Hyperthyroidism can present along a spectrum from the minimally symptomatic to severely decompensated and presentation can vary with age
If there are a lot of interconnecting systems complaints consider obtaibning a TSH, t3 and t4
Once you’ve diagnosed hyperthyroidism, dont anchor on it. Look for what might have caused it especially in those with comorbidities
If the patient is stable and reliable you can discharge them home with Atenolol. Make sure to have the patient follow up with their PCP or Endocrinologist. If, however, you feel uncomfortable doing that or the patient needs more social support, call your endocrinologist on call and get their recommendations.