Peds Final - Child Abuse

Question 1

neglect

Answer 1

failure to provide for the child’s basic needs, provide adequate level
omission vs commission

Question 2

consequences of global neglect

Answer 2

-developmental delay
-neuropathlogic consequences
-multiple minor scarring injuries
-parentification
-death d/t inappropriate supervision
-when paired w/ physical or sexual abuse, personality associated criminal & abusive behaviors

Question 3

consider neglect when the child ….

Answer 3

-misses school lots
-begs or steals food or money
-lacks needed medical care
-consistently dirty
-lack sufficient clothing
-abuses alcohol or drugs
-states no one is at home

Question 4

consider neglect when the parents

Answer 4

-appears to be indifferent to the child
-seems apathetic or depressed
-behaves irrationally or in a bizarre manner
-is abusing alcohol or drugs

Question 5

family factors that put a child more at risk for being abused

Answer 5

-domestic violence
-isolation
-poverty / unemployment
-single parent
-animal abuse
-increased exposure between parent & child
-major life changes

Question 6

parental characteristics that put a child more at risk for being abused

Answer 6

-substance abuse
-low self esteem
-poor impulse control
-abused as a child
-teenage parent
-negative view of child
-depression
-unrealistic expectations of child
-corporal punishment

Question 7

factors in a child that puts them more at risk for being abused

Answer 7

-development disability
-hyperactivity
-resemblance to abusive person from past relationship
-prolonger or chronic illness
-colic #1 reason for abuse
-multiple birth
-lack of bonding

Question 8

warning signs of abuse

Answer 8

-physical evidence
-no hx to explain physical findings
-injury not consistent w/ hx or developmental level
-delay in seeking medical attention
-changes in story
-parent blames the child or sibling
-seek medical attention far from home
-reaction to injury is inappropriate

Question 9

behavioral characteristics of abused children

Answer 9

-don’t turn to parent for support
-overly compliant or passive
-aggressive towards animals
-school performance declines or have laerning problems
-do not want to go home

Question 10

physical indicators of abuse

Answer 10

bruises, welts, lacerations, abrasions or broken bones esp those in various stages of healing & in atypical sites

Question 11

what is the #1 sign of abuse

Answer 11

bruising that doesn’t make sense
between eyes, ears, groin, thighs or that look like something

Question 12

rule of T-E-N in <4yrs old

Answer 12

Torso, Ears, Neck -> if bruised think abuse

Question 13

mongolian spots

Answer 13

hyper pigmented deeper spots, often seen in darker skin people uniform color

Question 14

what age is most likely to have severe affects if abused

Answer 14

infants

Question 15

immediate signs and symptoms of PAHT

Answer 15

-seizure
-posturing
-unequal pupils, change in LOC
-retinal hemorrhages, vision loss
-pale, mottled, cold, clammy skin
-poor feeding & vomiting
-brusing
-decreased in smiling or vocalizing
-change in head control
-brady (both), apnea
-bulging fontanel

Question 16

perpetrator characteristics

Answer 16

-male
-<30 yrs
-ed less than high school
-depression
-social isolation
-substance abuse
-low self esteem
-poor impulse control

Question 17

risk factors in the child

Answer 17

-male
-colic
-low birth wt
-drug & alc exposure or withdrawal
-special needs
-infants w/ NAS
-being one of multiple kids

Question 18

fractures for abuse

Answer 18

-spiral usually means abuse
-most common: femur, humerus, tibia
-multiple old ones

Question 19

possible reasons for abuse of toddlers

Answer 19

-potty training can be hard
-temper tantrums
-perceived disobedience/disrespect

Question 20

how do you know if it is an accidental burn

Answer 20

you have one intense area and then splash marks
non accidental is more uniform

Question 21

5 S’s if child won’t stop crying

Answer 21

-shushing
-side/stomach positioning
-sucking
-swaddling
-swinging

Question 22

6 fatal mistake

Answer 22

1) non specific signs & symptoms attributed to benign causes
2) dx injury as accidental
3) subtle physical exam clues missed
4) contaminate the hx
5) nice people gig
6) give the benefit of the doubt

Question 23

nurses role when caring for a possible child abuse case

Answer 23

-meet needs
-prove a role model for parenting
-provide support
-document fully and objectively
-report
do not judge

Question 24

if a child asks you not to tell, what do you do

Answer 24

never tell them you won’t tell but say I will do everything I can to protect you and keep you safe

Question 25

sexual abuse stats

Answer 25

-1 in 7 child are abused
-1 in 3 girls by the age of 18
usually by someone in power and that the child knows and usually repetitive

Question 26

do children make up sexual abuse

Answer 26

rarely

Question 27

nursing interventions in sexual abuse

Answer 27

-always believe victum
-provide play opportunities for role play
-avoid leading statements
-never promise not to tell

Question 28

MSP perpetrator characteristics

Answer 28

-usually mother
-thrive in health care environment
-some health care knowledge
-loving, cooperative, competent
-suggest tests & procedures