RN Nursing · Thyroid Disorders · Practice question
The nurse suspects that the client is experiencing hyperthyroidism. The nurse is most concerned about the client experience ____ as evidenced by the client's ____
Female Client with Thyroid Symptoms
Nurses' Notes
0900: Female client presents to the clinic with reports of fatigue, constipation, muscle aches and weakness. Client states, "I have also noticed that my hair is thinning, and I am gaining weight, but I'm not eating more. I just can't deal with this anymore." Client is alert and oriented x3. Client's skin is cool and dry. hair is dry and coarse. Facial edema noted, and mild edema to hands and feet. Abdomen soft and round, hypoactive bowel sounds. Lungs clear, S1 and S2 noted. Thyroid palpated; no nodules noted. Weight 76 kg (168 lb) Height 165 cm (65 in) BMI 28Vital Signs
0900: Temperature 36.4° C (97.6° F), Heart rate 58/min Respiratory rate 14/min Blood pressure 105/68 mm Hg SpO2 98% on room airAnswer & explanation
Correct:
Although the question stem says the nurse suspects hyperthyroidism, the clinical picture is actually consistent with hypothyroidism. The most serious concern is myxedema coma, a life-threatening complication of severe hypothyroidism. The client's statement 'I just can't deal with this anymore' raises concern for depression, which can be a manifestation of severe hypothyroidism and precedes myxedema coma. Depression and altered mental status are early warning signs. Bradycardia, low temperature, and edema further support the risk for myxedema coma (ATI Nursing Education; Endocrine Society guidelines).
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