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child abuse_
munchausen's by proxy, emotional, sexual, nursing care
| Question | Answer |
|---|---|
| Battered child syndrome | a broad term that refers to the clinical condition in young children who have received serious physical abuse, neglect, or maltreatment. Generally from a parent or foster parent. |
| CAPTA, Federal Child Abuse Prevention and Treatment Act, amended by Keeping Children and Families Safe Act of 2003, defines child abuse and neglect as? | Any recent act or failure to act on the part of a parent or caretaker which results in death , serious physical or emotional harm, sexual abuse or exploitation; or an aact or failure to act which presents an imminent risk of serious harm. |
| Child Maltreatment, Includes intentional what, usually by adults? | physical abuse or neglect, emotional abuse or neglect, and sexual abuse of children , one of the most significant social problems affecting children |
| In 2004 how many cases were referred for possible abuse, how many were referred from a pro, and how many were validated? | In 2004 over 2. 9 million cases were referred for possible abuse. 50% from professionals. 1/2 ruled out. 1/3 ruled in. |
| True or False: Child abuse refers to the clinical condition of a child who has received physical abuse or neglect? | TRUE. |
| what percent of perpetrators are male, female or one parent? | 3/5 female (60%). 3/4 one parent (87%). 11% sexual abuse cases committed by male (parent, relative or other). |
| what is neglect and the three forms? | Neglect is the failure of a parent or other person legally responsible for the child’s welfare to provide for the child’s basic needs. 3 forms: Physical neglect. Emotional neglect. Emotional abuse. |
| signs of neglect, Child’s Appearance: | Not clean, tired, no energy. Lack of food, no breakfast. Alone. Needs medical attention. |
| signs of neglect in the child's behavior | Absent from school. Begs or steals. Substance abuse. Vandalism. Sexual misconduct. |
| signs of neglect in the parent/caretaker behavior? | Substance abuse. Upset home life. Disinterested, apathy.Isolation. Lack of social skills. Chronic illness. History of neglect. |
| What are the three forms of neglect? | Physical neglect. Emotional neglect. Emotional abuse. |
| what is the definition of physical abuse? | Physical abuse is the deliberate infliction of physical injury on a child. 1 million cases reported per years |
| what are risk factors for child abuse? | Children from large families. Younger children are at greater risk of death. Pre-term babies are at a greater risk of abuse. Temperament of parent and child. Often one child is singled out. Different children are at greater risk |
| Child Abuser Characteristics | Most do NOT suffer from psychosis. Severely punished as children. Have difficulty coping Are socially isolated have low self-esteem |
| child abuser characteristics | History of abuse. Harsh discipline- inappropriate. Story doesn’t fit. Unconcern for child. Repeated visits to the ER with injuries. |
| characteristics of child suffering abuse | Difficult temperament, hyperactive Illegitimate, unwanted Brain damaged, physically disabled Remind parent of someone they dislike Pre-term babies, difficult pregnancy or labor Sickly Unattractive Difficult temperament, hyperactive |
| Characteristics of the Child | Concealing clothes. Story doesn’t fit. Little separation distress. Fear of parents. |
| Environmental Characteristics of child abuse | Chronic stress Divorce Poverty Unemployment Frequent relocation Alcoholism Drug addiction Crowded living conditions |
| physical abuse warning signs | Child’s Appearance: Bruises. Welts. Burns. Fractures. Bite marks. “Accidents”. |
| Warning Signs | Child’s Behavior: Self-report (innocently). Extreme behavior: Little or no response to pain. Indiscriminate friendliness to strangers. Fear of being touched. |
| angiomas, port wine stains, and mongolian spots all have what in common? | they are not signs of child abuse. |
| Child Protective Services United States Children’s Bureau UCMJ: | UCMJ Article 134: Indecent liberties or acts with a child Article 120: Rape and carnal knowledge |
| Each state has its own laws Certain professionals are obligated by law to report suspected abuse to CPS: | Health & Mental health care providers Teachers and other school personnel Social workers Day care providers Law enforcement personnel Any person can report child abuse. |
| List 3 factors that predispose children to physical abuse. | They include: Multiple siblings. Premature babies. Difficult temperament. Hyperactive. Physically disabled. Illegitimate or unwanted. |
| True False: The law actually prescribes that a health care professional must only report confirmed cases of abuse to the appropriate authorities. | FALSE report all suspected cases to the appropriate authorities. |
| What are 3 behaviors from parents or caretakers which may be considered warning signs for child abuse? | Inappropriate responses, conflicting stories with the child, excessive delay in seeking treatment, repeated visits to the emergency room with injuries to the child. |
| Munchausen by Proxy, what and why | Is illness that one person fabricates or induces in another person.It is done usually to gain the attention of the medical professionals. |
| what are some examples of Munchause by Proxy? | Adding maternal blood to the child’s urine to simulate hematuria. Presenting a fictitious medical history. Chronic poisoning of the child.It is very hard to confirm and requires a high index of suspicion to protect the children. |
| Munchausen by Proxy Warning Signs | Unexplained, prolonged, recurrent or extremely rare illness. Discrepancies between clinical findings and history. Illness unresponsive to treatments. Signs and symptoms occurring only in the parents’ presence. |
| Warning Signs Con’t | Parents knowledgeable about illness, procedures and treatments. Parents very interested in interacting with the health care team. Parents overly attentive toward child. Family members with similar symptoms |
| Munchausens mortality | 10% of the illnesses result in death. |
| What is Munchausen’s Syndrome by Proxy? | Munchausen’s syndrome by proxy (MSP) refers to illness that one person fabricates or induces in another person. |
| Emotional abuse refers to the deliberate attempt to destroy or significantly impair a child’s self-esteem or competence. Emotional abuse may include: | Rejecting. Isolating. Terrorizing. Ignoring. Corrupting. Verbally assaulting. Overpressuring the child. |
| Child’s Appearance: emotional abuse | Signs are often less obvious than other forms of maltreatment. Behavior is best indicator. |
| emotional abuse child's behavior | Extremes: Unusually pleasant or disruptive. Adult behavior or overly young for age. Behind in age in physical, emotional, or intellectual development. |
| Parent or caretaker’s behavior: Blames and belittles the child. Rejecting to child, withholds love. Unequal treatment to other children. | Emotional Abuse |
| What is emotional abuse? | Emotional abuse refers to the deliberate attempt to destroy or significantly impair a child’s self-esteem or competence. |
| Child sexual abuse constitutes approximately 10% of officially substantiated child maltreatment cases. what is sexual abuse? | “the use, persuasion, or coercion of any child to engage in sexually explicit conduct for producing any visual depiction of such conduct or rape, molestation, prostitution or incest with children” The Child Abuse and Prevention Act (Public Law 100-235) |
| Sexual Abuse child's appearance | Torn, stained, bloody underclothing. Pain on urination, swelling or itching in genitals. STD’s, nonspecific vaginitis or HPV. Pregnancy in young adolescents. Difficulty walking or sitting. |
| sexual abuse child's behavior | Withdrawn. Regressive behavior like bedwetting or thumb sucking. Poor relationships with other children. Delinquent acts, runs away from home. Suicidal attempts or ideation. |
| sexual abuse, Parent or caretaker's behavior | Protective or jealous. Comes from all levels of society. Parents have an estranged relationship. Have difficulty showing concern towards their child. During hospitalization, the parents do not become involved in the child’s care. |
| about identifying abused children: in nursing care | Maintain a high level of suspicion. Document factually and objectively. Review records to discover patterns. Be suspicious of delays in seeking medical care. Be suspicious of children who are upset about being discharged. |
| Approaching the child: Nursing care | Approach quietly and explain all treatments carefully. Allow child to express feelings through play. Keep direct questioning to a minimum and praise. Avoid speaking about the parents negatively in front of the child. |
| Points to Remember, when nursing care intervenes | The child’s needs are basically the same as those of any hospitalized child. Do not become a substitute parent. The goal is to provide a role model for the parents in helping them to relate positively and constructively to their child. |
| How does one identify high risk parents early. | Use questionnaires. Observe the mother-infant bonding process. Look at the social, financial, and parental history. A lack of interest, indifference, or negative comments about the baby may be significant |
| Approaching the parents in nursing care of child abuse | Parents experience loss and mourn when children are placed in foster homes. This is a time of crisis- remain open to the parents.Maintain a non-judgmental attitude at all times. Don’t assume that you know who did it. |
| Support of the Family- Team Approach: nursing care | Family planning. Protective services. Child care centers. Parenthood education Classes. Hotline to child shelters. Child advocate. |
| what are other related services? | Financial assistance. Employment services. Transportation. Emotional support and long term follow-up. |
| Prevention: primary intervention. | Home health nursing is instrumental. Educate parents and children. Inform children what a good touch is. Inform them that their body belongs to them. Secrets and surprises are not the same. Stay away from strangers. |
| Do not listen to people who say you will grow up by doing “adult” things. Remember that “nice” people can also be offenders. and what else ? | Remember there are two people suffering… The child and the abuser! |
Created by:
redhawk101
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