A patient who is being seen in the community mental health center for post-traumatic stress disorder (PTSD) is being considered for eye movement desensitization and reprocessing (EMDR). The nurse is asked to conduct an assessment to validate the patient’s appropriateness for this treatment. Which of the following data collected by the nurse are most important to document when determining appropriateness for treatment with EMDR? Select all that apply.

Choice A reason: A history of seizure disorder is critical to document because EMDR involves rapid eye movements and heightened neurological stimulation, which could potentially trigger seizures. This makes seizure history a contraindication or at least a precaution requiring careful evaluation. Choice B reason: A detached retina is important to document because EMDR requires eye movement exercises. Any retinal damage could worsen with repetitive eye movements, posing a risk to vision. This condition may contraindicate EMDR or require ophthalmologic clearance before proceeding. Choice C reason: Alcohol use in increasing quantities is concerning but not a direct contraindication for EMDR. It may complicate therapy outcomes and coping mechanisms, but it does not directly interfere with the physiological safety of eye movement exercises. It should be addressed as part of overall treatment planning but is not the most critical factor for EMDR appropriateness. Choice D reason: A history of electroconvulsive therapy (ECT) is relevant to mental health history but does not directly contraindicate EMDR. While ECT may affect memory and cognition, it does not pose a direct physiological risk during eye movement exercises. Documentation is useful but not as critical as seizure or retinal history. Choice E reason: Suicidal ideation with a plan is a major safety concern. EMDR can bring up intense traumatic memories, which may exacerbate suicidal risk. Documenting this is essential because active suicidality requires stabilization before trauma-focused therapies like EMDR can be safely initiated.