NR 511 Week 6 Part 1 Case Study

NR 511 Week 6 Part 1 Case Study A 56 year old female patient reports constant fatigue for 2-3 months with a 5 pound weight gain in the last six months. The patient reports sleeping approximately 8 hours at night but feels unrested with lack of energy to perform daily tasks. She is an office manager in a physician office full time and reports missing work one day 2 weeks ago due to extreme fatigue. Other reported clinical symptoms that could determine a differential diagnosis include: constipation, generalized weakness, and muscle cramping intermittently to calves, cold intolerance, as well as worsening depression due to feeling unproductive. Physical assessment finding that are pertinent to clinical diagnosis includes: dry skin, thick coarse hair and decreased deep tendon reflexes in BLE, thyroid is small and firm. Her PMH includes; HTN, Depression and is postmenopausal. Her allergies include iodine dyes. BP 146/95 she is prescribed Bisoprolo-HCTZ 2.5mg/6.25mg. The patient denies sleep disorders and any complaints of sleep apnea which also rules out the cause of her chief complaint. With all the gathered information I have concluded the following differential diagnoses in order as most likely to least likely. 1. Hypothyroidism 2. Anemia 3. Depression