When there is stimulation of the sympathetic nervous system (SNS), blood is diverted away from the gastrointestinal (GI) tract. What might the nurse assess that would indicate this diversion of blood flow to the GI tract?

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.

A) Stop taking the medication immediately: Abruptly stopping amitriptyline without the guidance of a healthcare provider can cause withdrawal symptoms and other complications. Discontinuing this medication should only be done under medical supervision.

B) Increase fluid intake: Amitriptyline can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps manage dry mouth by stimulating salivation and helps alleviate constipation by promoting bowel regularity.

C) Request another antidepressant: While amitriptyline can cause side effects like dry mouth and constipation, switching medications should not be the first step. These side effects are often manageable with lifestyle modifications, such as increasing fluid and fiber intake, and adjustments to the treatment plan can be considered if the symptoms are severe or persistent.

D) Notify the provider: While it is important for the nurse to document and inform the provider about any significant side effects, this instruction alone does not provide immediate relief to the patient. It is more appropriate to first recommend increasing fluid intake, and then the nurse can discuss with the provider if the symptoms persist or worsen.