Which of the following statements by an eighteen-year-old best illustrates their developmental stage?

Choice A reason: Mild abdominal pain is not an urgent finding in a child who had emergency reduction for intussusception. It is expected that the child may have some discomfort after the procedure, which can be managed with analgesics and comfort measures. Mild abdominal pain does not indicate a recurrence or complication of intussusception.

Choice B reason: Currant jelly stools are a serious finding in a child who had emergency reduction for intussusception. They are a sign of bowel ischemia and necrosis, which can lead to perforation and peritonitis. Currant jelly stools are stools mixed with blood and mucus, which have a red or purple color and a jelly-like consistency. They are caused by the pressure of the intussuscepted bowel segment on the blood vessels, resulting in bleeding and inflammation. Currant jelly stools indicate that the intussusception has not been completely reduced or has recurred, and require immediate medical attention.

Choice C reason: Axillary temperature of 37.3°C is not an alarming finding in a child who had emergency reduction for intussusception. It is within the normal range for an axillary temperature, which is usually lower than the oral or rectal temperature. A slight elevation of temperature may also be due to the stress of the procedure or a mild infection, which can be treated with antibiotics and fluids. Axillary temperature of 37.3°C does not suggest a serious complication of intussusception.

Choice D reason: BP of 100/54 is not a worrisome finding in a child who had emergency reduction for intussusception. It is within the normal range for a 10-month-old child, which is about 90/60 mmHg. A slight variation of blood pressure may also be influenced by factors such as activity, emotion, pain, or medication. BP of 100/54 does not indicate a problem with the child's circulation or cardiac function.

Choice A reason: This is not the correct order, as obtaining blood cultures should be done after starting high dose antibiotics, not before. This is because antibiotics can interfere with the detection of bacteria in the blood and affect the accuracy of the diagnosis¹.

Choice B reason: This is not the correct order, as administering high dose steroids is not indicated for infective endocarditis, unless there is evidence of severe inflammation or allergic reaction. Steroids can suppress the immune system and increase the risk of infection².

Choice C reason: This is not the correct order, as starting the child on high dose aspirin is not recommended for infective endocarditis, unless there is evidence of thromboembolic complications or Kawasaki disease. Aspirin can increase the risk of bleeding and interfere with the action of antibiotics³.

Choice D reason: This is the correct order, as starting high dose antibiotics, obtaining serial blood cultures, and putting the child on high flow oxygen are the appropriate interventions for infective endocarditis. Antibiotics are the main treatment to eradicate the infection and prevent complications. Serial blood cultures are done to monitor the response to antibiotics and identify the causative organism. High flow oxygen is given to improve the oxygen delivery and tissue perfusion¹².