A client primary care provider prescribed a B-adrenergic receptor blocker. Which of the following therapeutic effects do the client and care provider likely seek?

A) The blood cells will migrate to the bone marrow:
While the bone marrow is responsible for producing red blood cells, dehydration and hypertonicity of the blood would not cause the red blood cells to migrate to the bone marrow. Migration of blood cells typically refers to white blood cells moving toward sites of infection or inflammation, not a response to dehydration.

B) The red cells will precipitate out of circulation:
Red blood cells do not precipitate out of circulation due to dehydration or hypertonic conditions. Instead, dehydration causes a shift in water balance that leads to changes in the shape and function of the red blood cells. Precipitation of cells is not a physiological response in this context.

C) They will swell and eventually rupture:
In conditions of hypertonicity, where the concentration of solutes (such as sodium) in the blood is higher than normal, red blood cells actually shrink, not swell. When blood is hypertonic, water moves out of the red blood cells into the extracellular space to balance the osmotic pressure, leading to cell shrinkage. Cells only swell in hypotonic conditions, when water moves into the cell.

D) The cells will shrink and shrivel, decreasing their oxygen-carrying ability:
When the body becomes dehydrated, the blood becomes hypertonic (more concentrated), leading to a shift of water out of the red blood cells to try to balance the osmotic gradient. As a result, the red blood cells shrink and shrivel. This shrinkage can impair their ability to carry oxygen effectively, as the cells may become more rigid and less flexible, making it difficult for them to navigate through small blood vessels and perform gas exchange in the lungs and tissues.

A) Risk for dehydration related to diarrhea:
Diarrhea is not a common issue directly associated with Parkinson’s disease or its typical treatments, such as dopaminergic medications. While some medications or conditions can cause gastrointestinal disturbances, dehydration due to diarrhea is not a primary concern in Parkinson’s disease.

B) Diarrhea related to dopaminergic effects:
Dopaminergic medications, such as levodopa, may cause gastrointestinal side effects, but diarrhea is not a primary or common side effect. Typically, dopaminergic effects can lead to constipation, not diarrhea.

C) Risk for injury related to CVS effects and incidence of orthostatic hypotension:
Parkinson's disease can cause autonomic dysfunction, which often leads to orthostatic hypotension increasing the risk of falls and injury. This is a valid and appropriate nursing diagnosis because patients with Parkinson’s disease often experience balance issues and dizziness due to this condition, making them more vulnerable to falls and injury.

D) Constipation related to dopaminergic effects:
While constipation is a common side effect of dopaminergic medications used to treat Parkinson's disease, the more appropriate diagnosis for a patient who has Parkinson’s disease would be one that addresses the immediate risks or complications related to mobility or autonomic dysfunction.