Six months ago an elderly patient was diagnosed with subclinical hypothyroidism. Today the patient returns and has a TSH of 11.0 and complains of fatigue.
He has taken Synthroid 25 mcg daily as prescribed. What is the best course of action for the nurse practitioner?
A. Assess further for a cause of fatigue
B. Double the dose of Synthroid
C. Discontinue the Synthroid
D. Prescribe Liotrix (T3 & T4 combination)
Question 2
A 62-year-old female complains of fatigue and lack of energy. Constipation has increased and the patient has gained ten pounds in the past 3 months.
Depression is denied although the patient reports a lack of interest in usual hobbies. Vital signs are within normal limits and the patient's skin is dry and cool. Which of the following must be included in the differential?
A. Hyperthyroidism
B. Hypothyroidism
C. Hyperparathyroidism
D. Grave's disease
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