A patient who is taking amitriptyline (Elavil) reports constipation and dry mouth. The nurse will give the patient which instruction?

A) Decreased sweating, decreased BP, and increased heart rate: This combination does not reflect a typical stress response. In stressful or threatening situations, the body activates the sympathetic nervous system, leading to increased sweating, elevated blood pressure, and other physiological changes, rather than a decrease in blood pressure.
B) Increased sweating, decreased respiratory rate, and increased BP: In a stressful situation, sweating would indeed increase due to the activation of the sympathetic nervous system. However, the respiratory rate would typically increase, not decrease, as the body prepares for the "fight or flight" response. Increased blood pressure is expected, but decreased respiratory rate does not align with this response.
C) Pupil constriction, increased respiratory rate, and decreased heart rate: Pupil constriction is not characteristic of the "fight or flight" response; instead, pupil dilation occurs as part of the body's preparation to react to a threat. Increased respiratory rate and heart rate are typically seen during stress, but decreased heart rate would not be expected in such a situation.
D) Increased blood pressure, increased heart rate, and pupil dilation: This is the correct response. When faced with a threatening situation, the body activates the sympathetic nervous system, triggering the "fight or flight" response. This includes increased blood pressure and heart rate to prepare the body for action, as well as pupil dilation (mydriasis) to enhance vision and perception of the environment. These changes help the body respond quickly to a perceived danger.

A) Norepinephrine: Norepinephrine is a neurotransmitter primarily involved in the sympathetic nervous system. It is not involved in terminating the stimulation caused by acetylcholine. Norepinephrine acts on adrenergic receptors, whereas acetylcholine primarily acts on cholinergic receptors.
B) Decarboxylase: Decarboxylase is an enzyme that plays a role in the synthesis of certain neurotransmitters, including dopamine, but it does not have a role in terminating the action of acetylcholine at the effector cell. It is unrelated to the termination of acetylcholine signaling.
C) Catecholamine: Catecholamines (such as dopamine, norepinephrine, and epinephrine) are a group of neurotransmitters involved in the sympathetic nervous system. While they play a role in synaptic transmission, they are not responsible for breaking down acetylcholine or terminating its effects. Their primary function is in adrenergic signaling.
D) Acetylcholinesterase: Acetylcholinesterase is the correct enzyme. It is responsible for breaking down acetylcholine (ACh) in the synaptic cleft after it has stimulated the effector cell. By hydrolyzing acetylcholine into acetate and choline, acetylcholinesterase effectively terminates the signal and allows the effector cell's membrane to repolarize. This action prevents continuous stimulation and ensures proper function of the cholinergic system.