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M6 13-005

Exam 12: Child Abuse

Neglect the failure of a parent or other person legally responsible for the child’s welfare to provide for the child’s basic needs. It takes on many different forms and all can be classified broadly as maltreatment.
Three forms of Neglect Physical. Emotional. Lack of intervention for or fostering of maladaptive behavior.
Most common form of maltreatment. Child neglect.
Contributing factors to child neglect Lack of knowledge of child’s needs. Lack of resources. Caretaker substance abuse.
Physical Abuse Deliberate infliction of physical injury on a child, usually by the child’s caregiver.
Factors that predispose children to physical abuse. Children with multiple siblings. Premature babies (poor parent-child bonding). Child with difficult temperament. Not confined to one child. Hyperactive, physically disabled, illegitimate or unwanted.
Regulatory Agencies United states Children's Bureau. Child Protective Services. UCMJ.
Warning Signs of Physical Abuse (Child) Child's appearance. Child report's Abuse. Child has inappropriate responses. Abused child may wear clothes that conceal abuse. Conflicting stories.
Warning Signs of Physical Abuse (Parents) Inappropriate responses (exaggerated or absent emotional response). Conflicting story with child. Complaint other than sign of abuse. excessive delay of seeking treatment. Repeated visits to the ER.
Munchausen's Syndrome by proxy (MSP) Refers to illness that one person fabricates or induces in another person.
MSP is usually done by the mother who fabricates signs and symptoms of illness in her child to gain the attention from the medical staff.
Warning signs of MSP (1) Unexplained, prolonged, recurrent or extremely rare illness. Discrepancies between clinical findings and history. Unresponsive to treatments. S/S occurring only in the parent's presence. Parents knowledgeable about illness, procedures and treatment.
Warning signs of MSP (2) Parents very interested in interacting with the health care team. Parents overly attentive toward child. Family members with similar symptoms.
Emotional Abuse refers to the deliberate attempt to destroy or significantly impair a child’s self-esteem or competence.
Emotional Abuse Include Rejecting. Isolating. Terrorizing. Ignoring. Corrupting. Verbally assaulting. Overpressuring the child.
Children suffering from emotional abuse demonstrate behavior that is to the extremes. How? They are either unusually pleasant or very disruptive. They either are overly mature or very immature
Characteristics of the Emotional Abuser Blames the child for their misgivings or failures. Belittles the child. May also reject the child. It is usually one child who is treated differently. The parent may give praises to one child, while ignoring the act worthy of praise from another.
Sexual Abuse one of the most devastating types of child abuse and constitutes approximately 10% of officially substantiated child maltreatment cases.
the Child Abuse and Prevention Act defines sexual abuse as “the use , persuasion, or coercion of any child to engage in sexually explicit conduct or any simulation of such conduct, for producing any visual depiction of such conduct, or rape, molestation, prostitution or incest with children.”
The child who has been sexually abused often has the following characteristics Abused children tend to be runaways. With incest, the eldest daughter is usually abused and reluctant to report the situation because of fear of retaliation and fear that they will not be believed. Male victims are less likely to report abuse.
suspicion of sexual abuse if children have the following appearance Torn, stained, bloody underclothing. Pain on urination, swelling or itching in genitals. STD’s, nonspecific vaginitis or HPV. Pregnancy in young dolescents. Difficulty walking or sitting.
Victims of Sexual Abuse behaviors includes Withdrawn. Regressive behavior like bedwetting or thumb sucking. Poor relationships with other children. Delinquent acts, runs away from home. Suicidal attempts or ideation. The child also may abuse alcohol or mood-elevating drugs.
The typical sexual abusive parent has many of the following characteristics Male, whom the victim knows. All levels of society. Most often with incest, the parents have an estrangement or sexual maladjustment. Parents may also be overly protective or jealous of the child's outside relationship.
. It is the principle responsibility for health care professionals to identify abusive situations as soon as they are presented or abuse is expected. Nurses may be the first person to see the child and parents and are the consistent caregivers if the child is hospitalized.
The goal of the consistent nurse-child relationship relationship is to provide a role model for the parents in helping them to relate positively and constructively to their child.
Created by: jtzuetrong