When there is stimulation of the sympathetic nervous system (SNS), blood is diverted away from the gastrointestinal (GI) tract. What might the nurse assess that would indicate this diversion of blood flow to the GI tract?

A) Suspect worsening of the anxiety disorder:
While it is possible that the patient's anxiety disorder is worsening, the more likely explanation for the reduced effectiveness of lorazepam is the development of drug tolerance. Over time, patients may require higher doses of a medication to achieve the same therapeutic effect, especially with medications like lorazepam that are used chronically.

B) Contact the provider to discuss changing to another benzodiazepine:
Changing to another benzodiazepine might be an option, but it is more likely that tolerance to lorazepam is the cause of the reduced effect, not an issue with the specific drug. Tolerance is common with long-term use of benzodiazepines, and switching drugs may not address the underlying issue. The first step would be to assess the current medication regimen and discuss possible adjustments with the provider.

C) Understand that the patient has developed tolerance to this drug:
Tolerance occurs when the body becomes accustomed to the effects of a medication over time, requiring higher doses to achieve the same therapeutic effect. This is a common phenomenon with benzodiazepines like lorazepam, which are often used for long periods to manage anxiety. As the patient has been taking lorazepam for six months, this reduced effectiveness is likely due to the development of tolerance, rather than a worsening of the anxiety disorder.

D) Notify the provider and discuss increasing the dose of lorazepam:
While increasing the dose of lorazepam could temporarily relieve symptoms, it is not the most appropriate first step. The nurse should first consider the possibility of tolerance and discuss this with the provider before increasing the dose. Long-term increases in benzodiazepine dosages can increase the risk of side effects, dependency, and withdrawal symptoms.

A) GABA-ergic:
GABA-ergic neurons use gamma-aminobutyric acid (GABA) as their neurotransmitter, not acetylcholine (ACh). GABA is the main inhibitory neurotransmitter in the brain, playing a crucial role in reducing neuronal excitability.

B) Dopaminergic:
Dopaminergic neurons release dopamine as their neurotransmitter. Dopamine is involved in several critical functions, including movement, reward, and regulation of mood. Since acetylcholine is not involved in dopaminergic transmission, this is not the correct answer.

C) Cholinergic:
Cholinergic neurons use acetylcholine (ACh) as their neurotransmitter. These neurons are involved in many functions, including muscle activation (in the somatic nervous system), as well as modulating parasympathetic responses in the autonomic nervous system.

D) Serotonergic:
Serotonergic neurons release serotonin (5-HT), which is a neurotransmitter involved in regulating mood, appetite, sleep, and other functions. Acetylcholine is not involved in serotonergic transmission