Final answer:
The nurse should contact a healthcare provider before administering levothyroxine in the case of distant and difficult to hear heart sounds, as this could indicate a serious cardiac issue that needs immediate attention.
Step-by-step explanation:
The finding that indicates the nurse should contact a healthcare provider before administering levothyroxine (Synthroid) to a patient with hypothyroidism and hypertension is c. Distant and difficult to hear heart sounds. These symptoms may suggest cardiac tamponade or severe fluid overload, both of which require immediate medical attention. Administering levothyroxine in such a situation could exacerbate the patient's condition.
Increased thyroxine (T4) levels would typically not be expected in hypothyroidism, as this condition is characterized by low levels of thyroid hormones. Therefore, administering levothyroxine is generally employed to correct this deficit. A blood pressure of 112/62 mmHg is within normal range and should not contraindicate levothyroxine administration. An elevated thyroid stimulating hormone (TSH) level is indicative of hypothyroidism, signaling a need for thyroid hormone replacement, hence levothyroxine would be indicated in this case.