Which assessment finding should alert the nurse that an older adult client withdrawing from alcohol is at risk for developing severe complications?

Rationale: A. Benign essential tremors are mild, non-progressive shaking movements that usually affect the hands and sometimes the head. These tremors are not related to alcohol withdrawal and do not increase the likelihood of severe complications such as seizures or delirium tremens. They represent a chronic neurologic condition that is independent of alcohol use. B. Liver disease can complicate alcohol withdrawal treatment because impaired hepatic metabolism can alter drug clearance, increasing sensitivity to medications like benzodiazepines. While liver disease contributes to overall medical risk, it does not directly predict severe acute withdrawal or delirium tremens, which are primarily neurologic complications. C. A prior history of DTs is the most significant predictor of severe alcohol withdrawal. DTs are characterized by sudden-onset confusion, hallucinations, severe autonomic instability (e.g., tachycardia, hypertension, hyperthermia), and risk of seizures. Patients with a history of DTs have increased CNS sensitivity and are more likely to develop life-threatening complications during subsequent withdrawal episodes. This history guides clinicians to implement proactive monitoring, early pharmacologic interventions, and ICU-level precautions if necessary. D. COPD may increase the risk of respiratory complications during hospitalization, particularly if sedatives are used to manage agitation. However, COPD is not a direct risk factor for severe alcohol withdrawal complications such as DTs or seizures.