A client with a history of hypothyroidism was initially admitted with lethargy and confusion. Which additional finding should the nurse act upon immediately?

Choice A rationale Cold and dry skin can be a symptom of hypothyroidism, but it’s not typically a sign that requires immediate action. Choice B rationale Facial puffiness and periorbital edema can be symptoms of hypothyroidism, but they’re not typically signs that require immediate action. Choice C rationale A hematocrit of 30% (0.30 volume fraction) is lower than the normal range, indicating anemia. While this is a concern and should be addressed, it’s not typically a sign that requires immediate action in the context of hypothyroidism. Choice D rationale A further decline in the level of consciousness can be a serious sign of deteriorating health in a client with hypothyroidism and should be acted upon immediately.