NRS 434 Topic 2 Discussion Question one
Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.
There a scores of resources available to the nurse designed to better identify possible abuse, whether it be physical or emotional. When considering possible signs of abuse or mistreatment, the nurse should recognize acute changes in the child’s behavior or patterns. According to the Child Welfare Department, a federally funded and mandated agency (Child Welfare Department, 2019), indicators that interventions may be needed are a decline in a child’s school performance. This may be related to lack of concentration as the child may withdraw as a sign of their own assessment of the degree of safety present in engaging and/or participating in contact with peers or authority figures outside of the home. Excessive absences may be attempts to allow time for healing of results of physical abuse such as abrasions, bruises, or fractures. Reluctantly to go home after school may also be an indicator of possible abuse.
Abuse goes beyond the physical nature. Emotional abuse has just as long lasting effects on school age children as physical abuse does. School age children are at a stage in their life where they desire to fit in with their peers, notice differences between themselves and other children, and may need assurance that abuse is not their fault (Falkner, 2018).
Child Welfare Information Gateway (2019). What is child abuse and neglect. Retrieved from https://www.childwelfare.gov/pubpdfs/whatiscan.pdf
Falkner, A. (2018). Grand Canyon University (E.D). Age-Appropriate Approach to Pediatric Health Care Assessment. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/2.
You have provided an in-depth post and I agree with you. Ideally, child abuse and maltreatment is associated with devastating effects on children (Gonzalez et al., 2021). As such, it is important to report any case of child abuse. As mandated, nurses are trained to recognize signs and symptoms of child abuse or maltreatment and report to the relevant authority. Failure to report may lead to legal actions against them or disciplinary actions by their employers or board of nursing. If a nurse infers abuse or maltreatment, the first step is to report to the physician, nurse managers, or physician assistant. If the victim is presented to the facility with the alleged perpetrator, the assessment should be done without the perpetrator in the room. A comprehensive head-to-toe examination should be conducted to identify physical signs of abuse. It is essential to have a witness if possible. Nurses should ensure a comprehensive documentation and description of the findings, non-verbal behaviors, victim statements, and the statements and behaviors of the alleged perpetrator. The law enforcement should be notified instantly while the victim is still in the facility. Moreover, Child Protective Services should be called and followed up with a documented report (Lee & Kim, 2018).
Gonzalez, D., Mirabal, A. B., & McCall, J. D. (2021). Child abuse and neglect. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK459146/
Lee, H. M., & Kim, J. S. (2018). Predictors of intention of reporting child abuse among emergency nurses. Journal of pediatric nursing, 38, e47-e52. https://doi.org/10.1016/j.pedn.2017.10.007
Great post and would like to contribute to it. Nurses are a great resource in health and therefore, they should be enlightened in every
aspect of health practice. Nurses are supposed to be educated on how best they can identify abuse in whatever form it presents itself with. This is in line with tradition and cultural beliefs. There is a traditional practice performed by some African native groups in which coining can leave some purpura and this can mimic abuse. Nurses are supposed to be oriented with these practices so that they don’t conflict with the patient’s beliefs. Nurses ought to be culturally competent in order to serve their patients well. Thank you Latasha for sharing once again.
Child abuse and maltreatment can occur through all stages of age from infant to 18 years of age. “Nearly 3 in 4 children-or 300 million children-ages 2-4 years regularly suffer physical punishment and/or psychological violence at the hands of parents and caregivers” as per (WHO).
According to American Acadamy of Pediatrics, “the highest rate of child abuse is in babies less than one year of age, and 25 percent of victims are younger than three”. Most cases reported to Child Protective Services are neglect, followed by physical and sexual abuse.
Warning signs of child abuse include withdrawal of friends or usual activity, depression, anxiety or unusual fears, hostility, or a sudden loss of confidence that can be detected assessments done by Nurses.
In California, reports of suspected child abuse or neglect shall be made by mandated reporters to any police department or sheriff’s department. Nurses are mandated reporters and should make child abuse or suspected abuse to designated agencies.
Replies to Latasha Brooks
According to Centers for Disease Control and prevention (CDC), child abuse and neglect is any act or series of acts of commission or omission by a parent, caregiver or another person in custodial role that results in harm, potential for harm or threat of harm to a child and it is preventable. Child abuse can occur in any age group usually the abusers are the nearest and dearest. Neglect, emotional, sexual and medical abuse are some of the abuses faced by infants. This age group is very prone to abuse because it is still very young and solely depends on the parents or caregiver and can not voice their concerns. Abusive head trauma , also known as Shaken head syndrome (SHS), is the worst form of abuse experienced by this population when a caregiver shakes the infant. The baby may experience trauma due to direct blow, when thrown to the ground or surfaces. This results in severe brain and neck injuries that may be irreversible and possibly death. Upon examination of the infant, lethargy or decreased muscle tone, poor feeding/suckling or vomiting for no cause, decreased level of consciousness or seizures are all cues to Abusive Head Trauma just to mention a few (Green S.Z,2018).
Several cultures today use folk remedies to treat various ailments. Moxibustion is the burning of rolled pieces of moxa herb (mugwort or Artemisia vulgaris) over the skin above acupuncture points and burns till start to feel pain. This is an Asian cultural practice for a variety of symptoms like fever and abdominal pain. The lesions from moxibustion look like a pattern of discrete, circular, target-like burns that maybe mistaken with cigarette burns from child abuse.
It is the nurses` duty to report any form of suspected child abuse. They are mandated reporters and should not assume that their colleagues will do the reporting. The supervisor is informed of any suspected case and law enforcement agents are engaged as well as the local county Department of Social Services: Child protection services.
Child Abuse and Neglect Prevention
Green S.Z. (2018) Health Assessment: Foundation For Effective Practice
Cultural Practices-Suspected Child Abuse
I agree that Children in the age group of birth to 1 year had the highest rate of victimization at 25.7 per 1,000 children of the same age in the national population. Most victims were from three races or ethnicities:6 White (43.5 percent), Hispanic (23.5 percent), and African American (20.9 percent). American Indian or Alaska Native children had the highest rates of victimization at 14.8 per 1,000 children in the population of the same race or ethnicity, and African American children had the second- highest rate at 13.8 per 1,000 children of the same race or ethnicity. Boys had a slightly higher child fatality rate than girls. The majority of children who died from maltreatment were one of three races or ethnicities8: White ,African-American or Hispanic .
This is an exception post on infant abuse and maltreatment. Other than the physical abuse to infants whose signs can easily be recognized, infants also suffer emotional abuse. Emotional abuse occurs when infants are treated in ways that traumatizes and compromises their normal development (Zeanah & Humphreys, 2018). Signs and symptoms of emotional abuse include demonstration of behavioral problems or changes such as avoiding a parent’s affection, acting depressed or agree, and becoming more clingy. They also display extremes in behavior. The infants may also be delayed emotionally and physically, talk and walk later than usual, or continue to show frequent temper tantrums (Kumari, 2020). However, children often develop at varying rates and sometimes it is challenging to establish whether the delays in development are associated with the abuse. Other signs and symptoms of emotional abuse include stopping communicating almost completely or demonstrating signs of speech disorders. Moreover, a usually assertive and sociable child turns abnormally passive and compliant, while a normally mild child could act in aggressive and demanding way (Buisman et al., 2018).
Buisman, R. S., Pittner, K., Compier-de Block, L. H., van den Berg, L. J., Bakermans-Kranenburg, M. J., & Alink, L. R. (2018). The past is present: The role of maltreatment history in perceptual, behavioral and autonomic responses to infant emotional signals. Child abuse & neglect, 77, 23-34. https://doi.org/10.1016/j.chiabu.2017.12.020
Kumari, V. (2020). Emotional abuse and neglect: time to focus on prevention and mental health consequences. The British Journal of Psychiatry, 217(5), 597-599. https://doi.org/10.1192/bjp.2020.154
Zeanah, C. H., & Humphreys, K. L. (2018). Child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 57(9), 637-644. https://doi.org/10.1016/j.jaac.2018.06.007