Chapter 22: Maltreatment of Children

Question 1

Child Maltreatment

Answer 1

includes abuse and neglect of a child less than 18 years of age by anyone who is in a caregiver or custodial role

Question 2

Child Physical Abuse

Answer 2

may result in injury inflicted by beating, pushing, kicking, pinching, burning, or choking

Question 3

Physical Abuse

Answer 3

includes traumatic brain injury, which manifests as symptoms r/t head trauma as a result of forceful shaking of the infant or young child

Question 4

Child Sexual Abuse

Answer 4

involves any sexually related act, usually between a child and an adult (related or not) that can include fondling, forced or assented oral sex or intercourse, sodomy, exposing children to adult sexual behavior (showing pornography to children), and exploiting through child pornography or prostitution

Question 5

Child Emotional Abuse

Answer 5

includes any behavior, attitude, or failure to act that disrupts children’s socio-emotional development and mental health
-ex: shaming or humiliating (“you are worthless”), and intimidating (threatening and frightening)

Question 6

Child Neglect

Answer 6

involves failure to provide emotional and physical care as well as opportunity for education

Question 7

Munchausen-by-proxy Syndrome

Answer 7

person, usually the mother, deliberately makes the child sick

Question 8

Electronic Sexual Luring

Answer 8

enticing children via computer or other electronic means

Question 9

Diagnosis

Answer 9

• family history, physical examination, and development assessment
• x-ray various areas of the body
• serum chemistry lab tests to determine any infection, drug induction, or toxicity

Question 10

Prevention

Answer 10

if nurse can identify risk factors

• children with disabilities
• children of very young parents
• children of single mothers who live in poverty
• parents who suffer from mental or chronic physical illness
• parents who have: extremely stringent ideas of discipline may use hard punishment, excessive stress, marital conflict
• parental substance abuse
• intergenerational history of abuse

Question 11

Nursing Care

Answer 11

• discuss with parents ways to discipline the child that do not involve physical or verbal aggression
• educate parents regarding birth control to decrease unintended pregnancies’
• instruct mothers about the use of alcohol or drugs during pregnancy and the impact it has on the growing baby
• decrease the use of drugs or alcohol by new parents
• improve the availability of and access to healthcare across the spectrum of the family’s life
• educate children and adolescents about the body and personal boundaries
• advocate for political initiatives to help avoid and ultimately stop child abuse

Question 12

Education/Discharge

Answer 12

• provide parents with information regarding “normal” stages of growth and development
• provide family education about what to expect from parenthood
• instruct parents how to cope with some of the difficult times related to raising a child
• help parents develop resources for support, such as babysitters, family members, and community resources

Question 13

Physical Abuse and What it Looks Like in the Child

Answer 13

bodily injury caused by intentional or unintentional physical aggression
-Tactics of Abuse: beating, hitting, slapping, poisoning, kicking, pinching, biting, shoving, choking, pulling hair, burning, excessive corporal punishment; Shaken baby syndrome; Munchausen by proxy
>S/S:
-suspicious bruises, welts, or burns
-unexplained fractures or dislocations
-new and healing or healed lacerations or abrasions
-wariness of adults or caregivers
-fearful of going home
-acting out with aggression
-retinal hemorrhages
-CNS injury
-prolonged or recurrent illnesses or injuries that cannot be explained

Question 14

Sexual Abuse and what it looks like in the Child

Answer 14

sexual acts involving an adult and a child
-Tactics of Abuse: penetration, incest, rape, oral sex, sodomy, fondling, violations of bodily privacy, exposing children to adult sexuality
>S/S:
-inappropriate or precocious interest in or knowledge of sexuality
-poor peer relationships
-sudden changes in behavior (regressive, acting out, sexual behavior, enuresis, recurrent urinary tract infections, redness and swelling of genitalia)
-running away from home or substance abuse
-rapidly declining school performance
suicide attempts

Question 15

Emotional Abuse and what it looks like in a Child

Answer 15

attitude, behavior, or failure to act that interferes with a child’s mental health or social development
-Tactics of Abuse: intimidation, belittling, shaming, habitual blaming, ignoring or rejection, extreme punishment, exposure to violence, child exploitation, child abduction
>S/S:
-apathy
-depression
-hostility
-difficulty concentrating

Question 16

Neglect and what is looks like in a Child

Answer 16

pattern of failing to meet basic needs
-Tactics of Abuse: physical, educational, emotional
>S/S:
-clothing unsuited to the weather
-poor hygiene
-hunger
-lack of supervision