The nurse assess that the patient is having a sympathetic response when noting what manifestation?

A) Central nervous system (CNS), memory, and cognition: Myasthenia gravis (MG) primarily affects the neuromuscular junction, causing muscle weakness, not directly the central nervous system. While cognitive function may be affected in some patients due to fatigue or medication side effects, it is not the main system affected by MG.

B) Cardiovascular system and postural muscles: Myasthenia gravis primarily affects skeletal muscles, especially those responsible for voluntary movements like facial muscles, swallowing, and respiratory muscles. While MG can lead to general weakness, it does not typically affect the cardiovascular system directly.

C) Respiratory system and facial muscles: This is the correct answer. Myasthenia gravis primarily affects the voluntary muscles, particularly those controlling eye movements, facial expressions, swallowing, and breathing. The respiratory system is vulnerable due to weakness of the diaphragm and intercostal muscles, which can lead to respiratory distress in severe cases. Facial muscles are commonly affected, leading to symptoms like ptosis (drooping eyelids) and difficulty smiling or speaking.

D) Gastrointestinal system (GI) and lower extremity muscles: Although myasthenia gravis can cause generalized muscle weakness, it is not typically associated with the gastrointestinal system. The primary impact is on the voluntary muscles, such as those in the face, throat, and respiratory system. Lower extremity muscles can be affected, but the respiratory and facial muscles are more commonly involved.

A) Pupil dilation:
Pupil dilation is typically a response from stimulation of the sympathetic nervous system, not the parasympathetic system. The parasympathetic system tends to cause pupil constriction, so pupil dilation would not be an expected response to a parasympathetic agonist.

B) Increased gastrointestinal motility:
Stimulation of the parasympathetic nervous system, which is responsible for the "rest and digest" response, promotes the movement of food through the digestive tract, increasing gastrointestinal motility. This response is a classic sign that the parasympathetic system is being activated. Drugs that stimulate the parasympathetic nervous system often aim to enhance digestive functions.

C) Vasoconstriction:
Vasoconstriction is typically mediated by the sympathetic nervous system, not the parasympathetic system. The sympathetic nervous system activates alpha-adrenergic receptors that cause blood vessels to constrict, raising blood pressure. The parasympathetic system, on the other hand, typically promotes vasodilation, lowering blood pressure.

D) Increased heart rate:
Increased heart rate is generally associated with the sympathetic nervous system, which prepares the body for "fight or flight." The parasympathetic nervous system, in contrast, slows down the heart rate through vagal stimulation, so an increase in heart rate would not be the expected response to parasympathetic stimulation.