A nurse is assisting in the care of an adolescent.

The nurse is reviewing the data collection findings.

Select the 5 findings the nurse should report to the provider.

• Report of menstrual cycle (absent for 3 months): The nurse’s notes state that the client has not had a menstrual period for three months. In hyperthyroidism, menstrual irregularities such as amenorrhea are common due to hormonal imbalance. This supports hyperthyroidism based on the client's current symptoms..
• Weight change (unplanned weight loss): The client reports experiencing unplanned weight loss over three months despite having a good appetite. This suggests an increased metabolic rate, which is consistent with hyperthyroidism. Unintentional weight loss despite normal eating is a key indicator.
• Skin condition (warm and moist): The client's skin is described as warm and moist during physical assessment. Hyperthyroidism causes increased blood flow and sweat gland activity, leading to this type of skin condition. It reflects the body's accelerated metabolic processes.
• Neck exam (goiter visualized): The nurse notes the presence of a visible goiter on neck examination. A goiter indicates thyroid gland enlargement, which occurs in hyperthyroidism due to overstimulation and overproduction of thyroid hormones. This is a major physical finding.
• Laboratory results (T3, T4, TSI ordered): The provider orders tests for T3, Free T4, and TSI to evaluate thyroid function. These specific labs are ordered when hyperthyroidism is suspected, particularly TSI which is associated with Graves’ disease. The decision to order them aligns with the findings.
• Eye appearance (exophthalmos noted): Exophthalmos, or outward bulging of the eyes, is noted by the nurse. This finding is strongly associated with hyperthyroidism, especially Graves' disease. It occurs due to inflammation and fluid buildup behind the eyes, worsening as thyroid dysfunction progresses.

A. "I have nosebleeds once per week.": Occasional nosebleeds are relatively common during pregnancy due to hormonal changes causing increased vascularity and congestion of the nasal passages. While the frequency should be noted, it's generally not a priority to report unless they are severe, frequent, or difficult to control.

B. "My heart feels like it skips a beat.": Palpitations can occur during pregnancy because of increased blood volume and changes in cardiovascular function. Occasional palpitations are typically benign but should be further evaluated if they become persistent or are associated with other symptoms like chest pain.

C. "I am experiencing persistent headaches.": Persistent headaches during pregnancy, especially after 20 weeks gestation, can be a warning sign of preeclampsia, a serious hypertensive disorder. Reporting this symptom immediately is critical to assess for elevated blood pressure, proteinuria, and other complications.

D. "The palms of my hands are red and blotchy.": Red, blotchy palms, known as palmar erythema, are a common and harmless finding during pregnancy due to increased estrogen levels. It does not usually indicate any serious condition and does not require urgent reporting.