K.B. is a 65-year-old man admitted to the hospital after a 5-day episode of "the flu" with complaints of dyspnea on exertion, palpitations, chest pain, insomnia, and fatigue. K.B
was diagnosed with Graves' disease
6 months ago and placed on methimazole (Tapazole) 15 mg/day. His other past medical history includes
heart failure and hypertension requiring antihypertensive medications; however, he states that he has
not been taking these medications on a regular basis. Vital signs (VS) are: 150/90, 124 irregular, 20, 100.2 °
F (37.9 ° C). Admission assessment findings are: height 5 ft, 8 in; weight 132 lb; appears anxious and restless; loud heart sounds; 1+ pitting edema noted in bilateral lower extremities; diminished breath sounds
with fine crackles in the posterior bases. K.B. begins to cry when he tells you he recently lost his wife; you
notice someone has punched several more holes in his belt so he could tighten it.
Which of K.B.'s assessment findings represent manifestations of hypermetabolism?
Anxiety, restlessness, insomnia, increased systolic blood pressure (BP), palpitations, dysrhythmias,
tachycardia, dyspnea, elevated temperature, low weight-to-height ratio.
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