Several clients are admitted to an inpatient detoxification unit for supervised withdrawal from various substances. The nurse should recognize that withdrawal from which substance carries the greatest risk of generalized tonic-clonic seizures within the first 48 hours after the last use?
Alcohol withdrawal causes a sudden loss of alcohol's CNS-depressant effect, producing excess neuronal excitability. This hyperexcitable state can precipitate generalized tonic-clonic seizures, most often 6-48 hours after the last drink. Opioid, cannabis, and cocaine withdrawal may be uncomfortable (e.g., flu-like symptoms, dysphoria, fatigue) but typically do not produce seizures because they do not create the same rebound excitatory surge. Therefore, the client withdrawing from alcohol is at the highest risk and should be placed on seizure precautions and started on benzodiazepines as indicated.
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Psychosocial Integrity
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