The mother of an adolescent patient says to the nurse, "I think my son is staying up too late studying. He seems listless, and I see him using eye drops all the time for his red eyes. Should I have his vision checked?" What is the best response by the nurse?

Question

1. "He might be depressed; insomnia is common with depression."
2. "He could be smoking marijuana, and I would talk to him."
3. "Sounds like he is using cocaine; I have seen this before."
4. "Yes, that is a great idea; he may need some glasses."

Answer 1

2
Rationale 1: Depression in this patient is possible, but depressed patients do not always have red eyes and do not commonly use eye drops.
Rationale 2: Chronic use of marijuana is associated with a lack of motivation in achieving or pursuing life goals. One hallmark symptom of marijuana use is red or bloodshot eyes, caused by dilation of blood vessels. It is important for the parent to discuss this with the adolescent.
Rationale 3: Red or bloodshot eyes are not commonly seen with cocaine abuse but are always seen with marijuana use.
Rationale 4: Having the adolescent's eyes checked may indicate that the mother is in denial and that the nurse needs to be more alert to the signs and symptoms of drug abuse.
Global Rationale: Chronic use of marijuana is associated with a lack of motivation in achieving or pursuing life goals. 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 may indicate that the mother is in denial and that the nurse needs to be more alert to the signs and symptoms of drug abuse. Depression in this patient is possible, but depressed patients do not always have red eyes and do not commonly use eye drops. Red or bloodshot eyes are not commonly seen with cocaine abuse but are always seen with marijuana use.