A nurse is creating a plan of care for a client who has a history of tonic-clonic seizure disorder. Which of the following interventions should the nurse include? (Select all that apply)

Choice A reason: Elevating side rails near the head is not a standard seizure precaution, as padded rails or lowering the bed are preferred to prevent falls. During tonic-clonic seizures, excessive neuronal firing causes uncontrolled movements, and improper rail positioning may increase injury risk rather than mitigate it. Choice B reason: Providing a suction setup is essential for tonic-clonic seizures, as excessive secretions or tongue biting can obstruct the airway during intense neuronal activity. Suctioning ensures airway patency, preventing aspiration and maintaining oxygenation, which is critical to avoid hypoxia during prolonged seizure episodes. Choice C reason: Keeping an oxygen setup at the bedside is vital, as tonic-clonic seizures can cause hypoxia due to apnea or prolonged muscle contractions from widespread cortical discharges. Oxygen administration supports cerebral oxygenation, reducing the risk of brain damage during seizures, making it a key precaution. Choice D reason: Placing the bed in the lowest position minimizes fall risk during tonic-clonic seizures, which involve violent muscle contractions due to synchronized neuronal firing. A low bed reduces injury severity if the client falls, aligning with seizure safety protocols to protect against trauma during uncontrollable movements. Choice E reason: Furnishing restraints is not recommended, as restraining during a tonic-clonic seizure can cause injury or increase agitation. Seizures involve involuntary movements from epileptiform activity, and restraints may lead to fractures or psychological distress, making them an inappropriate intervention for seizure management.