Ch. 43: Psychosocial Issues of Infants, Children, and Adolescents-Maltreatment of Infants and Children

Question 1

Maltreatment of children is made up of several specific types of behavior, which include what? (4)

Answer 1

• Physical maltreatment
• Sexual maltreatment
• Emotional maltreatment
• Neglect

Question 2

What kind of maltreatment is this:

Causing pain or harm to a child

Answer 2

Physical

Question 3

What are examples of physical maltreatment?

Answer 3

• Shaken baby syndrome
• Fractures
• Munchausen syndrome by proxy

Question 4

What kind of maltreatment is this:
Occurring when sexual contact takes place without consent, whether or not the victim is able to give consent

*includes sexual behavior toward a minor and dating violence among adolescents

Answer 4

Sexual maltreatment

Question 5

What kind of maltreatment is this:
Humiliating, threatening, or intimidating a child

*includes behavior that minimizes an individuals feelings of self worth

Answer 5

Emotional maltreatment

Question 6

What are the two types of neglect?

Answer 6

1. Physical care

2. Emotional care &/or stimulation

Question 7

What are examples of physical care neglect?

Answer 7

Neglecting to feed, clothe, shelter, provide medical/dental care, provide safety, and education

Question 8

What are examples of emotional and/or stimulation neglect?

Answer 8

Neglecting to nuture, provide affection, or attention

Question 9

What are some parental characteristics to those who are more likely to do maltreatment (9)

Answer 9

Young parents
Single parents 
Socially isolated
Substance abuse disorder
Low income
Low self-esteem
Lack of lower education level
Lack of knowledge of parenting
History of being abused

Question 10

What are characteristics of children who are at risk for maltreatment? (3)

Answer 10

• 1 year or younger=greater risk due to need of constant attention and increased demand of caregiving
• Infants and children who are UNWANTED, HYPERACTIVE, or PHYSICALLY/MENTALLY disabled!–> all require increased demands!!
• PREMATURE INFANTS–due to possible failure of parent child bonding at birth

Question 11

What are environmental characteristics that put children at risk for maltreatment?

Answer 11

Chronic stress (of parent..?)
Divorce
Alcohol use disorder
Drug addiction
POVERTY
Unemployment
Inadequate housing
Crowded living conditions

Question 12

What are some subjective and objective data that may be gathered if suspected abuse?

Answer 12

• Inconsistencies between parents report and childs injuries
• Inconsistency between nature of injury and development level of the child
• Repeated injuries that require emergency treatment
• Inappropriate responses from the parent to child

Question 13

What type of maltreatment:

• FTT
• Malnutrition
• Lack of hygiene
• Frequent injuries
• Delay in seeking healthcare
• Dull affect
• School absence
• Self stimulating behaviors`

Answer 13

Physical neglect

Question 14

What type of maltreatment:

• Bruises, welts in various stages of healing
• Burns
• Fractures
• Lacerations
• Fear of parents
• Lack of emotional response/reaction
• Superficial relationships
• Withdrawal
• Aggression

Answer 14

Physical abuse

Question 15

What type of maltreatment:

• FTT
• Eating disorder
• Enuresis
• Sleep disturbances
• Self stimulation behaviors
• Withdrawal
• Lack of social smile (infant)
• Extremem behaviors
• Delayed development
• Attempts suicide

Answer 15

Emotional neglect and abuse

Question 16

What type of maltreatment:

• Bruises, lacerations, bleeding of genitalia, anus, or mouth
• STI
• UTI
• Regressive behavior
• Withdrawn
• Personality changes

Answer 16

Sexual abuse

Question 17

What happens to the baby in shaken baby syndrome?

Answer 17

Shaking can cause intracranial hemorrhage

Question 18

What are some manifestations of shaken baby syndrome?

Answer 18

• Vomiting, poor feeding and listlessness
• Respiratory distress
• Bulging fontanels
• Retinal hemorrhages
• Seizures
• Posturing
• LOC changes
• Apnea
• Bradycardia

Question 19

What happens if bruising is present in an infant less than 6 months?

Answer 19

Deemed suspicious by the nurse

Question 20

What lab tests are given to assess for STI or bleeding?

Answer 20

CBC

Urinalysis

Question 21

Where would we assess for unusual bruising?

Answer 21

Abdomen
Back
Buttocks

Question 22

What kind of bruises should we observe for–what shape?

Answer 22

Welts in the shape of a belt buckle or other object

Question 23

What should we observe for burns?

Answer 23

Burns that appear glove or stocking like on the hands or feet (immersion into boiling water)

Or burns that are small and round (cig burns)

Question 24

What kind of fracture could be caused by twisting the extremity forcefully?

Answer 24

Forearm spiral fractures

Question 25

The presence of multiple fractures is ____

Answer 25

Suspicious

Question 26

For maltreatment cases, what is the nurses priority in regards to nursing care?

Answer 26

Have the child removed from the abusive situation

Question 27

Mandatory reporting is required of all health care providers. Do we still report if we only suspect it?

Answer 27

Yes, mandatory reporting is required of all health care providers, including SUSPECTED or ACTUAL cases of child abuse

Question 28

What charges may we face if we did not report abuse?

Answer 28

Civil and criminal penalties!!

Question 29

Should we photograph visible injuries of abuse?

Answer 29

Yes–photograph and detail all visible injuries

Question 30

What kind of questions should we ask the clients of abuse?

Answer 30

Use open-ended questions that require a descriptive response–these questions are less threatening and elicit more relevant info

Question 31

Is it okay to probe the child when trying to get information about abuse?

Answer 31

NO!! AVOID proving the child!!! (remember, probing is non-therapeutic form of communication!)