What sign may indicate a cocaine overdose when assessing a client?

Dilated pupils are a significant sign that may indicate a cocaine overdose. Cocaine is a stimulant that affects the central nervous system, and its use often causes physiological changes. One of the key effects of cocaine is the activation of the sympathetic nervous system, which can lead to increased heart rate, elevated blood pressure, and pupil dilation, also known as mydriasis.

During a cocaine overdose, this dilation occurs as the body's response to increased levels of norepinephrine and other neurotransmitters that stimulate the body's fight-or-flight response. Hence, if a client is assessed and found to have dilated pupils, it is a strong indicator that they may be experiencing a cocaine overdose.

While constricted or unresponsive pupils are indicative of different types of substance use or neurological issues, they are not typically associated with cocaine. Normal pupil size can occur in various contexts and does not specifically suggest an overdose scenario on its own. Therefore, recognizing dilated pupils in the context of a client suspected of having taken cocaine is critical for timely intervention and treatment.