A nurse in a provider's office is collecting data from a client who has hypothyroidism. Which of the findings should the nurse expect?

Choice A rationale Hypothyroidism results from a deficiency in thyroid hormones, specifically thyroxine and triiodothyronine, which govern the body's basal metabolic rate. A decrease in these hormones leads to a slowing of all metabolic processes, including the cardiac conduction system. Consequently, the heart rate drops below the normal range of 60 to 100 beats per minute, leading to bradycardia. This reflects the overall systemic slowing characteristic of the disease. Choice B rationale Clients with hypothyroidism typically present with cool, dry, and coarse skin rather than moist skin. Moist or diaphoretic skin is a hallmark sign of hyperthyroidism, where the metabolic rate is pathologically accelerated. In hypothyroidism, decreased activity of the sweat and sebaceous glands, combined with reduced peripheral circulation, leads to the classic dry and "doughy" skin texture often noted during a physical examination of the client. Choice C rationale Insomnia is a common symptom of hyperthyroidism due to excessive sympathetic nervous system stimulation. In contrast, hypothyroidism causes significant lethargy, somnolence, and fatigue. These clients often feel the need to sleep for long periods and may still feel unrefreshed upon waking. The lack of thyroid hormone slows brain activity, leading to mental fog and an increased desire for sleep, which is the opposite of insomnia. Choice D rationale Blurred vision is not a standard clinical finding directly caused by hypothyroidism. While severe hyperthyroidism can cause exophthalmos and resulting visual disturbances due to pressure on the optic nerve, hypothyroidism is more closely associated with periorbital edema or a dull facial expression. Visual changes are generally absent unless the hypothyroidism is secondary to a large pituitary tumor that is physically compressing the optic chiasm.