Ch. 43: Psychosocial Issues of Infants, Children, and Adolescents-Maltreatment of Infants and Children Flashcards
Maltreatment of children is made up of several specific types of behavior, which include what? (4)
- Physical maltreatment
- Sexual maltreatment
- Emotional maltreatment
- Neglect
What kind of maltreatment is this:
Causing pain or harm to a child
Physical
What are examples of physical maltreatment?
- Shaken baby syndrome
- Fractures
- Munchausen syndrome by proxy
What kind of maltreatment is this:
Occurring when sexual contact takes place without consent, whether or not the victim is able to give consent
*includes sexual behavior toward a minor and dating violence among adolescents
Sexual maltreatment
What kind of maltreatment is this:
Humiliating, threatening, or intimidating a child
*includes behavior that minimizes an individuals feelings of self worth
Emotional maltreatment
What are the two types of neglect?
- Physical care
2. Emotional care &/or stimulation
What are examples of physical care neglect?
Neglecting to feed, clothe, shelter, provide medical/dental care, provide safety, and education
What are examples of emotional and/or stimulation neglect?
Neglecting to nuture, provide affection, or attention
What are some parental characteristics to those who are more likely to do maltreatment (9)
Young parents Single parents Socially isolated Substance abuse disorder Low income Low self-esteem Lack of lower education level Lack of knowledge of parenting History of being abused
What are characteristics of children who are at risk for maltreatment? (3)
- 1 year or younger=greater risk due to need of constant attention and increased demand of caregiving
- Infants and children who are UNWANTED, HYPERACTIVE, or PHYSICALLY/MENTALLY disabled!–> all require increased demands!!
- PREMATURE INFANTS–due to possible failure of parent child bonding at birth
What are environmental characteristics that put children at risk for maltreatment?
Chronic stress (of parent..?) Divorce Alcohol use disorder Drug addiction POVERTY Unemployment Inadequate housing Crowded living conditions
What are some subjective and objective data that may be gathered if suspected abuse?
- Inconsistencies between parents report and childs injuries
- Inconsistency between nature of injury and development level of the child
- Repeated injuries that require emergency treatment
- Inappropriate responses from the parent to child
What type of maltreatment:
- FTT
- Malnutrition
- Lack of hygiene
- Frequent injuries
- Delay in seeking healthcare
- Dull affect
- School absence
- Self stimulating behaviors`
Physical neglect
What type of maltreatment:
- Bruises, welts in various stages of healing
- Burns
- Fractures
- Lacerations
- Fear of parents
- Lack of emotional response/reaction
- Superficial relationships
- Withdrawal
- Aggression
Physical abuse
What type of maltreatment:
- FTT
- Eating disorder
- Enuresis
- Sleep disturbances
- Self stimulation behaviors
- Withdrawal
- Lack of social smile (infant)
- Extremem behaviors
- Delayed development
- Attempts suicide
Emotional neglect and abuse
What type of maltreatment:
- Bruises, lacerations, bleeding of genitalia, anus, or mouth
- STI
- UTI
- Regressive behavior
- Withdrawn
- Personality changes
Sexual abuse
What happens to the baby in shaken baby syndrome?
Shaking can cause intracranial hemorrhage
What are some manifestations of shaken baby syndrome?
- Vomiting, poor feeding and listlessness
- Respiratory distress
- Bulging fontanels
- Retinal hemorrhages
- Seizures
- Posturing
- LOC changes
- Apnea
- Bradycardia
What happens if bruising is present in an infant less than 6 months?
Deemed suspicious by the nurse
What lab tests are given to assess for STI or bleeding?
CBC
Urinalysis
Where would we assess for unusual bruising?
Abdomen
Back
Buttocks
What kind of bruises should we observe for–what shape?
Welts in the shape of a belt buckle or other object
What should we observe for burns?
Burns that appear glove or stocking like on the hands or feet (immersion into boiling water)
Or burns that are small and round (cig burns)
What kind of fracture could be caused by twisting the extremity forcefully?
Forearm spiral fractures
The presence of multiple fractures is ____
Suspicious
For maltreatment cases, what is the nurses priority in regards to nursing care?
Have the child removed from the abusive situation
Mandatory reporting is required of all health care providers. Do we still report if we only suspect it?
Yes, mandatory reporting is required of all health care providers, including SUSPECTED or ACTUAL cases of child abuse
What charges may we face if we did not report abuse?
Civil and criminal penalties!!
Should we photograph visible injuries of abuse?
Yes–photograph and detail all visible injuries
What kind of questions should we ask the clients of abuse?
Use open-ended questions that require a descriptive response–these questions are less threatening and elicit more relevant info
Is it okay to probe the child when trying to get information about abuse?
NO!! AVOID proving the child!!! (remember, probing is non-therapeutic form of communication!)
