The client presents to clinic reporting a 3-month history of unplanned weight loss, increased sweating and heat intolerance, and feeling fatigued and unable to sleep well.

Oriented x 4. Answers questions appropriately, follows simple commands. Heart rate regular, S1 S2 auscultated. No abnormal heart sounds heard. Respiration even and unlabored. Lung sounds clear to auscultation. Abdomen soft, flat, normoactive bowel sounds in all four quadrants. Client states, "appetite is good" and stools are soft and brown.

Reports voiding without difficulty, clear yellow urine.

Reports last menstrual period was 3 months ago.

Skin is warm and moist. Exophthalmos noted, goiter visualized on neck.

Client's partner reports that the client is irritable and anxious lately.