A patient is admitted to the emergency department in shock. Isoproterenol (Isuprel) is admitted. What would the nurse expect the effect of this drug would be?

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) Bradycardia: Bradycardia is a common symptom of a cholinergic crisis. It results from excessive acetylcholine at the neuromuscular junction, which can overstimulate the parasympathetic nervous system, leading to a decrease in heart rate.

B) Rash: A rash is not a typical symptom of a cholinergic crisis. Rash might occur as a side effect of medications or other conditions, but it is not a hallmark feature of a cholinergic crisis in myasthenia gravis.

C) Vomiting: Vomiting is a potential symptom of a cholinergic crisis. It occurs due to the excessive stimulation of the parasympathetic nervous system, which can cause gastrointestinal distress and nausea.

D) Fever: Fever is not typically associated with a cholinergic crisis, but it can occur if there is an underlying infection or other condition. A cholinergic crisis itself usually leads to symptoms like weakness and excessive salivation, not fever.

E) Weakness: Weakness is a hallmark symptom of a cholinergic crisis, as it results from overstimulation at the neuromuscular junction, leading to muscle fatigue and paralysis. This is similar to the symptoms of myasthenia gravis, but in a cholinergic crisis, the weakness is more profound.

F) Drooling: Drooling is another common symptom of a cholinergic crisis. Excessive acetylcholine can lead to excessive salivation due to overstimulation of the parasympathetic nervous system.