Reply to Amanda Do you take any medications? Have you ever been diagnosed with a thyroid disorder? Are you allergic to anything? Have you experienced any significant life changes? Additional stress etc? Hypothyroidism is six times more common in women than men, and is most common in older women (Carson, 2009). A thorough physical assessment should be completed. Clinical signs and symptoms may include paleness, brittle appearing hair and skin, elevated blood pressure, and bradycardia (Carson, 2009). The patient may have a puffy appearance to her face, irregular periods, and report sustained fatigue (Roberts et al, 2009). Anemia, Depression TSH Will be elevated in Hypothyroid Free T4 Result will be low in Hypothyroid Cholesterol Often elevated with Hypothyroid CBC To rule out anemia CMP To monitor other electrolytes EKG to assess for any blocks, prolonged QRS, or electrolyte abnormalities Patients with symptomatic hypothyroidism should be treated to prevent long-term complications (Roberts et al, 2004) Depending on the results of her TSH & T4 I would initiate a daily regimen of Levothyroxine. 4-6 weeks after the initiation of Levothyroxine I would recheck the patients TSH. After the TSH has reached a therapeutic level I would recheck it again in 6 months. Carson, M. (2009). Assessment and management of patients with hypothyroidism. (18), 48-56; quiz 58. Retrieved from Roberts, C. G. P., & Ladenson, P. W. (2004). Hypothyroidism. (9411), 793-803. doi:http://dx.doi.org/10.1016/S0140-6736(04)15696-1 reply to Quiana Some questions include: Hypothyroidism can increase lipids and alter cardiac function (Chaker, et al., 2017). EKG may reveal cardiac abnormalities. CBC can reveal anemia. The metabolic panel can reveal diabetes or problems with hepatic or renal function. Hypothyroidism continues to be researched as far as the specific link to renal and hepatic dysfunction (Chaker, et al., 2017). The depression screen serves, like the other lab orders, to exclude causes of her symptoms. The most obvious test is a thyroid panel. To assess the circulating amount of hormone in the body is to judge her thyroid function. References Baisier, W. V., Hertoghe, J., & Eeckhaut, W. (2000). Thyroid insufficiency. is TSH measurement the only diagnostic tool? (2), 105-113. Retrieved from https://prx-herzing.lirn.net/login?url=https://search.proquest.com/docview/215623935?accountid=167104 Bathla, M., & Singh, M. (2016). Reply to how prevalent are depression and anxiety symptoms in hypothyroidism?. (6) doi:http://dx.doi.org/10.4103/2230-8210.192913 Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. (10101), 1550-1562. doi:http://dx.doi.org/10.1016/S0140-6736(17)30703-1 Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). , (4th ed.). [VitalSource Bookshelf version]. Retrieved from https://bookshelf.vitalsource.com/books/9780803655621
