The school nurse practitioner is consulted by a fifth-grade teacher about a student who has become increasingly inattentive and hyperactive in the classroom. The nurse notes that the child's weight has changed from the 50th percentile to the 30th
percentile. The nurse is concerned about possible hyperthyroidism. What additional sign or symptom should the nurse anticipate?
a. Skin that is cool and dry
b. Blurred vision and loss of acuity
c. Running and being active during recess
d. Decreased appetite and food intake
ANS: B
Visual disturbances such as loss of visual acuity and blurred vision are associated with hyperthyroidism. They may occur before the actual onset of other symptoms. The child's skin is usually warm, flushed, and moist. Although the signs of hyperthyroidism include excessive motion, irritability, hyperactivity, short attention span, and emotional lability, these children are easily fatigued and require frequent rest periods. Children with hyperthyroidism have increased food intake. Even with voracious appetites, weight loss occurs.
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