The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?

A) Beta 1-receptors:
Beta 1-receptors are primarily found in the heart, and their stimulation leads to increased heart rate and contractility. These receptors are not typically involved in vasoconstriction, pupil dilation, or piloerection.

B) Beta 2-receptors:
Beta 2-receptors are primarily located in smooth muscles such as the bronchi and blood vessels. Their stimulation causes smooth muscle relaxation, leading to bronchodilation and vasodilation. Beta 2-receptors are not responsible for the effects of vasoconstriction, piloerection, or pupil dilation described in the question, making this option incorrect.

C) Alpha 2-receptors:
Alpha 2-receptors are involved in the inhibition of norepinephrine release and play a role in regulating sympathetic tone. They are not primarily responsible for vasoconstriction or the other physiological responses listed in the question. Alpha 2-stimulation typically results in decreased sympathetic activity, not the effects described here.

D) Alpha 1-receptors:
Alpha 1-receptors are located on smooth muscle, including the blood vessels, and their stimulation results in vasoconstriction. They are also involved in other actions such as piloerection (hair standing on end), pupil dilation (mydriasis), and closure of the salivary sphincter. Additionally, they play a role in male sexual emission (ejaculation). The physiological responses described in the question—vasoconstriction, piloerection, pupil dilation, and male sexual emission—are all consistent with alpha 1-receptor stimulation.

A) Tell the spouse that medication therapy can be curative if drugs are begun in time: Medication for Parkinson's disease (PD), such as levodopa, can help manage symptoms, but it is not curative. PD is a progressive neurodegenerative disease, and while medications can improve quality of life by alleviating symptoms, they do not stop the disease’s progression. Therefore, suggesting that medication therapy can be curative would be misleading.
B) Recommend exercise, nutritional counseling, and group support to help manage the disease: This is the most accurate and appropriate response. While medications are an important part of managing Parkinson's disease, non-pharmacological approaches, such as exercise, nutritional counseling, and support groups, play a critical role in improving overall function, mobility, and quality of life. Exercise, in particular, can help maintain mobility and reduce rigidity, while a balanced diet can assist in managing issues like constipation or swallowing difficulties. Group support can provide emotional support and help the patient and family navigate the challenges of living with PD.
C) Tell the spouse that the disease will not progress if mild symptoms are treated early: Parkinson's disease is a chronic, progressive condition, and while early treatment can help manage symptoms, it does not prevent the disease from progressing. Suggesting that the disease will not progress if symptoms are treated early would be unrealistic and could create false hope.
D) Counsel the spouse that parkinsonism is a normal part of the aging process in some people: While Parkinson's disease symptoms may appear in older adults, it is not a normal part of aging. Parkinson’s disease is a specific neurodegenerative condition, and its symptoms, such as tremor, bradykinesia, and rigidity, go beyond normal age-related changes. Misleading the spouse by categorizing it as "normal aging" would undermine the importance of proper diagnosis, treatment, and care.