A client prescribed levothyroxine presents to the emergency center complaining of diaphoresis, new onset tremor, and anxiety. Vital signs are listed below. What adverse effect of levothyroxine does the nurse suspect? Vital Signs Heart Rate: 112 Respiratory Rate: 18 Blood Pressure: 150/89 Temperature: 99.9 Temporal

Rationale: A. Hypothyroidism: Hypothyroidism typically presents with fatigue, weight gain, cold intolerance, bradycardia, and slowed metabolism. The client’s symptoms of tachycardia, tremors, diaphoresis, and anxiety are opposite of what is expected in a low thyroid state, indicating increased metabolic activity instead. B. Hypoglycemia: Hypoglycemia may cause tremors, diaphoresis, and anxiety due to sympathetic nervous system activation. However, it is usually accompanied by symptoms such as confusion, dizziness, and possible loss of consciousness, and does not cause sustained tachycardia and hypertension as seen with thyroid hormone excess. C. Hyperthyroidism: Excess levothyroxine can lead to symptoms of hyperthyroidism, including tachycardia, elevated blood pressure, tremors, diaphoresis, anxiety, and low-grade fever. These findings reflect increased metabolic rate and sympathetic stimulation, consistent with thyroid hormone over-replacement. D. Hyperglycemia: Hyperglycemia is associated with polyuria, polydipsia, fatigue, and blurred vision rather than tremors and diaphoresis. It does not typically produce the heightened sympathetic symptoms or vital sign changes seen in this client.