A patient who is taking amitriptyline (Elavil) reports constipation and dry mouth. The nurse will give the patient which instruction?

A) The blood cells will migrate to the bone marrow:
While the bone marrow is responsible for producing red blood cells, dehydration and hypertonicity of the blood would not cause the red blood cells to migrate to the bone marrow. Migration of blood cells typically refers to white blood cells moving toward sites of infection or inflammation, not a response to dehydration.

B) The red cells will precipitate out of circulation:
Red blood cells do not precipitate out of circulation due to dehydration or hypertonic conditions. Instead, dehydration causes a shift in water balance that leads to changes in the shape and function of the red blood cells. Precipitation of cells is not a physiological response in this context.

C) They will swell and eventually rupture:
In conditions of hypertonicity, where the concentration of solutes (such as sodium) in the blood is higher than normal, red blood cells actually shrink, not swell. When blood is hypertonic, water moves out of the red blood cells into the extracellular space to balance the osmotic pressure, leading to cell shrinkage. Cells only swell in hypotonic conditions, when water moves into the cell.

D) The cells will shrink and shrivel, decreasing their oxygen-carrying ability:
When the body becomes dehydrated, the blood becomes hypertonic (more concentrated), leading to a shift of water out of the red blood cells to try to balance the osmotic gradient. As a result, the red blood cells shrink and shrivel. This shrinkage can impair their ability to carry oxygen effectively, as the cells may become more rigid and less flexible, making it difficult for them to navigate through small blood vessels and perform gas exchange in the lungs and tissues.

A) Beta 1: Beta-1 adrenergic receptors are primarily located in the heart and are responsible for increasing heart rate (chronotropy), the force of contraction (inotropy), and the conduction speed of electrical impulses within the heart (dromotropy). When a drug is given to increase heart rate and myocardial activity, it is stimulating the beta-1 receptors, which enhance the heart's performance..

B) Beta 2: Beta-2 receptors are predominantly found in smooth muscles, such as those
in the bronchi, blood vessels, and uterus. Stimulation of beta-2 receptors leads to relaxation of these muscles, including bronchodilation and vasodilation, which would not have a direct effect on increasing heart rate or myocardial activity.

C) Alpha 2: Alpha-2 receptors are primarily located in the central nervous system (CNS) and act to inhibit the release of norepinephrine, leading to a reduction in sympathetic nervous system activity. They have the opposite effect of what is desired in this case, as stimulation of alpha-2 receptors would actually lower heart rate and decrease myocardial activity, not increase it.

D) Alpha 1: Alpha-1 receptors are found in the smooth muscle of blood vessels and when stimulated, cause vasoconstriction, which increases blood pressure. While alpha-1 receptors do affect the cardiovascular system, they do not directly influence heart rate or myocardial contractility.