Final answer:
The nurse should report severe symptoms indicating high ADH levels resulting in water retention and hyponatremia, such as confusion or altered consciousness in patients with SIADH. Similarly, for diabetes insipidus, the lack of ADH leads to increased thirst and urination, posing a risk of dehydration and electrolyte imbalances.
Step-by-step explanation:
The topic in discussion relates to the syndrome of inappropriate antidiuretic hormone (SIADH), which is characterized by excess release of antidiuretic hormone (ADH) or vasopressin. This hormone plays a critical role in regulating the body's water balance by signaling the kidneys to reabsorb more water. In the context of SIADH, the nurse should report critical findings that may indicate severe elevations in ADH resulting in water retention and hyponatremia (low sodium levels in the blood), which could present as confusion, seizures, or an altered level of consciousness.
These symptoms could be exacerbated in situations like that presented in the emergency department scenario where a patient has a low blood pressure of 70/45, is confused, and complaining of thirst, which may indicate shock and severe hyponatremia requiring immediate medical intervention.
A contrasting condition is diabetes insipidus, which is characterized by the underproduction of ADH or a mutation in the ADH receptor. Patients with diabetes insipidus exhibit symptoms like increased thirst and urine output due to the kidneys' inability to retain water, leading to persistent dehydration and possible electrolyte imbalances if the condition is severe.