A 70-year-old woman comes to the emergency department with a history of confusion and increasing depression over the last week. Auscultation of the heart and lungs reveals fine crackles and an S3 heart sound

Question

Among other possible etiologies, the nurse considers which endocrine disorder? 1. Hypothyroidism
2. Graves' disease
3. Diabetes mellitus
4. Deficiency of luteinizing hormone

Answer 1

1
Rationale 1: Older adults with hypothyroidism are more likely to present with heart failure symptoms and cognitive impairment than are younger patients.
Rationale 2: Graves' disease is a form of hyperthyroidism, which would more likely present with cardiac dysrhythmia.
Rationale 3: Diabetes mellitus would be unlikely to present initially with depression and fluid volume overload.
Rationale 4: Luteinizing hormone stimulates ovulation, estrogen, and progesterone secretion in females. It is not likely to be a factor in a 70-year-old woman.