A nurse in an acute mental health unit is caring for a group of clients. For which of the following clients is seclusion contraindicated?

A. A client exhibiting psychotic behavior

Group therapy is generally not recommended for clients who are actively exhibiting psychotic behavior. Psychotic behavior can include hallucinations, delusions, and severe thought disturbances, which might impede the individual's ability to effectively participate and benefit from group therapy. Such clients often require more immediate and individualized attention to address their acute symptoms.

B. A client who has been taking amitriptyline for 3 months for depression

This is the correct choice. A client who has been taking amitriptyline for 3 months for depression is likely to have their symptoms more stabilized and under better control compared to acute situations. They might be at a stage where they can engage in group therapy to discuss their experiences, coping strategies, and learn from others in a similar situation.

C. A client who is experiencing alcohol intoxication

Group therapy is not appropriate for clients who are currently intoxicated, as their ability to actively participate and engage in therapeutic discussions may be compromised. Addressing the effects of alcohol intoxication and ensuring the client's safety would be a priority before considering group therapy.

D. A client admitted 12 hours ago for acute mania

Clients admitted for acute mania often require stabilization and intervention to manage their manic symptoms. In the early stages of admission, they might not be in a state conducive to group therapy. Once their acute symptoms are better controlled and they have had time to stabilize, they could potentially benefit from group therapy as part of their overall treatment plan.

A) "My child was born with a birth defect due to an exposure I had overseas."

This statement does not directly relate to the core symptoms of PTSD. While exposure to trauma can have a variety of consequences, including potential exposure-related health issues, this statement does not necessarily indicate the re-experiencing, avoidance, or hyperarousal symptoms characteristic of PTSD.

B) "I check any room I enter because the enemy is still after me and could be hiding anywhere."

This statement is more indicative of hyperarousal and hypervigilance, which are common symptoms of PTSD. However, it does not explicitly involve re-experiencing the traumatic event through nightmares or intrusive memories, as described in the correct answer.

C) "In my dreams, all I can see are the wounded reaching out and trying to grab me."

Explanation:

The statement "In my dreams, all I can see are the wounded reaching out and trying to grab me" indicates symptoms commonly associated with posttraumatic stress disorder (PTSD). This statement reflects the re-experiencing symptom cluster of PTSD, where individuals may have distressing and intrusive memories, nightmares, or flashbacks related to the traumatic event they experienced. The imagery of wounded individuals trying to grab the person suggests a strong emotional impact and ongoing distress related to the traumatic experience.

D) "I killed four enemy soldiers with my bare hands and saved my entire battalion."

While this statement might reflect exposure to a traumatic event and could contribute to symptoms of PTSD, it is presented in a way that seems more like a narrative of heroic actions rather than a symptom of distress or re-experiencing.