The nurse continues to care for the client.

Exhibits

For each assessment finding, click to specify if the finding is consistent with psychosis or mania. Each finding may support more than one diagnosis.

A. "My home has running water and electricity." This statement suggests adequate access to basic utilities, which supports hygiene and reduces risk for illness. It does not indicate a health risk.
B. "I eat vegetables directly from the field where I work." This poses a significant health risk due to potential pesticide exposure and contamination with harmful chemicals or microbes. Produce should be properly washed before consumption to reduce the risk of illness or poisoning.
C. "I wear a hat and long sleeves while I am working." This is a protective behavior, helping to reduce sun exposure, skin damage, and pesticide contact, and is not a health risk.
D. "I am currently sharing my home with two roommates." While crowded living conditions can pose some risk, this alone does not indicate a major health concern, especially if basic sanitation and ventilation are adequate.

• 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.