Mrs. Greene, 28-year-old female who is six weeks postpartum. Mrs. Greene is being seen for her routi
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Mrs. Greene, 28-year-old female who is six weeks postpartum. Mrs. Greene is being seen for her routine six-week postpartum check-up. She appears anxious and expresses she has had loose stools for the last week. She also expresses that she is feeling extremely fatigued, irritable, and anxious and has been experiencing tremors in her hands and heart palpitations.
Upon assessment, the nurse notes her pulse is bounding and irregular with a rate of 110 bpm. Her blood pressure is normal at 136/89. Her respiratory rate is twenty breaths per minute, and her oxygen saturation is 98%. Her temperature is mildly elevated at 100 degrees Fahrenheit, and her skin is warm and moist to the touch. The nurse notes a slight appearance of enlargement in her neck. Abdominal sounds are hyperactive, and edema is seen in her extremities. Labs are drawn, and the results are:
Mrs. Greene’s laboratory results
Test
Value
Normal Range
Flag
Platelet count
128,000
130,000-400,000
Low
Hematocrit (HCT)
38%
Female: 36%-47%
Male: 40%-54%
WBC
12.2
3.4 – 9.6
High
RBC
4.0
Female: 4.2-5.4
Male: 4.6-6.19
Hemoglobin
12.2
12-16
Glucose
76
74-106 mg/dL
Potassium
4.1
3.5-5 mmol/L
Mg
1.0
1.5-2 mEq/L
Blood Urea Nitrogen
24
8-21 mg/dL
High
pO2
98
75-100 mmHg
Na
138
135-145 mmol/L
Creatinine
0.7
0.8-1.3 mg/dL
pH
7.35
7.35-7.45
TSH
0.1
0.5-5
Low
Free T3
1.2 ng/dL
0.2-0.5ng/dL
High
Free T4
28 pmol/L
10-20 pmol/L
High
What might be the cause of Ms. Greene’s symptoms?
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