A 16-year-old patient is being seen in the emergency department (ED) after being involved in a minor motor vehicle accident

The guardian has voiced that the patient has been spending more time in his or her room, has difficulties getting along with friends, and has declining grades over the past 3 months. The patient seems distant and angry all the time. Which of the following top-ics is most important for the nurse to discuss with the guardian? a. Accident prevention measures
b. Enrolling the patient in a defensive driving course
c. The possibility of substance abuse
d. The importance of automobile insurance


C
To assess for possible substance abuse, have parents look for environmental and psychosocial clues. Environmental clues include the presence of drug-oriented magazines, beer and liquor bot-tles, drug paraphernalia, blood spots on clothing, and the continual wearing of long-sleeved shirts in hot weather and dark glasses indoors. Psychosocial clues include failing grades, change in dress, increased absenteeism from school, isolation, increased aggressiveness, and changes in interpersonal relationships. Fatal crash rates for teens are high largely because of their immaturity combined with driving inexperience. Accident prevention measures, a defensive driving course, and automobile insurance are not the most important topics. Accident prevention, defensive driving, and insurance will not be effective if substance abuse is not addressed.

Nursing

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