A 49-year-old woman (5’2″, 170 lbs) comes to your clinic with a chief complaint of feeling poorly for the past
few months. When asked for more details, she complains of a list of symptoms including fatigue, cold
intolerance, weight gain, and constipation. Her physical appearance is normal except for a noticeable yellow tint
to her skin, and puffiness of her face. Her thyroid gland appears firm and enlarged. Her lab tests indicate free
thyroxine (FT4) = 0.5 ng/dL (normal: 0.7-1.9); TSH = 70 IU/ml (normal: 0.5-4.7); thryoperoxidase antibodies =
140 IU/L (normal <100).
1.What is the most likely diagnosis?

  1. What medications could be prescribed to treat this client?
  2. What are signs of euthyroidism
    John Jones is a 55-year-old African American man. He has been HIV positive for 5 years. He is currently taking
    Atripla one tablet by mouth daily. He presents to the physician’s office complaining of pain in his mouth and
    white patches on his tongue and cheeks.
  3. While triaging Mr. Jones, what information should the nurse obtain?
  4. Mr. Jones tells the nurse he has started taking St. John’s wort because he heard it had antiviral effects and he
    was feeling a bit depressed lately. What should the nurse tell Mr. Jones about the St. John’s wort?
  5. The physician writes a prescription for Mr. Jones to receive fluconazole (Diflucan) 200 mg on day 1 and 100
    mg on days 2 through 14. What should the nurse tell Mr. Jones?
  6. What patient teaching will the nurse provide Mr. Jones for the Atripla that is prescribed ?

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