The nurse suspects the client's dose of levothyroxine (Synthroid) is too low when the client displays which symptom?

Choice A reason: While individuals with rheumatoid arthritis may have an increased risk of infection due to the disease itself or the use of immunosuppressive medications, it does not pose as high a risk as intravenous lines for sepsis.

Choice B reason: A peripherally inserted central catheter (PICC) line, especially when used for total parenteral nutrition (TPN), presents a significant risk for infection due to the direct access to the bloodstream, making this client at the highest risk for sepsis.

Choice C reason: Asthma and bronchitis can lead to respiratory infections, but these conditions do not typically result in sepsis unless the infection becomes severe and systemic.

Choice D reason: Renal calculi (kidney stones) can cause infections; however, they are less likely to lead to sepsis compared to a central line.

Choice A reason: Tachycardia and weight gain are not typically associated with low T4 levels. Tachycardia and weight loss are more commonly seen in hyperthyroidism, where T4 levels would be elevated.

Choice B reason: Diarrhea and hypoglycemia are not directly related to low T4 levels. Diarrhea can be a symptom of hyperthyroidism, while hypoglycemia is not commonly associated with thyroid function.

Choice C reason: Hypotension and periorbital edema are findings that can be associated with hypothyroidism, which is consistent with the low T4 level of 2.9 mcg/dL. Hypothyroidism can lead to reduced cardiac output and systemic vascular resistance, causing hypotension. Periorbital edema is also a common sign of hypothyroidism due to mucopolysaccharide deposition in the skin.

Choice D reason: Tremors and dyskinesias are more commonly associated with hyperthyroidism, not hypothyroidism. Elevated levels of thyroid hormones can lead to these neurological symptoms.