Which of these assessments is the priority for a 14-year-old client diagnosed with ulcerative colitis?

Choice A rationale:
Hypoplastic left heart syndrome involves inadequate development of the left side of the heart, leading to systemic hypoperfusion. It is characterized by decreased pulmonary blood flow due to underdeveloped left heart structures.
Choice B rationale:
Tetralogy of Fallot is characterized by obstruction to blood flow, specifically pulmonary stenosis, which obstructs blood flow from the right ventricle to the pulmonary artery.
Choice C rationale:
Atrial Septal Defect (ASD) is a left-to-right shunt, leading to increased pulmonary blood flow. This occurs because oxygenated blood from the left atrium flows back into the right atrium and then into the pulmonary circulation.
Choice D rationale:
Aortic Stenosis is not correctly matched with its hemodynamic classification. Aortic stenosis involves obstruction to blood flow from the left ventricle to the aorta.

Choice A rationale:

Ribbon-like stools are a classic sign of Hirschsprung's disease, indicating narrowed or obstructed bowel segments due to the absence of ganglion cells in the intestine's muscular layers.

Choice B rationale:

A distended abdomen is common in Hirschsprung's disease due to the accumulation of stool and gas in the narrowed segments of the intestine.

Choice C rationale:

Chronic constipation is a result of the dysfunctional intestinal motility caused by Hirschsprung's disease. The absence of ganglion cells leads to a lack of peristalsis and difficulty passing stools.

Choice D rationale:

Black and tarry stools are indicative of upper gastrointestinal bleeding, often caused by conditions like peptic ulcers. This finding is not directly related to Hirschsprung's disease.