Mr. Johnson is a 63-year-old client who has been admitted to the emergency depar

Question

Mr. Johnson is a 63-year-old client who has been admitted to the emergency department following traffic accident. He is exhibiting manifestations of an increased heart rate, increased cardiac output. His Accu-Chek shows an elevated blood glucose level. His respiratory rate is increased, and he has audible wheezes. During a neurological check, he exhibits pupil dilation.

1. Compare and contrast the sympathetic nervous system with that of the parasympathetic nervous system.

2. Discuss the difference between the efferent neurons and afferent neurons of the peripheral nervous system.

3.What are the primary neurotransmitters of the ANS?

4.Discuss how albuterol may be effective with this client.

Frank Brown is a 72-year-old retired accountant. An accomplished musician and composer, Mr. Brown also worked as an organist in various churches during all of his adult life. Over the past several years, Mr. Brown has had increasing difficulty with his memory, finding that he is now unable to play familiar pieces of music that he had memorized years before. His increasing difficulty with memory and with cognitive ability has recently forced him to retire from his organist positions. Mr. Brown, accompanied by his wife, is seen at the medical clinic today. The Browns are informed that Frank is exhibiting symptoms of early Alzheimer’s disease.

1. Mr. Brown is given a prescription for rivastigmine. Mrs. Brown asks if this medication will cure the Alzheimer’s disease. How should the nurse respond?

2. Mr. Brown states that a friend of his was diagnosed with Alzheimer’s disease and is on donepezil. He asks why he has not been given this drug. How should the nurse answer this question?

3. Discuss the major points that the nurse should include in a teaching plan for the Browns regarding rivastigmine.

Explanation / Answer

1. Compare and contrast the sympathetic nervous system with that of the parasympathetic nervous system.

2. Discuss the difference between the efferent neurons and afferent neurons of the peripheral nervous system.

The neuron is the structural and functional unit of the nervous system. These cells are specialized to respond to chemical and physical stimuli and to conduct and transfer messages throughout the body. Depending on the shapes and functions of the neurons, there are three types of neurons; namely, afferent neurons, interneurons, and efferent neurons.

3.What are the primary neurotransmitters of the ANS?

The Primary Neurotransmitters of the ANS Are Acetylcholine and Norepinephrine.

Acetylcholine (ACh) - is the transmitter released by the preganglionic nerve terminals of both the sympathetic and the parasympathetic divisions.

Norepinephrine (NE) - is the neurotransmitter for postganglionic synapses of the sympathetic division.

4.Discuss how albuterol may be effective with this client.

Albuterol also known as salbutamol, Albuterol belongs to a class of drugs known as bronchodilators. It is used to treat wheezing and shortness of breath caused by breathing problems such as asthma.
In this case , Mr. Johnson has increased respiratory rate and audible wheeze, Albuterol can act as a quick-relief medication which works in the airways by opening breathing passages and relaxing muscles which helps in controlling his symptoms.

Sympathetic Nervous System vs Parasympathetic Nervous System Sympathetic nervous system Parasympathetic nervous system Introduction The sympathetic nervous system (SNS) is one of two main divisions of the autonomic nervous system (ANS). Its general action is to mobilize the body's fight-or-flight response. The parasympathetic nervous system is one of the two main divisions of the autonomic nervous system (ANS). Its general function is to control homeostasis and the body's rest-and-digest response. Origin Originated from the cranial, thoracic and limbar region of the central nervous system Originated from the cranial and sacral region of the central nervous system. Sacral region of spinal cord, medulla, cranial nerves 3, 7, 9, and 10. Function Prepare the body for intense physical activity. Control the body's response during perceived threat. Relax the body and inhibit high energy functions. Control the body's response while at rest. Position of ganglion Close to the spinal cord, away from the effector Away from the spinal cord, close to the effector Size of pre-ganglionic fibres Short Long Size of post-ganglionic fibres Long Short Number of post ganglionic fibres Large numbers Very few numbers Coverage area of pre-ganglionic fibres Covers a wide area Covers only a restricted area Neuron Pathways Very short neurons, faster system Longer pathways, slower system Mode of effect Show diffused effects in the area of influence Shows localized effects in the area of influence Transmitter substance Noradrenaline released at the effector Acetylcholine released at the effector General Body Response Body speeds up, tenses up, becomes more alert. Functions not critical to survival shut down. Counterbalance; restores body to state of calm. Control Control reactions to stress Control routine body activates Homoeostatic effect Excitatory homoeostatic effect Inhibitory homeostatic effect Musculoskeletal System Muscles contract Muscles relax Effect on blood level Increase Decrease Effect on metabolic rate Increase Decrease Cardiovascular System (heart rate) Increase Decrease Effect on sensory awareness Raise sensory awareness Restore sensory awareness to normal level Effect on pupil Dilate pupils Constrict pupils Salivary Glands Inhibit saliva secretion Stimulate saliva secretion Pulmonary System (lungs) Dilates bronchial tubes Constrict bronchial tubes Adrenaline release Release adrenaline from adrenal gland No action of adrenal gland Effect on the conversion of glycogen to glucose Increase the rate of glycogen to glucose for muscle power No action in the conversion Urinary Response Decrease urinary output Increase urinary output Effect on rectum Rectum is contracted Rectum is relaxed

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