Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action?
a. New-onset changes in the patient's voice
b. Apical pulse rate at rest 112 beats/minute
c. Elevation in the patient's T3 and T4 levels
d. Bruit audible bilaterally over the thyroid gland
ANS: A
Changes in the patient's voice indicate that the goiter is compressing the laryngeal nerve and may lead to airway compression. The other findings will also be reported but are expected with Hashimoto's thyroiditis and do not require immediate action.
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