A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient’s provider to discuss changing from aspirin to which drug?

A) Decrease in heart rate and perfusion, and an increase in inflammatory response: These manifestations suggest parasympathetic nervous system activation, not the sympathetic response. The sympathetic system generally increases heart rate and perfusion to support "fight or flight" responses. Additionally, inflammatory responses are more immune-related and are not a direct effect of sympathetic activation.

B) Increase motility and secretion in the GI tract, constriction of bronchi and pupils: This is characteristic of parasympathetic nervous system activity. The parasympathetic system stimulates digestion (increased motility and secretion) and causes bronchoconstriction and pupil constriction (miosis). The sympathetic nervous system, in contrast, inhibits GI motility and causes bronchodilation and pupil dilation.

C) Increase in blood pressure, bronchodilation, and decrease bowel sounds: These are hallmark signs of sympathetic nervous system activation. When the sympathetic system is activated during stress or danger, it leads to vasoconstriction, which increases blood pressure. Bronchodilation occurs to allow more oxygen intake, and GI motility decreases (manifested as reduced bowel sounds) to redirect energy to more vital functions, like increased circulation to muscles.

D) Decrease in sweating, decrease in respiration, and pupil constriction: These signs suggest parasympathetic or a relaxed state. The sympathetic nervous system typically increases sweating, respiration, and causes pupil dilation to prepare the body for increased activity. Decreased sweating and respiration, along with pupil constriction, would not be consistent with the sympathetic response.

A) Myasthenia gravis (MG):
Weakness of the extremities and diplopia (double vision) are hallmark symptoms of myasthenia gravis, an autoimmune disorder that affects the neuromuscular junction. In MG, antibodies attack acetylcholine receptors, leading to muscle weakness that worsens with activity and improves with rest. The weakness typically affects voluntary muscles, including those responsible for eye movement, which leads to symptoms such as diplopia and ptosis (drooping eyelids).

B) Multiple sclerosis (MS):
Multiple sclerosis involves the demyelination of neurons in the central nervous system, leading to a variety of neurological symptoms. While MS can cause weakness and visual disturbances, the typical symptoms of MS include fatigue, muscle spasticity, ataxia, and sensory deficits. Diplopia can occur in MS but is usually accompanied by other neurological signs such as numbness, tingling, or loss of coordination.

C) Cerebral palsy (CP):
Cerebral palsy is a group of disorders affecting movement and posture due to non-progressive brain injury or abnormal brain development, often occurring in early childhood. While CP can cause muscle weakness and coordination issues, it does not typically present with diplopia. Instead, it often involves spasticity, motor impairment, and difficulty with fine motor tasks.

D) Parkinson disease (PD):
Parkinson disease is characterized by tremors, bradykinesia (slowness of movement), rigidity, and postural instability. While PD can lead to muscle weakness and visual issues like blurred vision, it is not typically associated with diplopia as a primary symptom. The hallmark motor symptoms are primarily related to tremor and difficulty initiating movements rather than generalized weakness and double vision.