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A 30-year-old woman with a history of hypertension, obesity, and hyperlipidemia presents to the primary care clinic with constipation. She states that over the past several months, she has been experiencing a change in bowel movements. She used to have 2-3 bowel movements per day but has only been having a bowel movement every 2 days for the last 4 months. In addition, she states that she has been feeling not like herself since her husband passed away a year ago. Her appetite has decreased, she doesn’t sleep well, and she sometimes has issues concentrating on things she once loved. She has had recent weight gain and feels cold frequently. Her current medications include atorvastatin (Lipitor) and metoprolol (Toprol). She also reports back and joint pain from time to time but denies any numbness, dryness of skin, tingling, loss of sensation, loss of bowel control, or altered mental status. The patient’s temperature is 98.5 degrees F, HR is 70, RR is 16, and BP is 100/60. Physical exam reveals dry skin., and mental-status exam shows she is mentally intact with difficulty concentrating and answering certain questions. Which of the following is the best course of action today?

1. Check thyroid hormone levels

2. stop current medications

3. administer laxative

4. administer steroids and interferon-beta

SCIENCE
HEALTH SCIENCE
NURSING
NURS 303

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