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) Hypothalamus and the medulla: While the hypothalamus and medulla play critical roles in regulating autonomic functions and overall sympathetic nervous system activity, the primary origin of the sympathetic nervous system's neural impulses comes from the spinal cord, specifically in the thoracic and lumbar regions. The hypothalamus and medulla are involved in coordinating and regulating sympathetic activity rather than being the origin of the impulses themselves.

B) Cranium and sacral area of the spinal cord: The cranium and sacral regions are primarily associated with the parasympathetic nervous system, not the sympathetic nervous system. The parasympathetic nervous system's nerve fibers arise from the brainstem and the sacral region, while the sympathetic fibers originate from the thoracic and lumbar areas.

C) Thoracic and lumbar section of the spinal cord: The sympathetic nervous system originates in the thoracolumbar region of the spinal cord, which includes the thoracic and lumbar segments (T1-L2). These regions house the preganglionic neurons whose axons exit the spinal cord and synapse in sympathetic ganglia, leading to the sympathetic effects on organs and tissues. This makes the thoracic and lumbar sections the correct location for the origin of SNS impulses.

D) Nerve membrane: The nerve membrane, or the cellular membrane of individual neurons, is not the location where impulses originate. The origin of the impulses is in the central nervous system (CNS), specifically in the spinal cord for the sympathetic system, not at the level of the individual nerve membranes.

A) Decreased bowel sounds:
When the sympathetic nervous system (SNS) is activated, such as during stress or a "fight-or-flight" response, blood is redirected away from the gastrointestinal (GI) tract to vital organs like the heart and muscles. This results in decreased gastrointestinal motility and function, which is reflected in a reduction in bowel sounds. Decreased bowel sounds are a direct consequence of reduced blood flow and decreased activity in the GI system.

B) Increased blood glucose level:
While it is true that SNS activation can lead to an increase in blood glucose due to the release of catecholamines (e.g., epinephrine), this response is related to the body’s preparation for physical exertion and not directly a result of blood being diverted from the GI tract. The increase in glucose levels is more about energy mobilization rather than an effect on blood flow to the GI tract.

C) Decreased immune reaction:
Sympathetic stimulation can indeed have effects on immune function, typically suppressing immune responses during a stress response. However, this is not directly linked to blood being diverted away from the GI tract. Immune suppression is more about the body prioritizing immediate survival (e.g., diverting energy to muscles for fight-or-flight) rather than a specific physiological consequence of GI blood flow changes.

D) Increased blood pressure:
Sympathetic nervous system activation does lead to an increase in blood pressure due to vasoconstriction and increased heart rate. However, increased blood pressure is a broader systemic response to SNS stimulation, and it is not directly related to blood being diverted from the GI tract. Blood pressure increases as part of the general "fight-or-flight" response, but it does not specifically indicate changes in GI blood flow.