A 12-year-old girl presents to the pediatric clinic with complaints of severe lower abdominal pain during her menstrual periods, which started six months ago.
She describes the pain as cramping and rates it as 8 out of 10 on the pain scale.
Her mother reports that over-the-counter pain medications have provided little relief.
What would be the recommended first-line treatment for her and what is the medical term for this condition?

Choice A rationale

Asking if the child has eaten recently is important for understanding potential causes of elevated blood glucose and to consider the timing of insulin administration relative to meals. However, it does not directly ensure the medication being administered is correct for the right patient.

Choice B rationale

Verifying the child's identity using at least two identifiers and comparing the medication order to the prescription ensures that the right medication, dose, route, and time are being administered to the correct patient. This is a critical step in preventing medication errors and ensuring patient safety, especially with a high-risk medication like insulin.

Choice C rationale

Ensuring the child is comfortable and relaxed is beneficial for the child's overall well-being and can indirectly influence physiological parameters. However, it does not directly address the critical step of verifying the medication and patient identity before administration.

Choice D rationale

Preparing insulin without checking the expiration date is a medication error. Expired medications may have reduced potency or altered chemical properties, potentially leading to ineffective treatment or adverse effects. Checking the expiration date is a fundamental safety check.

Choice A rationale

Currant jelly stools (stools mixed with blood and mucus) and drawing the knees to the chest are classic signs and symptoms of intussusception in infants. The telescoping of one part of the intestine into another leads to bowel obstruction, inflammation, and bleeding, resulting in the characteristic stool appearance and abdominal pain that causes the infant to draw their knees up in an attempt to relieve the discomfort.

Choice B rationale

Ribbon-like stools and visible peristalsis are more characteristic of Hirschsprung's disease (congenital aganglionic megacolon), a condition where a segment of the colon lacks nerve cells, impairing motility and leading to constipation and a narrowed segment of the bowel. Visible peristalsis can occur due to the bowel trying to push stool through the narrowed segment.

Choice C rationale

Explosive watery diarrhea and fever are typical signs of gastroenteritis, an inflammation of the gastrointestinal tract usually caused by a viral or bacterial infection. While vomiting can occur in both conditions, the stool characteristics and the presence of fever are more indicative of gastroenteritis rather than intussusception.

Choice D rationale

Bright red blood in the stool without other symptoms is less specific to intussusception. While blood can be present, it is usually mixed with mucus, giving the currant jelly appearance. Bright red blood alone might suggest other conditions like anal fissures or lower gastrointestinal bleeding. .