A child is diagnosed with juvenile hypothyroidism. The nurse should expect to assess which symptoms are associated with hypothyroidism. (Select all that apply.).​​​​​​

Vernix caseosa is a cheese-like, whitish substance that fuses with the epidermis and serves as a protective coating for the newborn.

Some possible explanations for the other choices are:

• Choice B. Surfactant is a protein that lines the alveoli of the infant’s lungs and helps prevent them from collapsing.
• Choice C. Caput succedaneum is a swelling of the tissue over the presenting part of the fetal head caused by pressure during delivery.
• Choice D. Acrocyanosis is a bluish discoloration of the hands and feet due to reduced peripheral circulation.

Normal ranges for vernix caseosa are not applicable as it varies depending on the gestational age and skin maturity of the newborn. However, it is usually more abundant in preterm infants than in term or post-term infants.

Sleepiness or fatigue and puffiness around the eyes are symptoms associated with hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the body’s metabolism and energy levels.

Choice A is wrong because weight loss is more likely to occur in hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormones.

Choice C is wrong because diarrhea is also more likely to occur in hyperthyroidism, as the excess thyroid hormones speed up the digestive system.

Choice E is wrong because limited hair growth is not a specific symptom of hypothyroidism. Hair loss or thinning may occur in both hypothyroidism and hyperthyroidism, depending on the severity and duration of the condition.

Normal ranges for thyroid hormones are:

• TSH: 0.4 to 4.0 mIU/L
• T3: 100 to 200 ng/dL
• T4: 4.5 to 11.2 mcg/dL