A nurse is planning care for a client who is to undergo electroconvulsive therapy (ECT). Which of the following actions should the nurse include in the plan?

Choice A reason: The belief that clients who talk about suicide are less likely to attempt it is a myth. Verbalizing suicidal ideation often reflects severe distress and heightened risk, as it may indicate prefrontal cortex dysfunction and impaired impulse control. This misconception underestimates the neurobiological basis of suicidal behavior, requiring vigilant assessment.

Choice B reason: Assuming clients who fail a suicide attempt will not try again is incorrect. Previous attempts increase future risk, as suicidal behavior is linked to persistent psychological distress and serotonin dysregulation. This assumption ignores the chronicity of underlying conditions like depression, necessitating ongoing monitoring and intervention to prevent recurrence.

Choice C reason: Claiming failed suicide attempts indicate a lack of intent to die is false. Many attempts fail due to external factors, not lack of intent. Suicidal behavior reflects complex neurobiological factors, including serotonin imbalance and prefrontal cortex deficits, requiring serious intervention regardless of outcome, as intent persists in high-risk individuals.

Choice D reason: A specific suicide plan indicates high risk, as it reflects advanced ideation and intent, often linked to prefrontal cortex dysfunction and reduced impulse control. Detailed planning suggests the client has visualized the act, increasing likelihood of completion. This principle guides nursing care to prioritize safety and immediate psychiatric intervention.

Choice A reason: Administering 2 teaspoons (10 mL) would deliver 500 mg of Amoxicillin, as the concentration is 250 mg/5 mL, and 1 teaspoon equals 5 mL. This dose is double the prescribed 250 mg, risking overdose. Amoxicillin overdose can cause gastrointestinal distress or, in rare cases, renal toxicity, making this choice scientifically inappropriate for the prescribed dose.

Choice B reason: Giving 3 teaspoons (15 mL) would deliver 750 mg of Amoxicillin, far exceeding the prescribed 250 mg dose. The concentration is 250 mg/5 mL, so 15 mL contains three times the required amount. This could lead to adverse effects like diarrhea or allergic reactions, as excessive antibiotic levels disrupt gut flora and increase toxicity risks.

Choice C reason: One teaspoon (5 mL) delivers exactly 250 mg of Amoxicillin, matching the prescribed dose, as the concentration is 250 mg/5 mL. This ensures therapeutic efficacy for treating infections like otitis media in children, maintaining serum levels within the therapeutic range (MIC for common pathogens like Streptococcus pneumoniae), minimizing side effects, and adhering to pediatric dosing guidelines.

Choice D reason: Four teaspoons (20 mL) would deliver 1000 mg of Amoxicillin, four times the prescribed dose. At 250 mg/5 mL, this excessive dose risks severe side effects, including nephrotoxicity or hepatotoxicity, and disrupts microbial balance, potentially causing antibiotic resistance. This is scientifically inappropriate, as it deviates significantly from the therapeutic dose for an 8-year-old.