A nurse is caring for a group of clients. For which of the following clients should the nurse implement seizure precautions?

Choice A reason:
Clients in mental health facilities generally have the right to refuse treatment, including prescribed medications, unless they are deemed incompetent to make decisions or pose an immediate danger to themselves or others. Forced medication is typically a last resort and requires legal and ethical considerations.

Choice B reason:
Clients have the right to the least restrictive environment necessary for their treatment. This means that they should not be subjected to more restrictive measures than are necessary for their safety and the safety of others. This principle is fundamental in mental health care to ensure that clients retain as much autonomy and freedom as possible.

Choice C reason:
Clients can withdraw consent after signing an informed consent form. Informed consent is an ongoing process, and clients have the right to change their minds about treatment at any time. This ensures that clients are always participating in their care voluntarily and with full understanding.

Choice D reason:
Clients maintain the right to an attorney. This right is crucial for protecting their legal interests, especially if they are involuntarily committed or if there are disputes about their treatment. Access to legal representation helps ensure that clients' rights are upheld.

Choice E reason:
Clients continue to have the right to privacy and confidentiality. This means that their personal and medical information must be protected and only shared with those directly involved in their care, unless the client gives permission or there is a legal requirement to disclose. Maintaining confidentiality is essential for building trust and ensuring that clients feel safe in sharing sensitive information.

a. Methadone 40 mg PO daily: This is contraindicated. Methadone is primarily used for opioid withdrawal and maintenance, not for alcohol withdrawal.

b. Nutritional consult: This is anticipated. Nutritional therapy can help balance out the loss of nutrients due to heavy drinking.

c. Perform Alcohol Use Disorders Identification Test (AUDIT): This is contraindicated. AUDIT is a screening tool for assessing alcohol consumption and related problems, but it’s not typically used once a diagnosis of alcohol use disorder has been established and the patient is in withdrawal.

d. Complete blood count and basic metabolic profile: This is anticipated. These tests can help assess the patient’s overall health status and identify any potential complications related to alcohol withdrawal67.

e. Group therapy: This is anticipated. Group therapy can provide peer support and is often beneficial in the treatment of alcohol use disorder.

f. Schedule electroconvulsive therapy (ECT): This is contraindicated. ECT is typically used for severe depression and other psychiatric disorders, not for alcohol withdrawal.

g. Diazepam 10 mg PO three times a day: This is anticipated. Diazepam, a benzodiazepine, is commonly used in the management of alcohol withdrawal to reduce symptoms and prevent complications.

h. Propranolol 40 mg PO twice a day: This is contraindicated. Propranolol, a beta-blocker, is not typically used as a first-line treatment for alcohol withdrawal. It may be used to manage some symptoms such as tremors or high blood pressure, but it does not prevent seizures, a potential complication of alcohol withdrawal.