Endocrine SIADH- Syndrome of Inappropriate Diuretic Hormone Too much ADH (antidiuretic hormone ) secretion leads to water intoxication and hyponatremia Causes include trauma, stroke, malignancies (often in the lungs or pancreas), medications, and stress S/S include signs of fluid volume overload, changes in level of consciousness and mental status changes, weight gain, hypertension, tachycardia, anorexia, nausea, vomiting, hyponatremia, concentrated urine, decreased urine output, serum osmolality decreased Nursing considerations include monitoring vital signs and cardiac and neurological status, providing a safe environment, particularly for the patient with changes in level of consciousness or mental status, monitoring intake and output and weight daily; monitoring fluid and electrolyte balance, monitoring serum and urine osmolality; restriction of fluids DI (Diabetes Insipidus)- Kidney tubules fail to reabsorb water Etiology includes stroke or trauma or may be idiopathic S/S include excretion of large amounts of dilute urine, polydipsia, dehydration (decreased skin turgor and dry mucous membranes), inability to concentrate urine, increased urine output, urine very dilute, Low urinary specific gravity, fatigue, muscle pain and weakness, headache, postural hypotension that may progress to vascular collapse without rehydration, tachycardia, hypernatremia Nursing Considerations: monitor vital signs and neurological and cardiovascular status, provide a safe environment, particularly for the patient with postural hypotension; monitor electrolyte levels and for signs of dehydration; maintain patient intake of adequate fluids; monitor intake and ouput, weight, serum osmolality and specific gravity of urine; instruct the patient to avoid foods and/or liquids that produce diuresis Hyperthyroidism- Too much thyroid hormone (T3 and T4) Characterized by an increased rate of body metabolism