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 important because EMDR involves rapid eye movements and stimulation that may increase neurological stress. Seizures could be triggered or worsened by such interventions, making this a critical contraindication or precaution. Choice B reason: A detached retina is significant because EMDR requires eye movement exercises. Any history of retinal damage could pose a risk of further injury or complications. Documenting this ensures that the treatment plan does not compromise ocular health. Choice C reason: Increasing alcohol use over the past 3 months is relevant because substance abuse can impair cognitive processing, emotional regulation, and treatment effectiveness. Alcohol use may also mask or worsen PTSD symptoms, making EMDR less safe or effective. Choice D reason: A history of electroconvulsive therapy (ECT) is less directly relevant to EMDR appropriateness. While ECT affects memory and mood regulation, it does not pose a direct contraindication for EMDR. Documentation is useful, but it is not as critical as seizure history, retinal issues, substance use, or suicidality. Choice E reason: Suicidal ideation with a plan is crucial to document because EMDR can evoke intense emotions and traumatic memories. If the patient is actively suicidal, EMDR may exacerbate risk. Safety must be prioritized, and stabilization is required before initiating trauma-focused therapy.