The mother of an adolescent male tells the clinic nurse that she found anabolic steroids in her son's room. How should the nurse respond? Select all that apply.

A. Describe how anabolic steroids increase muscle strength to improve athletic performance: While anabolic steroids do enhance muscle mass and strength, emphasizing this could inadvertently normalize or encourage their misuse rather than addressing the serious health risks involved.

B. Advise of the need to observe for changes in behavior, such as increased aggression: Anabolic steroids can cause mood disturbances, including aggression, irritability, and even psychiatric symptoms. Educating the parent to monitor for behavioral changes is critical for early intervention.

C. Explain that this is a schedule II controlled substance: Anabolic steroids are actually classified as Schedule III controlled substances under the Controlled Substances Act, not Schedule II. Providing inaccurate information could lead to confusion and mismanagement of the situation.

D. Encourage a clinic visit to assess the adolescent for cardiovascular complications: Steroid use can increase the risk of serious cardiovascular problems like hypertension, lipid abnormalities, and myocardial damage. Prompt medical evaluation is essential to detect early complications.

E. Identify the use of any other herbal supplements: Adolescents who misuse anabolic steroids may also be using other supplements or substances that could have dangerous interactions. A full assessment of all substances being used is important for comprehensive care and counseling.

A. Positive guaiac of stool: A positive guaiac test indicates the presence of blood in the stool, suggesting gastrointestinal bleeding. Given the client’s history of frequent ibuprofen use, which can cause gastric ulcers and GI bleeding, this is a critical finding that must be reported immediately to the healthcare provider.

B. Hemoglobin 13 g/dL (130 g/L): Although slightly below the normal reference range for males, a hemoglobin of 13 g/dL is not critically low. It suggests mild anemia but is not an urgent finding compared to evidence of active gastrointestinal bleeding.

C. Hematocrit 42% (0.42 volume fraction): A hematocrit of 42% falls within the normal reference range for a male client. Therefore, this finding is stable and does not require immediate reporting in the context of the client's current symptoms.

D. Gastric pH 2: A gastric pH of 2 is within the normal range for stomach acid levels (1.5 to 3.5). The current gastric pH suggests that their acid production is within expected limits and is not the immediate concern. This value does not indicate any acute problem by itself and would not require immediate notification of the healthcare provider.