligns with therapeutic principles to prevent escalation in a safe manner.

Choice D reason: Escorting to a secluded area may increase risk, as isolation can heighten agitation or fear, potentially triggering violence. Public or supervised settings are safer for de-escalation, allowing monitoring and intervention if needed, making this action less appropriate than offering timeout options.