A nurse is speaking with a family member of a client who has a terminal diagnosis. The family member states, "I'm having a hard time letting her go." The nurse should recognize that the family member is experiencing which of the following types of grief?

• Pain rating: Severe, intermittent abdominal pain where the child draws their knees to the chest and then returns to normal behavior is a classic symptom of intussusception. Neither Crohn’s disease nor appendicitis typically presents with this pattern, appendicitis pain is usually constant and worsening, while Crohn’s pain is chronic and non-episodic.
• Vomiting: Vomiting in intussusception is common and often non-bilious in early stages, aligning with the child's light-colored emesis. Vomiting also occurs in appendicitis, especially in the early stages. However, it is not a prominent or early symptom of Crohn’s disease unless obstruction is present.
• Stool: The presence of blood and mucus in the stool ("currant jelly stool") is strongly associated with intussusception and may also occur in Crohn’s disease during flares due to colonic inflammation. Appendicitis does not typically cause bloody or mucoid stools, making this finding inconsistent with that diagnosis.
• Temperature: A temperature of 37.4°C is within normal limits, appendicitis however may present with low grade fever. The absence of fever at this time limits its diagnostic value in this case.
• Abdominal findings: A distended abdomen with hypoactive bowel sounds and a palpable sausage-shaped mass in the right upper quadrant is highly indicative of intussusception. These findings are not characteristic of appendicitis, which usually involves RLQ pain, or Crohn’s, which rarely presents with a discrete palpable mass.

A. "You should take a second dose if there is no relief within fifteen minutes after the initial dose." The second dose of sumatriptan should not be taken sooner than 2 hours after the first dose if there is no relief or if the migraine returns. Taking it too soon increases the risk of adverse effects.
B. "You may experience low blood pressure while taking this medication." Sumatriptan more commonly causes hypertension, not hypotension. It can cause vasoconstriction, which may elevate blood pressure and poses risks, especially in clients with cardiovascular disease.
C. "You should have complete relief in six hours after taking this medication." Relief from sumatriptan is often experienced within 1–2 hours after administration. While not all clients achieve complete relief, the medication acts quickly, and six hours is not the expected timeframe.
D. “You may experience muscle cramps as a potential adverse effect of the medication." Muscle cramps or tightness in the chest, neck, or limbs can occur due to vasoconstriction caused by sumatriptan. This is a known side effect and should be reported if severe or persistent.