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Name Date
Scenario:
K.B. is a 65-year-old man admitted to the hospital after a 5-day episode of "the flu" with symptoms of
dyspnea on exertion, palpitations, chest pain, insomnia, and fatigue. K.B. was diagnosed with Graves'
disease 6 months ago and placed on methimazole (Tapazole) 15 mg/day. His other past medical history
includes heart failure and hypertension requiring antihypertensive medications; however, he says that
he has not been taking these medications on a regular basis. Vital signs (VS) are: 150/90, 124 irregular,
20, 100.2° F
(37.9°C). Admission assessment findings are height 5 ft,
8
in (173 cm); weight 132 lb (60 kg);
appears anx
ious and restless; loud heart sounds; 1+ pitting edema noted in bilateral lower extremities;
diminished breath sounds with fine crackles in the posterior bases. K.B. begins to cry when he tells
you he recently lost his wife; you notice someone has punched several more holes in his belt so he
could tighten it.
Chart View
Laboratory Test Results
Hemoglobin (Hgb)
Hematocrit (Hct)
Erythrocyte sedimentation rate
(ESR)
Sodium
Potassium
Chloride
Blood urea nitrogen (BUN)
Creatinine
Free thyroxine (T )
Triiodothyronine (T
)
11.8 g/dL (118 g/L)
36%
48
mm/hr
141 mEq/L (141 mmolfL)
4.7 mEq/L (4.7 mmolfL)
101 mEq/L (101 mmol/L)
33 mg/dL (11.78 mmolfL)
1.9 mg/dL (168 mcmol/L)
14.0 ng/dL (180 pmol/L)
230 ng/dL (353 nmolfL)
1.
Which of
K.B:s
assessment findings represent manifestations of hypermetabolism?
2. Interpret K.B:s lab results.
