Question

When assessing a client for cocaine use, for which signs would the nurse observe? (Select all that apply.) a. Hypotension b. Tachycardia c. Tachypnea d. Dilated pupils c. Agitation f. Lack of concentration g. Slurred speech h. Poor coordination i. Hypervigilance j. Tremors

Short answer

b. Tachycardia, c. Tachypnea, d. Dilated pupils, c. Agitation, i. Hypervigilance, j. Tremors

Step-by-step solution

Identify common physiological signs of cocaine use

Cocaine use typically increases sympathetic nervous system activity. Look for signs that indicate heightened alertness and bodily functions, such as increased heart rate and respiratory rate.

Consider signs related to pupil reaction

Cocaine use often results in dilated pupils due to its stimulatory effects on the nervous system.

Review behavioral and psychological signs

Agitation and hypervigilance are common behavioral signs due to the stimulating and paranoid effects of cocaine.

Look for other physiological responses

Tachycardia (rapid heartbeat), tachypnea (rapid breathing), and tremors can also be observed due to the stimulating effects of cocaine.

Exclude contradictory signs

Signs such as hypotension, slurred speech, lack of concentration, and poor coordination are not typically associated with cocaine use and may indicate other issues or substances.

Key concepts

Tachycardia

Tachycardia refers to an abnormally rapid heart rate. When someone uses cocaine, it stimulates their central nervous system, leading to a 'fight or flight' response. This often results in a noticeable increase in heart rate.
Cocaine causes the release of adrenaline, a hormone that sharpens the body’s response to stress and danger. This acceleration is tachycardia.
If you suspect someone has used cocaine, notice if they have a racing heartbeat. It is one of the key indicators.

Tachypnea

Tachypnea is characterized by an increased rate of breathing beyond normal.
Just like tachycardia, cocaine use triggers the body’s flight or fight mechanism. This ends up demanding more oxygen, resulting in faster breathing.
Pay close attention to rapid breathing as it indicates elevated physiological arousal, another common sign of cocaine use.
Remember, tachypnea pairs frequently with other stimulant effects like rapid heartbeat and agitation.

Dilated pupils

Dilated pupils are another physiological reaction to cocaine.
The drug affects the autonomic nervous system, leading to pupil dilation. This happens because cocaine inhibits the reuptake of norepinephrine, a neurotransmitter that widens the pupils.
Larger-than-normal pupils could be an indicator that someone has ingested cocaine or another stimulant drug.
This effect is quite noticeable and can help in suspecting substance use.

Agitation

Agitation, or the state of being restless and unable to concentrate, is a behavioral sign of cocaine use.
Triggered by the overstimulation of the brain, it manifests as excessive energy, nervousness, and discomfort.
If someone is unusually restless, check for other accompanying signs like tachycardia and dilated pupils.
Agitation is often paired with a jittery behavior that stands out immediately.

Hypervigilance

Hypervigilance refers to an enhanced state of sensory sensitivity and alertness.
In cocaine users, this often translates into a heightened state of paranoia or extreme alertness to their surroundings.
Someone may appear on edge, constantly scanning their environment for perceived threats.
This symptom, combined with other signs, increases the likelihood of cocaine usage.

Tremors

Tremors are involuntary, rhythmic muscle contractions often caused by heightened nervous system activity.
Cocaine stimulates the central nervous system, sometimes leading to muscle tremors or shaking.
Look for signs of shaking hands or jitteriness. This physical response is quite common among cocaine users.
Tremors are not just a minor sign but a significant indicator of heightened stimulant activity in the body.