Author Question: The mother of an adolescent client says to the nurse, I think my son is staying up too late ... (Read 119 times)

nelaaney · **on:** Jul 23, 2018

The mother of an adolescent client says to the nurse, I think my son is staying up too late studying, and I see him using Visine eye drops all the time for his red eyes.

Should I have his vision checked? Which response by the nurse is the most appropriate?
1. It sounds like he could be smoking marijuana, and I would talk to him.
2. Yes, that is a great idea, he might need some glasses.
3. Sounds like he is using cocaine; I have seen this before.
4. He might be depressed; insomnia is common with depression.

Question 2

The client is admitted to the inpatient substance abuse unit. She tells the nurse she has been buying yellow jackets (pentobarbital, or Nembutal) on the street, but has not had any for a few days.

Which plan, by the nurse, is the most appropriate at this time?
1. Prepare to do frequent room searches, as the client's friends will most likely bring drugs in for her.
2. Prepare to manage the depression and suicidal thoughts the client will have.
3. Prepare to manage a withdrawal that will likely be minimal.
4. Prepare to manage a withdrawal that could be life threatening.

vboyd24 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale 1: One hallmark symptom of marijuana use is red or bloodshot eyes, caused by dilation of blood vessels. Visine constricts the blood vessels of the eyes, reducing the redness. It is important for the parent to discuss this with the adolescent.
Rationale 2: Having the adolescent's eyes checked might indicate that the mother is in denial, and that the nurse needs to be more alert to the signs and symptoms of drug abuse.
Rationale 3: Red or bloodshot eyes are not commonly seen with cocaine abuse but are seen with marijuana use.
Rationale 4: Depression in this client is possible, but depressed clients do not always have red eyes and do not commonly use Visine eye drops.
Global Rationale: One hallmark symptom of marijuana use is red or bloodshot eyes, caused by dilation of blood vessels. Visine constricts the blood vessels of the eyes, reducing the redness. It is important for the parent to discuss this with the adolescent. Having the adolescent's eyes checked might indicate that the mother is in denial, and that the nurse needs to be more alert to the signs and symptoms of drug abuse. Red or bloodshot eyes are not commonly seen with cocaine abuse but are seen with marijuana use. Depression in this client is possible, but depressed clients do not always have red eyes and do not commonly use Visine eye drops.

Answer to Question 2

Correct Answer: 4
Rationale 1: Doing room searches is a good idea, but preparing for withdrawal is a higher priority.
Rationale 2: Physical needs have priority over psychological needs, such as depression, in this case.
Rationale 3: Withdrawal from barbiturates will more likely be life threatening, not minimal.
Rationale 4: Barbiturates are central nervous depressant (CNS) drugs. Withdrawal symptoms resemble those of alcohol withdrawal, and can be life threatening.
Global Rationale: Barbiturates are central nervous depressant (CNS) drugs. Withdrawal symptoms resemble those of alcohol withdrawal, and can be life threatening. Doing room searches is a good idea, but preparing for withdrawal is a higher priority. Physical needs have priority over psychological needs, such as depression, in this case. Withdrawal from barbiturates will more likely be life threatening, not minimal.