Reply 1
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.
Child abuse can be a very hard issue to tackle, we as nurses are obligated to report any type of abuse including child abuse. We as health care professionals need to be able to identify how to determine if further investigation is needed. There are signs and symptoms that should be understood to identify if a toddler is suspected of being abused by a parent and or a caregiver (Mayoclinic, 2018). Symptoms to be identified for child abuse include withdrawing from spocial activities with friends, changes in behavior such as agression, anger or hostility also an apparent lack of supervision. Physical signs and symptoms of abuse include unexplained injuries or injuries thaty dont match the explanation given by the parent or caregiver such as bruises, burns and fractures. If these signs and symptoms are assessed, its important to continue to ask more questions and assess for further signs and symptoms of abuse in order to get a better idea of the type of abuse the toddler may be experiencing. Since toddlers more than likely are not able to communicate, its important to assess for developmental delay, assess the genatalia for bleeding and possible UTI. Its important to figure out a baseline in the cognitive behavior of the child as best as possible and figure out of if the toddler is declining in the cognitive development.
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 are many cultural differences that should not be misinterpreted as abuse, one of which is coining and cupping. Both are practiced in the asian culture and are used to treat many illnesses and to relieve the body from heatiness and negative energies. Both can leave marks on the individual which can be easily identified as abuse, but the two leave distinct marks which can allow the nurse to navigate throught their assessmnet whether or not this is a form of physical abuse or coining or cupping. Coining leeaves linear bruises because a hot coin is scraped across the individual. Cupping causes a round bruise in multiple areas on the body, thats because the theres a suction cup being pressed on the body creating these circle bruises or hematomas.
As nurse working in a hospital in California it is important to notify our direct supervisor if abuse is assessed. The direct supervisor would then notify an d a report would be filed to an abuse agency who would then perform an investigation. There is more investigation that needs to be performed in order for this to be handled by the law enforcement and child protective services. This is to ensure that the child is being abused and that the agency has collected enough information to file a claim.
Reference
Child abuse. (2018, October 05). Retrieved August 06, 2020, from https://www.mayoclinic.org/diseases-conditions/child-abuse/symptoms-causes/syc-
20370864
SA, V. (n.d.). Cultural Awareness: Coining and Cupping. Retrieved August 06, 2020, from https://clinmedjournals.org/articles/ianhc/international-
archives-of-nursing-and-health-care-ianhc-3-080.php?jid=ianhc
Reply 2
Compare the physical assessment of a child to that of an adult.
Physical assessment of a child and an adult is different in a few ways. First, vital signs measurements are different. Second, assessment for a child is more growth centered and preventative with emphasis on vaccines, nutrition, and interaction. A third difference, the assessment includes the family as a unit, because where the child is is where the parent is, so sometimes it is neccessary to assess the child alone if possible. lastly, another difference is the size of the child makea a difference of approach in assessment. For example, a child may be 12 years old and their height is 5 foot 4 inches. That height makes a difference on an assessment in the head to toe assessment, and sometimes emotional assessment of the child.
In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.
It is mportant to make a connection with the child with something the child connects with. If it music, a toy,, a tv show it is important to communicate with the child. Sometimes, it is needed to direct the child through the assessment with a step by step approach while allowing the child to participate in the process. What is important is the trust, connection, and communication through their language that the child understands. In the article, “Communication in the Nursing Practice” it shares the importance of understanding the patient experience and how they express them.”(Kourkouta, L., & Papathanasiou, I. V. (2014))
References
:Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65–67. https://doi.org/10.5455/msm.2014.26.65-67
