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NURS 306 - Exam 4 > Child Maltreatment > Flashcards

Child Maltreatment Flashcards

1
Q

What is child maltreatment?

A

Intentional physical, emotional, or sexual abuse

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2
Q

Most cases of child maltreatment are ______

A

Neglect

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3
Q

Who are the typical perpetuators of child maltreatment? (4)

A
  • Parents
  • Caregivers
  • Home visitors
  • Significant others of parents
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4
Q

What is child neglect?

A

Failure of a parent to provide basic needs / care

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5
Q

Child neglect typically affects children of what age?

A

< 5 years old

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6
Q

Why are children < 5 years old most at risk for child neglect?

A

They rely on adults for basic needs - food, water, clothing (cannot get help)

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7
Q

What factors contribute to neglect? (3)

A
  • Lack of knowledge
  • Lack of resources
  • Caregiver substance abuse
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8
Q

The nurse is required to treat parents of suspected child neglect …

A

As if they are innocent

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9
Q

What is the nurse’s responsibility regarding a child of suspected abuse / neglect (based on physical signs)

A

Report to CPS - it is not the nurse’s responsibility to make accusations

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10
Q

What service is used to report child maltreatment?

A

Child Line

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11
Q

What are the types of neglect? (4)

A
  • Physical
  • Emotional
  • Lack of intervention / fostering maladaptive behavior
  • Destruction of self-esteem
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12
Q

What is physical neglect?

A

Not providing necessities to a child

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13
Q

What is emotional neglect?

A

Lack of affection / attention / emotional nurturing (not showing interest)

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14
Q

What are some examples of lack of intervention / fostering maladaptive behavior? (2)

A
  • Serving the child alcohol
  • Not caring if the child gets to school
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15
Q

What is an example of destruction of self-esteem?

A

Telling the child they are worthless, dumb, ugly, etc.

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16
Q

What is physical abuse?

A

Deliberate infliction of physical injury

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17
Q

What are the warning signs of physical abuse? (5)

A
  • History incompatible with injury
  • Inconsistent stories
  • Parent disappears after bringing in child
  • Child brought in by an unrelated adult
  • Delay in seeking care
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18
Q

What are some examples of obvious evidence of physical abuse? (3)

A
  • Twisted arm
  • Multiple fractures
  • Bruising on an immobile child
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19
Q

What is the most important factor in determining whether physical evidence is inflicted or accidental?

A

Whether or not history is compatible with the injury - does the story make sense regarding the extent of the injury?

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20
Q

Where are accidental injuries normally found?

A

Bony prominences due to falls (knees, elbows, forehead, chin, nose)

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21
Q

Where are deliberate injuries normally found?

A

Soft tissue / concealed areas (buttocks, arms, stomach, thighs, cheeks)

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22
Q

Describe the physical characteristics of accidental bruises (2)

A
  • Irregular
  • Descending pattern
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23
Q

Describe the physical characteristics of deliberate bruises (4)

A
  • Crisp / well-defined margins
  • Distinct patterns
  • Shaped like an object
  • Various stages of healing
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24
Q

What parental characteristics increase the risk for child maltreatment? (3)

A
  • Parent abused as a child
  • Young / single parent
  • Lack of support system
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25
What is the number one thing to remember about a child suffering from maltreatment?
It is NEVER the child's fault
26
What characteristics of children < 1 year make them likely to become victims of child maltreatment? (3)
- Very fussy - Difficult temperament - Difficult to manage
27
What child characteristics increase the risk for child maltreatment? (5)
- Unwanted children - Disabled children - Hyperactive children - Difficult temperament - Premature infants
28
What environmental characteristics increase the risk for child maltreatment? (3)
- Crowded living conditions - Daycare providers - Babysitters
29
What is the most common type of abusive head trauma in children?
Shaken baby syndrome
30
What is shaken baby syndrome?
Inflicted head / brain injury caused by violent shaking
31
What characteristics of infants contribute to brain damage from shaken baby syndrome? (3)
- No head control - Large head / small body - Large amount of fluid in the brain
32
Describe the pathophysiology of shaken baby syndrome (2)
- Violent shaking causes brain to rotate in the skull - Shearing forces tear vessels / neurons
33
Shaken baby syndrome often has ...
No external signs of injury
34
Shaken baby syndrome can include what other injuries? (3)
- Retinal hemorrhage - Rib fractures - Long bone fractures
35
What are the presenting manifestations of shaken baby syndrome? (2)
- Flu-like symptoms - Unresponsiveness
36
What are the long-term effects of shaken baby syndrome? (4)
- Seizures - Visual impairment - Cognitive / motor impairment - Developmental delays
37
Describe the education for parents to prevent shaken baby syndrome (2)
- Put the infant in a safe place - Remove yourself from the situation until calm enough to handle the child without frustration
38
What is munchausen syndrome by proxy (MSBP)?
Medical child abuse / factitious disorder by proxy
39
What are the warning signs of munchausen syndrome by proxy (MSBP)? (5)
- Fabrication of history - Exaggeration of symptoms - Caregiver implying how the child feels - Child unresponsive to treatments - Child acts different once the caregiver leaves the room
40
Who is the typical perpetrator of munchausen syndrome by proxy (MSBP)?
Parent with healthcare background - misleads healthcare workers
41
What are the manifestations of munchausen syndrome by proxy (MSBP)? (3)
- Nausea / vomiting / diarrhea - Altered mental status - Seizures
42
What questions are used to determine munchausen syndrome by proxy (MSBP)? (3)
- Is there any diagnostic evidence to support? - Has anyone else witnessed symptoms? - Do symptoms resolve once child is removed from the perpetrator?
43
What are the types of sexual abuse? (5)
- Incest - Molestation - Exhibitionism - Child pornography - Child prostitution
44
Describe incest
Usually between siblings (does not have to be blood-relatives)
45
Describe exhibitionism
Adult exposing themself to a child
46
Who is the typical perpetrator of child sexual abuse?
A male that knows the child
47
Describe the characteristics of child sexual abuse perpetrators (4)
- Often active in the community - Often have no prior records - Often commit many assaults before being caught - Often have direct contact with children through employment (coaches, teachers)
48
Describe the characteristics of child sexual abuse victims (2)
- Often reluctant to report - Typically 12 - 14 years old
49
Describe the occurrence of sexual abuse (2)
- Begins discreetly - Perpetrator gains trust (grooming)
50
Describe assessment of a child of suspected abuse (4)
- Gain trust - Consider development - Observe the child / caregiver interaction - Ask open ended questions (no leading statements)
51
When communicating with a victim of child sexual abuse, NEVER ...
Promise to not tell - MUST be reported
52
Describe child responses that are warning signs of sexual abuse (4)
- Unresponsive to parent - Avoids eye contact - Excessively clingy / attached - Unusually affectionate and outgoing
53
Describe nursing documentation in the case of suspect child maltreatment (3)
- Direct quotes from both caregiver and child - Date / time / location of injury - Who was present at time of injury
54
Why is thorough documentation necessary in the case of suspected child maltreatment?
All documentation can be used as legal evidence
55
When assessing history of a child of suspected maltreatment, it is important to rule out ...
Family history of bleeding / bone disorders
56
What are some often overlooked areas of physical abuse? (4)
- Scalp - Behind the ears - Frenulum - Genitalia
57
Describe physical assessment for suspected sexual abuse (3)
- Assess bleeding / bruising / discharge - Collect evidence from underwear / linens - Collect specimens for STDs
58
Describe support for the child / family in the case of child maltreatment (3)
- Treat the child as any other hospitalized child - not as a victim of abuse - Be a role model for parents - help them relate constructively to the child - Education - non-violent discipline, dealing with anger
59
What is failure to thrive?
Inability to obtain / use calories needed to grow
60
______ is not always due to child maltreatment, but may be associated in some cases
Failure to thrive
61
What is the growth requirement to confirm diagnosis of failure to thrive?
< 5th percentile for height / weight
62
What are the categories of failure to thrive? (3)
- Inadequate caloric intake - Inadequate caloric absorption - Excessive caloric expenditure (ex. hyperthyroidism)
63
What are the risk factors of failure to thrive? (6)
- Poverty - Pre-term - Low birth weight - Health beliefs / fad diets - Inadequate nutritional knowledge - Breastfeeding problems
64
What tests may be used in the diagnosis of failure to thrive? (2)
- Stool samples - Lead levels
65
Treatment of failure to thrive is aimed at ...
Identification / treatment of the underlying cause
66
Describe treatment of failure to thrive (3)
- Calorie dense foods - Multivitamins - Multi-disciplinary - refer to other services
67
Describe the nursing interventions associated with failure to thrive (4)
- Daily height / weight measurements - Record caloric intake - Feeding schedule - Encourage parental bonding while feeding
68
Prognosis of failure to thrive is typically better if due to ...
Knowledge deficit

NURS 306 - Exam 4 (4 decks)

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