child abuse

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Author:
mthompson17
ID:
209715
Filename:
child abuse
Updated:
2013-03-26 20:03:25
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nursing child abuse
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child abuse
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  1. What age group has the highest rate of child abuse?

    Why
    age birth to 1 year old

    their crying makes ppl crazy
  2. PURPLE?
  3. Abuse in order of prevalence? (4)
    neglect, physical, psychological, sexual
  4. Why do most ppl neglect their children?

    What should the nurse do even if it is not extreme neglect?

    Intervention?
    parent for some reason cannot take care of child, but most want to

    do something about

    do not blame the parent
  5. S/S of neglect?
    • 1. inappropriate dress
    • 2. hungry all the time:  hoarding food at school
    • 3. poor hygiene:  staff infection
    • 4. rashes
    • 5. consistent lack of supervision:  left alone
    • 6. medical neglect:  not taken to the MD not r/t financial
    • 7. abandonment
    • 8. nonorganic failure to thrive
    • 9. missing a lot of school
  6. When should nurse report s/s of neglect/abuse?
    mandatory reporting for reasonable suspision

    do not have to prove it
  7. Serious abuse rates are highest in ____ & ____ pt.
    infants and medicaid pt
  8. PURPLE?
    • P- peak of crying - cry more each week until 2 months old then less at 3-5 mo old
    • U- unexpected - crying can come and go for no reason
    • R- resists soothing - may cry nonstop no matter what you do
    • P- pain-like face - may look like they are in pain even if they arent
    • L- long lasting - can last up to 5 h per day
    • E- evening - may cry more in late pm
  9. Shaken baby syndrome?
    causes coup-contrecoup injury with BV sheared off b/c head is so big and
  10. Complications of shaken baby?
    sheared BV with subdural hematomas and intracranial hemorages, retinal hemorrhages, cranial and skeletal fractures, posterior rib fractures
  11. Number one red flag for child abuse?
    history doesn't fit the clinical picture
  12. S/S of shaken baby syndrome?
    • 1. lethargy
    • 2. irritability
    • 3. vomiting
    • 4. fever
    • 5. poor feeding
    • 6. breathing abnormalities
    • 7. apnea
    • 8. bulging fontanel
    • 9. seizures
  13. Complication of shaken baby syndrome?
    long term neuro defects
  14. 4 perpetrators of shaken baby syndrome in order of prevalence?
    father, stepfather, mother, baby sitters
  15. How can shaken baby syndrome be reduced?
    education of caregivers about the risks
  16. What to teach CG about babys who cry a lot?
    sometimes OK to just let them cry
  17. Intervention to encourage parent and point out a bond b/t baby and parent?
    let parent know they are doing good and point out a detail that shows bond b/t parent and child
  18. Teaching about a baby that cries a lot?
    • 1. make sure all needs are met
    • 2. make sure not sick or have temp
    • 3. recognize when they are getting frustrated and have a plan
    • 4. put baby in crib on back and step away for a while
    • 5. good if can call support person to come get the kid
  19. In all age groups who is most at risk for child abuse?
    children who get medicaid
  20. Family risk factors that increase abuse potential?
    • 1. escalating stress levels
    • 2. social isolation with no support
    • 3. unstable family situations:  domestic violence, alcohol, drugs
    • 4. parent with depression
    • 5. young, single parent with no one to help
    • 6. lower education level
    • 7. parent who was abused as a child
  21. Risk factors associated with the child?
    • 1. preemies - require a lot of care
    • 2. disabilities in child
    • 3. first-born child may be abused more
    • 4. stepchild
    • 5. if child has been abused once much higher risk for next abuse
  22. Questions that can clue that there could be a prob?
    • 1. who helps
    • 2. how are you handling it
    • 3. is it what you expected
    • 4. what do you think is the hardest part
  23. S/S of child abuse?
    • 1. delay in seeking medical help
    • 2. evasiveness/vagueness
    • 3. initial report of no trauma
    • 4. changing story
    • 5. evidence of previous injuries
    • 6. inconsistencies/ clinical findings do not match Hx
  24. 2 cultural practices that may be mistaken for abuse?
    coining and cupping
  25. What is coining?
    purposefully bring the blood to the surface to get rid of fever and illness
  26. What is cupping?
    take a cup and put a candle under it to get all the O2 out of it then put it on the back to suction it- to get rid of pain
  27. What types of marks are deliberate?
    usually linear or circular
  28. Characteristics of bruising that signal abuse?
    • 1. unexplained
    • 2. in different stages of healing
    • 3. in strange patterns
  29. Characteristics of burns that are intentional?
    normal burns are splatter burns

    intentional will be sock or mitten burns
  30. Mouth trauma and abuse?
    can be caused by putting bottle in too hard and tear frenulum
  31. Abuse and ear trauma?
    bruises on the back indicate abuse
  32. Bite marks and abuse?
    little kids bite each other

    measure the bit mark- if it is big ppl teeth it is child abuse
  33. First priority with child abuse?
    do whatever you need to do to protect the child

    do not let the child leave with the child:  lie
  34. Types of emotional abuse?
    verbal, extreme punishment that terrorizes the child, corruption, not showing affection
  35. S/S of emotional abuse?
    • 1. extremes in behavior being very aggressive or very passive
    • 2. delayed physical, emot, or intellectual dev
    • 3. low self esteem
    • 4. depression
    • 5. anxiety
    • 6. clingy/needy
    • 7. probs with school work
    • 8. alc, drugs
    • 9. eating disorders
    • 10. scuicidal
    • 11. criminal behavior
  36. S/S of sexual abuse?
    • 1. regression:  bedwetting, thumb sucking
    • 2. new words for private body parts that parents didn't teach them
    • 3. don't want to remove clothing when it would be appropriate
    • 4. play sexual games or play sexually with dolls
    • 5. wetting, soiling accidents that are not related to potty training - can be a sing of trauma
    • 6. self-injury
    • 7. inadequate personal hygeine and weight gain
    • 8. sexual promiscuity
    • 9. compulsive eating or eating disorders
  37. Physical S/S of sexual abuse?
    • 1. pain, discoloration
    • 2. around genitals or mouth
    • 3. sti
    • 4. pain on urination or defecation
  38. Best way to prevent sexual abuse?
    • 1. diff b/t good and bad touch
    • 2. know that they can say no
    • 3. with kids need to use concrete examples
    • 4.
  39. Consequences of abuse?
    • 1. more teen pregnancy
    • 2. be arrested as adults and juvenile
    • 3. more likely to do violent crime
    • 4. more likely to have a psychological disorder
    • 5. economic cost of medical treatment
    • 6. more likely to abuse their children
  40. Reporting abuse?
    • 1. Try to remain objective and give facts with no opinions or conclusions you've drawn
    • 2. report the abuse to child protective services NOT your nursing supervisor
    • 3. reporter should someone who has firsthand knowledge of the facts
  41. How do you behave around a suspected abuser?
    do not be accusatory and allow them to know that you suspect them of abuse

    don't act any differently that you normally would and STAY with the child
  42. Common excuses to not reprot?
    • 1. probably wrong
    • 2. don't want to interfere
    • 3. break up home
    • 4. they'll know it was me
    • 5. It won't make any difference anyway
  43. Stopping abuse in a public place?
    • 1. start a conversation with the adult to divert att. from the child:  Say that ch can wear you out and ask if there is anything you can do to help
    • 2. Talk to child to divert their att if they are misbehaving
    • 3. Look for the first oppurtunity to praise the adult or child
    • 4. Offer assistance if the child is in danger
    • 5. Avoid negetive remarks or looks
  44. 3 ways nurse can prevent child abuse?
    • 1. educate parents
    • 2. be aware of support groups
    • 3. voluteer
  45. 8 behavioral indicators of physical abuse?
    • 1. self destructive
    • 2. withdrawn and/or aggressive
    • 3. arrives early and stays late to school - doesn't want to go home
    • 4. chronic runaway
    • 5. complains of soreness or moves uncomfortably
    • 6. wears clothing inapporpriate to weather to cover body
    • 7. bizarre explanation of injuries
    • 8. wary of adult contact
  46. 7 behavioral S/S of physical neglect?
    • 1. regular fatigue/listlessness
    • 2. steals food, begs
    • 3. reports no CG at home
    • frequently absent or tarsdy
    • 4. self destructive
    • 5. school dropout
    • 6. extreme lonliness and need for affection
  47. 6 behavioral S/S of sexual abuse?
    • 1. excessive seductiveness
    • 2. role reversal, overly concerned for siblings
    • 3. massive weight change
    • 4. suicide attempts
    • 5. inappropriate sex play or premature understanding of sex
    • 6. thretended by phys contact, closeness
  48. 6 S/S of emotional abuse?
    • 1. habit disorder
    • 2. antisocial, destructive
    • 3. neurotic traits
    • 4. passive and aggressive behavior extremes
    • 5. developmentally delayed

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